The patient-centered medical home model of care delivery is beginning to gain currency in the industry. NCQA has certified some 4,900 primary care practices as medical homes. Its stamp of approval serves as the industry’s gold standard. Gaining the recognition is not easy, however, and a practice must have a wealth of information system capacity—an EHR, patient portal, and data mining capabilities are critical.

But when you ask providers for a definition of a medical home, the answers are varied as widely as the groups themselves. Here are a few definitions offered by physicians whose groups have passed muster with NCQA:

* “A medical home is like a real home,” says Sal Volpe, M.D., a solo physician in Staten Island, N.Y. “If you live in a home, everyone cares about everyone else. Everyone in the home pitches in to make sure everyone succeeds. You migrate that idea to the doctor office. So the front desk isn’t brusque with people and the staff asks patients about their families, about the daughter who just went to college.”

* “In a medical home, the patient has one physician who handles the majority of care rather than having care fragmented with different physicians as a touch point for diabetes or depression. We are not siloed, and the primary care physician may connect with the endocrinologist but the patient’s point of entry is with a personal doctor,” says Christine Sinsky, M.D., an internist at Dubuque, Iowa-based Medical Associates Clinic and Health Plans.

* “We wanted to transition from acute episodic care—we were waiting for patients to call us and we were not managing the needs of the population,” says Meryl Moss, chief operating officer at Coastal Medical, a 75-physician group practice in Providence, R.I. and winner of 2012 Ambulatory HIMSS Davies Award.  The Level III medical home deployed an EHR from eClinicalWorks in 2006.

Three years later, it decided to change its business model after holding a strategic planning retreat. “We wanted to focus on prevention, getting our sickest patients in and keeping them out of ER. We had been waiting until they were sicker than they should have been to see us. The EHR gave us a tool to manage our patients in a different way.”


The cover story of HDM’s January issue will focus on the technology and change management experiences of physicians and their staffs pursuing medical home status.

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