Transforming primary care: improving on the medical home model.

摘要

Given the convergence of exponential spending on health care in the US, poor health outcomes relative to other countries, an aging population, and outdated methods of delivering primary care, there is no better time for instituting a "disruptive" innovation in primary care redesign than the present (Christensen, Bohmer, & Kenagy, 2000). In the midst of health reform in the US, the concept of the patient-centered medical home (PCMH) is garnering significant attention as a potential solution to address financial and performance issues (Vincent & Velkoff, 2010). While the model has worthy attributes, including an emphasis on care coordination and patient engagement, recent studies highlight the gaps and limitations in the existing approaches (Nutting et al., 2009; Rogers, 2008). Some of these gaps and limitations in the traditional PCMH model include difficulties in accomplishing shared decision making with the patient and health care team, effective communication across services, and offering a broad range of health care services.