Patient-Centered Medical Home

Chair, Gary Rosenthal, MD 
Hosted by the Society of General Internal Medicine, the Society of Teachers of Family Medicine and the Academic Pediatric Association in partnership with the Agency of Healthcare Research and Quality, the Veterans Health Administration, US Department of Veterans Affairs.

Broader adoption of PCMHs at this time raises a number of new questions and issues regarding the dissemination, implementation, and sustainability of the PCMH model. The overarching goal of the conference was to develop an agenda for future research on the implementation and impact of the PCMH. The meeting reviewed emerging evidence about the impact of the PCMH model on quality, access, and costs of care, and prioritized key unanswered research questions surrounding the PCMH with respect to:

• organizational and professional factors (e.g., workforce development, practice transformation) that may influence PCMH implementation; 
• payment models to support PCMH implementation and emerging trends (e.g., emergence of ACOs, implementation of the ACA) that are likely to impact PCMH implementation;
• the impact of the PCMH implementation on healthcare disparities; and
• strategies for effective patient and family engagement and for the integration of behavioral healthcare into the PCMH. 

The conference addressed these questions in two ways. First, the conference brought together over 100 key stakeholders and the research community to define the policy-relevant research agenda that is needed to move the PCMH model of care forward. Second, by reviewing emerging evidence on the clinical and economic impact of the PCMH model, the conference was able to shed additional insight on the effectiveness of the PCMH over traditional primary care models and spur further interest by payers and purchasers in devoting the necessary additional resources to support the PCMH model. The conclusions of the conference will be disseminated through white papers published in appropriate venues, workshops at major professional society meetings, and concise briefs intended for practitioners and policy makers. 

 

Chair, Judith Bowen, MD

The main purpose of the Summit was to address the gap between primary care internal medicine practice redesign toward medical home models and the current GME training models. Seven work groups explored aspects of the ideal PCMH training environment, clarified different visions and definitions of PCMH and developed a series of papers based on their work and discussion during the 2011 conference. The Entrustable Professional Activities paper has been accepted for Fall 2012 publication in the Journal of General Internal Medicine; other papers are in process of submission to other publications. 

1. Chang A. et al. Transforming Primary Care Training – Patient-Centered Medical Home Entrustable Professional Activities for Internal Medicine Residents
2. Leasure EL et al. There is no “I” in Teamwork in the Patient Centered Medical Home: Defining Teamwork Competencies for Academic Practice
3. Bowen et al. Toward a Patient-Centered, Learner-Centered Medical Home: Interpersonal Continuity in Graduate Medical Education
4. Clay M. et al. Teaching While Learning While Practicing: Reframing Faculty Development for the Patient Centered Medical Home
5. Bitton A. The EFECT Framework for Inter-Professional Education in the Patient Centered Medical Home
6. Patel MS. Estimating the Staffing Infrastructure for a Patient-Centered Medical Home
7. Lee PT et al. New Models of Primary Care Practice Require New Training: A Call to Action 

Supported by the Josiah Macy Jr, Foundation and United Healthcare the Veterans Health Administration, US Department of Veterans Affairs and the American College of Physicians

 

Chair, Bruce Landon, MD, MBA 
Hosted in partnership with the Society of Teachers of Family Medicine and the Academic Pediatric Association.

This first collaborative effort brought together the major academic primary care societies to organize a research conference to develop a policy-relevant research agenda around the PCMH. The conference objectives were to inform and advance the state of the science of PCMH, to develop partnerships and build capacity to implement a practical evaluation model for a variety of stakeholders, to develop and recommend a research agenda to inform the development and broad implementation of the PCMH model and to disseminate the synthesis of the conference. 
The conference included six invited papers. The papers were published as a group along with an accompanying editorial by the investigative team in the June 2010 issue of the Journal of General Internal Medicine. The papers and their primary authors are listed below:

1. Current Landscape of PCMH Demonstrations (Asaf Bitton, MD, and Bruce Landon, MD, MBA)
2. Defining and Measuring the PCMH (Kurt Stange, MD, PhD)
3. Clinical, Quality of Care, and Satisfaction Outcomes of the PCMH (Diane Rittenhouse, MD, MPH)
4. Financing and Payment Models for the PCMH (Robert Berenson, MD, and Eugene Rich, MD)
5. Transforming Practice (Charles Homer, MD, MPH, and Richard Baron, MD)
6. The Medical Neighborhood (Mai Pham, MD, MPH)

Supported by AHRQ, the Commonwealth Fund and the ABIM Foundation.