Patient Centered Medical Home: Military medicine undergoes transformation
January 18, 2012
FORT CARSON, Colo. -- For most people, home is the place to see a familiar face, feel comfortable and talk about the things in life.
It's exactly how the Fort Carson Medical Department Activity staff wants its patients to feel about the place where they receive their health care.
The Patient-Centered Medical Home model, being implemented Armywide, is a new approach designed to improve access and continuity of care. The concept creates medical homes, or clinics, that act as a small family practice. Beneficiaries at a medical home get their own core team made up of their primary care provider -- a physician, physician's assistant or nurse practitioner, licensed practical nurses and registered nurses. The idea is that patients will get a group of caregivers who know them well and a personalized care plan unique to them.
"It's patient focused. The patient is the center of the team and we are all around that person," said Col. Robert Rudolphi, Fort Carson MEDDAC physician champion for PCMH. "It's a comprehensive approach that addresses the mind, body and spirit."
Fort Carson caregivers are in the midst of intense training and implementation of PCMH. Through practices such as "team huddles" about the upcoming day to more contact time with patients, caregivers say this radically changes how they work.
"I like the concept of working as a team," Rudolphi said. "It should free up time for providers to really communicate with patients."
Patients will begin to see a number of changes as PCMH takes hold. Beneficiaries will have a lot more time with nurses as they conduct screenings and prepare a patient for a provider, said Maj. Ramona Decker, Army nurse.
"This allows us to work at the top of our licenses," Decker said. "Appointments are more comprehensive and we can build trusting relationships with our patients. We want to be their partner in health care."
Decker said beneficiaries will also find access to care becomes broader and easier. The PCMH model calls for communication between the patient and provider through nontraditional means. The face-to-face interaction is supplemented by telephone, video or secure email messaging. The secure messaging site allows beneficiaries to see lab results, X-rays and send messages to their provider. The site also has health education information and worksheets.
PCMH also requires a transformation to a more active role on the part of beneficiaries.
"We want them to own their health care," Decker said. "We want them to express their concerns and follow up on their referrals. This is about more than acute concerns. Care improves as you get to know your team and we can focus on wellness."
"It's a reformation for everyone," Rudolphi said. "It's a journey that will take practice and we want patients to take responsibility as well."
Three Fort Carson-MEDDAC clinics are already applying for certification from the National Committee for Quality Assurance under the PCMH model. Rudolphi said the other clinics are in various stages of implementing the plan.