Army Soldier Centered Medical Care--The Line Mission Is Our Mission
February 13, 2014
The Army Soldier Centered Medical Home (SCMH) is the Soldier's version of the Patient Centered Medical Home (PCMH). PCMH is defined by the ability to provide comprehensive primary care, promote wellness through empowered patients, and seamlessly coordinate care within the "medical neighborhood" to achieve optimal health for our beneficiaries.
The SCMH mission is to improve and enhance individual and unit medical readiness by utilizing the PCMH multi-disciplinary health care team approach. This consists of primary care, behavioral health (BH), clinical pharmacy, physical therapy, nutrition care, and nurse case management; operating in a proven model of integrated, comprehensive, proactive care.
Lt. Col. Matthew Fandre, SCMH Program Manager, MEDCOM PCMH Task Force, explained the evolution of SCMHs. "We recognized that our Soldiers have unique needs, both from a medical readiness standpoint as well as the types of illnesses and injuries. To meet the needs of our Soldiers, our primary customers, we modified the standard PCMH model to meet those needs." In addition to the PCMH model, SCMH integrates physical therapy assets and better aligns behavioral health specialists to meet Soldier needs.
Fandre stated "the greatest benefit of SCMH is the integration of the organic unit medical team with the hospital medical providers and staff. This provides true continuity for both the Soldiers and the staff, even during deployments and training exercises. Furthermore, we can use our extended team members to maximize performance, reduce injuries, and improve readiness".
The SCMH is to be as near the Soldier's work place as possible to minimize time away from their unit. SCMH is designed around the brigade or brigade equivalent troop population (~4,000 Soldiers) as the scalable unit for which support staff, facility, information technology, and other equipment requirements are planned. Initial, Brigade combat teams (BCTs), combat aviation brigades, and regiments were the first priority, but SCMH is now expanding to serve all brigade-sized equivalents, USASOC and TRADOC units.
SCMHs will tailor the Soldier's medical readiness needs in a single site aligned by the Soldier's unit and chain of command, delivering 90% of all Soldier care at one location. All SCMHs must meet the same recognition standards as PCMHs through the National Committee for Quality Assurance (NCQA). The Army currently has ten SCMHs caring for 86K Soldiers. Those locations have shown an improvement in medical readiness, decreases in polypharmacy and no-show rates, and increased efficiency of staff and resources. When fully implemented, 65 SCMHs will provide Soldier care across Army Medicine.
PCMH is designed around one core principle: putting patients first. SCMH focuses on meeting the needs of the Soldier or as Fandre explained "the line mission is our mission; we now have the system structured to maximize Soldier care."
Soldier Centered Medical Home: Integrated Care Where You Serve