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What does PCMH mean?

Defining elements of a Patient-Centered Medical Home:
1. Comprehensive Care
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Provide physical and mental health care needs, including prevention and wellness, acute care, and chronic care.
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Team approach: physicians, advanced practice nurses, physician assistants, nurses, pharmacists, nutritionists, social workers, educators, and care coordinators.
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In small practices this may be a virtual team, linking services within the community.
2. Patient-Centered
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Model of shared decision making with patients and families.
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A holistic approach tailored to the needs, values, culture, and preferences of each individual.
3. Coordinated Care
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Coordinate services across the spectrum from acute hospitalization, to specialty visits to home care.
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Serve as a bridge when the patient transitions back to the community after hospitalization.
4. Accessible Services
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Patients must have access to the care team outside of traditional office hours.
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Access to appointments for acute issues in a timely manner.
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Availability of care in-person, by telephone, or even email depending on preferences of the patient.
5. Quality and Safety
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Ongoing quality improvement activities and the use of evidence-based practices.
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Collect data on performance measures and participate in public reporting.
PCMH is a solution to many of our challenges in health care: fragmented care, duplication of services, excessive use of specialty care, and lack of preventive services.