Spotlight on PATH Practices and Programs: The Medical Home
In 1976, the American Academy of Pediatrics introduced the concept of Patient Centered Medical Home, or simply “medical home.” The basis of medical home is the premise that quality medical care requires continuity in the provider and patient relationship. According to the Future of Family Medicine Project, a medical home should be “accessible, accountable, comprehensive, integrated, patient-centered, safe, scientifically valid, and satisfying to both patients and their physicians” (Martin, 2004). Above all else, the modern medical home is about a relationship between a medical provider and a patient that is grounded in compassion and based on open
communication and holistic, longitudinal care.
Primary care is holistic and person-centered; it connects physical and mental health, substance use, and psychiatric services into a focused care delivery environment. In 1978, the Institute of Medicine (IOM) defined the essence of primary care as “accessible, comprehensive, coordinated and continual care delivered by accountable providers of personal health services” (p. 1). Underlying this definition is the idea that primary care is longitudinal and sustainable. Primary care is relationship driven and requires that all team members collaborate to provide the best care possible. Increased access to primary care reduces the need for, and unnecessary use of, emergency department services with a resulting decrease in overall health care costs (Gill, Mainous, & Nsereko, 2000; McGuire, Gelberg, Blue-Howells, & Rosenheck, 2009). Because of improved health outcomes in the management of chronic illness, researchers advocate for coordinated care that links consumers to primary care (Hwang, Tolomiczenko, Kouyoumdjian, & Garner, 2005; Menec, Sirski, Attawar, & Katz, 2006; Strehlow, Kline, Zerger, Zlotnick, & Proffitt, 2005). Primary care addresses co-occurring disorders, and improves quality of life.
Dr. Jim O’Connell, President of Boston Health Care for the Homeless, promotes integrated care models to ensure that providers address all of the needs of the patient. “We are dealing with a population that has co-occurring medical illnesses, substance use disorders, and mental illnesses. Treatment must be fully integrated where you have medical care with mental and substance abuse care. I can see patients with our psychiatrist and deal with the whole person” (Waldroupe, 2010). Creating care linkages is fundamental to primary care—and PATH. (Authors)
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