Making the Medical Home More Homey

Adelante Healthcare is a federally qualified health center in Mesa, Arizona that was formed in the late 1970s to serve migrant workers. Back then, clinicians worked out of ramshackle trailers. Today it’s a different story.


Adelante Healthcare is a federally qualified health center in Mesa, Arizona that was formed in the late 1970s to serve migrant workers. Back then, clinicians worked out of ramshackle trailers. Today it’s a different story.

Serving the working poor and uninsured, the clinic recently completed construction of a new LEED Platinum-certified patient care facility, one its leaders say upholds the true meaning of the “medical home” distinction. CEO Avein Saaty-Tafoya noted that the 43-provider clinic has gone beyond the technical definitions of a patient-centered medical home, an I.T.-rich model in which primary care physicians coordinate care across diverse settings. Certified as a medical home by the Joint Commission, Adelante has been using EHR technology to document and coordinate care for the last five years, Saaty-Tafoya noted.

Its new facility, which Adelante described last week in Chicago at a conference hosted by the Center for Health Design, upholds the idea that the “ patient-centered ‘medical home’ means comfort, trust and making patients feel welcome.” She emphasized how the building’s design is designed to reduce anxiety among patients.

Jain Malkin, the project’s architect, noted how the 43,000-square-foot building attempts to mirror both the colors and materials predominant in the southwest. Malkin pointed to such amenities as the “concierge station,” a long, curving desk where a greeter welcomes all arrivals. “You don’t expect to see smiling face at a low desk when you enter a clinic; it’s like a hotel,” she said. Physicians also were granted private offices, a step in the opposite direction most commercial clinics are taking with the medical staff. Exam rooms are built to accommodate families in attendance as well. Skylights are common throughout the structure, offering natural light, and clinical areas are color-coded at the ceiling, thus reducing the need for cluttering signs, Malkin added.

Provider workstations accommodate computer documentation stations, but are designed so that the provider can sit and talk to the patient face-to-face while working in the EHR, Malkin noted.

Avein noted that since the center opened, the clinic has broadened its appeal among the local population. “We have kept our old patients but broadened the payer mix,” she said, citing a 27% increase in Medicare patients.