Patients are the cornerstone: I am deeply involved with the patient-centered medical home, and the issue relates to how the term “patient-centered” is being misused and abused. If you look at the more recent standards, it relates again to the diversion away from the patient and back to concepts like “meaningful use” and “population care,” and things that don’t relate to a patient.
Patients are the cornerstone. We have revamped the definition; but we have not revamped the culture.
Focus on patients, not populations: I am seeing a difference with those organizations that are transforming their practices to where they are putting the patient in the center of their focus, and getting away from the disease and case management and into the patient care, which leads to prevention, wellness, and healthy lifestyle assessments. You aren’t going to get at those cornerstone prevention and wellness issues unless you have a relationship, and you are not going to have a relationship based on episodic care.
Create the dialogue; pass the baton: If you don’t have that patient having a dialogue and committed to the awareness that this is their coordinated care, then that is not a medical home. The challenge is to get the baton moved from the lab or the doctor’s office and into the patients’ hands because they are the ones running the race. Not the provider.