Part 1: Paper Proposal
The Patient- Centered Medical Home (PCMH) is a model of care delivery that ensures the coordination of patient treatment with the primary care physician to enhance the essential care when needed, and in a way that can be understood. The objective of the PCMH is to create a centralized setting that promotes individual patients and physicians partnerships. The care services offered is enabled by registries, exchange of health information, information technology, or any viable means that guarantees patients access to care when need. Care is offered in an accepted cultural and linguistic manner. PCMH is related to the future of managed health care delivery systems in various ways. It predicts the future of care to be patient-centered. The stakeholders (practitioners, patients, and families) are expected to collaborate to make decisions that will improve the delivery of health care services. The future of health system focuses on features supported by PCHM. These includes patient-centered services, comprehensive care, coordination, accessibility to care services, and the commitment to improve quality and safety.
Part 2: Annotated bibliography
Nutting, P. A., Miller, W. L., Crabtree, B. F., Jaen, C. R., Stewart, E. E., & Stange, K. C. (2009). Initial lessons from the first national demonstration project on practice transformation to a patient-centered medical home. The Annals of Family Medicine, 7(3), 254-260.
The article describes the increasing sense of urgency to demonstrate the feasibility of the Patient-centered Medical Home (PCMH). Together with a 3-tiered recognition process of the National Committee for Quality Assurance, the design and implementation of PCMH are influenced. Nutting et.al (2009) refers to the 1st National Demonstration Process (NDP) conducted by the American Academy of Family Physicians launched in 2006. The objective of the study was to test a PCMH model from a varied national sample of 36 family practices. The real-time qualitative analysis of the NDP questions the status of most proposed PCMH demonstration projects. The article also describes lessons learned from NDP to address the raised concerns and offers recommendations that will boost primary care practices.
Jackson, G. L., Powers, B. J., Chatterjee, R., Bettger, J. P., Kemper, A. R., Hasselblad, V., & Gray, R. (2013). The patient-centered medical home: a systematic review. Annals of internal medicine, 158(3), 169-178.
The objective of the study is to examine approaches for the implementation of PCMH. In addition, Jackson et.al (2013) states the effects of PCMH on patients and staff experiences, clinical and economic outcomes, and the process of care. The results of the study indicated that in 19 comparative studies, the interventions of PCMH showed a lessened positive impact on patient experiences and staff. Moreover, the study demonstrated a moderate strength of evidence on positive effects on the delivery of preventive care services. In conclusion, the article argued that PCMH had the potential to improve the staff and patients experiences, but at the same time, there was no evidence that illustrated the overall cost savings.
Bitton, A., Martin, C., & Landon, B. E. (2010). A nationwide survey of patient centered medical home demonstration projects. Journal of general internal medicine, 25(6), 584-592.4
Cross-sectional key-informant interviews were used as a research design. The participants in the research came from leaders from the existing PCMH demonstration projects. The researchers used a semi-structured interview tool with different domains. The sample size was 26 demonstrations that covered 18 states. The demonstrations comprised of more than 14,000 physicians that offered care services to approximately 5 million patients. The demonstration projects illustrated that external payment reform comprised of numerous patients and physicians and a wide range of implementation models.
Friedberg, M. W., Schneider, E. C., Rosenthal, M. B., Volpp, K. G., & Werner, R. M. (2014). Association between participation in a multipayer medical home intervention and changes in quality, utilization, and costs of care. Jama, 311(8), 815-825.
The article establishes the increasing interventions to transform primary care practices into PCMH but questions efficiency in improving quality. The objective of the study was to assess the participation in the Southeastern Pennsylvania Chronic Care Initiative and the impact on quality, utilization and costs of care. The results of the study found a limited improvement in the quality of care and was not linked to reductions in hospital, emergency departments, or ambulatory care services utilization. Therefore, Friedberg et.al (2014) asserted that home interventions need auxiliary refinement.
Rittenhouse, D. R., Casalino, L. P., Shortell, S. M., McClellan, S. R., Gillies, R. R., Alexander, J. A., & Drum, M. L. (2011). Small and medium-size physician practices use few patient-centered medical home processes. Health affairs, 10-1377.
The article consists of the first national data that illustrates the utilization of medical home processes like the nurse care managers, chronic diseases registries or even the systems to integrate patient feedback, from 1,344 small and medium-size physician practices. From the study, it is only one-fifth of the practices of the PCMH that were considered to be part of the research. The study also identified the internal capabilities and the external incentives related to a broad utilization of the PCMH.
References
Bitton, A., Martin, C., & Landon, B. E. (2010). A nationwide survey of patient centered medical home demonstration projects. Journal of general internal medicine, 25(6), 584-592.4
Friedberg, M. W., Schneider, E. C., Rosenthal, M. B., Volpp, K. G., & Werner, R. M. (2014). Association between participation in a multipayer medical home intervention and changes in quality, utilization, and costs of care. Jama, 311(8), 815-825.
Jackson, G. L., Powers, B. J., Chatterjee, R., Bettger, J. P., Kemper, A. R., Hasselblad, V., & Gray, R. (2013). The patient-centered medical home: a systematic review. Annals of internal medicine, 158(3), 169-178.
Nutting, P. A., Miller, W. L., Crabtree, B. F., Jaen, C. R., Stewart, E. E., & Stange, K. C. (2009). Initial lessons from the first national demonstration project on practice transformation to a patient-centered medical home. The Annals of Family Medicine, 7(3), 254-260.
Rittenhouse, D. R., Casalino, L. P., Shortell, S. M., McClellan, S. R., Gillies, R. R., Alexander, J. A., & Drum, M. L. (2011). Small and medium-size physician practices use few patient-centered medical home processes. Health affairs, 10-1377.
