Patient Centered Medical Home
What is a Patient Centered Medical Home (PCMH)?
A Patient Centered Medical Home is a team of healthcare professionals who work together to provide patient-centered, comprehensive, coordinated, accessible and collaborative health services. Your team gets to know you well and works together with support staff and the broader healthcare system to provide the best possible care for you.
A Medical Home is About YOU
Caring about YOU is the most important job of a medical home. We will partner with you and your family to ensure that you are fully informed partners in establishing your care plan. You will be an active participant in all decisions related to your ongoing medical care and improving the quality of your overall health.
How a Medical Home Works for YOU
- Your medical home team will help to coordinate your appointments with specialists, hospitals, and other services. We will act as your advisor and advocate and will help assure that all testing, procedures, and specialist appointments are appropriate and coordinated in an efficient and high quality fashion.
- Your medical home team will develop a personal care plan to help you achieve the best possible health outcomes. Your personal care plan will be respectful of and responsive to your preferences, needs and values.
- A member of your healthcare team is available when you need them; communication is available around-the-clock by telephone or electronic access through our secure web portal, NextMD. You will choose the method by which you wish to communicate.
- Appointments will be scheduled in a timely manner with shorter waiting times for urgent care, even on the same day when needed.
- Your medical home team will monitor your medical needs and will contact you to schedule follow-up appointments if they are not already arranged.
The Patient Centered Medical Home Manages Care Through:
- selection of a primary care clinician;
- involvement in his or her own treatment plan;
- management of referrals;
- coordination of care;
- collaboration with patient-selected clinicians who provide specialty care or second opinions;
- communication with the Patient Centered Medical Home about healthcare concerns/other information
- We are your Patient Centered Medical Home (PCMH)
- We are all here to support you. We are your team.
- We care about all of you. We want to help you with your physical and mental well-being. We want you to be as well as you can be.
- We can help you see specialists and get support from services in the community.
- We are here for you. Call us, visit us, contact us online. Ask front desk staff about our patient portal NextMD where you can access your electronic health record or email your provider.
- We want you to have great and safe care.
SCH has Patient Centered Medical Home certification by NCQA. The NCQA Patient-Centered Medical Home program reflects the input of the American College of Physicians (ACP), American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP) and American Osteopathic Association (AOA) and others. As a Patient Centered Medical Home, SCH is dedicated to adhering to several core functions and attributes:
- Patient-centered care – Relationship-based care focuses on the whole person and understanding and respecting each patient’s needs, culture, values and preferences.
- Comprehensive care – A team of providers (may include physicians, advanced practice nurses, physician assistants, nurses, pharmacists, nutritionists, mental health workers, social workers and others) work to meet each patient’s physical and mental health care needs, including prevention and wellness, acute care and chronic care.
- Coordinated care – Care is coordinated across the broader health care system, including specialty care, hospitals, home care and community services and support. This is particularly critical during transitions between sites of care, such as when patients are discharged from the hospital.
- Superb access to care – Patients have access to services with shorter waiting times for urgent needs, enhanced in-person hours, around the clock telephone or electronic access to members of the care team, and alternative methods of communication such as e-mail and telephone.
- Systems-based approach to quality and safety – The PCMH uses evidence-based medicine and clinical decision support tools, engages in performance measurement and improvement, measures and responds to patient experiences and satisfaction, practices population health management, and publicly shares robust quality and safety data and improvement activities.
“NCQA Patient-Centered Medical Home Recognition raises the bar in defining high-quality care by emphasizing access, health information technology and coordinated care focused on patients,” said NCQA President Margaret E. O’Kane. “Recognition shows that Shenandoah Community Health has the tools, systems and resources to provide its patients with the right care, at the right time.”NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make more-informed health care choices. NCQA can be found online at
http://www.ncqa.org.
