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Patient Centered Medical Home

What is Patient Centered Medical Home?

A Patient Centered Medical Home is a system of care in which a team of health professionals works together with you, the patient—and, where appropriate, your family—to provide you with the best possible health outcomes. Your primary care provider leads the care team, which may include nurses, medical assistants, receptionists, specialists and other healthcare professionals working together with you as the center of the care team. When you take an active role in your care, you can be sure you are getting the care that you need.

How Does a Patient Centered Medical Home Benefit You?

Your PCMH team:

  • Is available when you need us. We will tell you when our office hours are and how to get clinical advice 24/7, during and after office hours.
  • Strives to know you and your health history so we can suggest treatment options that are optimal for your health.
  • Will focus on preventative care to keep you as healthy as possible.
  • Makes sure that you understand your condition and how to best take care of yourself. We help you understand your care options and help you make decisions about your care.
  • Help you coordinate your health care across the healthcare system, making appointments and making sure that specialists that the information they need about your to care for you.
  • Uses technology to share records to help eliminate duplicate testing and make sure that all your health records are maintained in one place.

Getting the Most from Your Medical Home

Your PCMH Care Team will:

  1. Learn all about you
    • We will get to know you and all aspects of your life which affect your health and well-being. We will update our records with your help each time you seek care.
    • We will listen to your questions and concerns and treat you as a full partner in your care.
  2. Communicate with you
    • Clearly explain your health situation and make sure you are aware of all the options for your care.
    • Give you time to ask questions and answer them in a way you understand.
    • Help you make the best decisions for your care.
    • Ask you for feedback about your patient experience and how we can better serve your healthcare needs.
    • Provide you with the information you need to obtain care and clinical advice during office hours and when the office is closed. The specific roles of your PCMH Team will be explained to you.
    • Clearly identify the roles of various members of your PCMH Care Team.
  3. Provide access to evidence-based care & self-management support
    • Provide treatment and recommend preventative services using evidence-based guidelines for care facilitated by electronic medical records.
    • Help you set goals for your care and help you meet these goals every step of the way.
    • Give you information to help educate you about your condition and ways to stay healthy including providing you with information about community support groups and services.
    • Coordinate your care across multiple settings and with specialist, when necessary, to provide you with the best possible care.

What You Can Do

  1. Be in charge of your health
    • Know that you are a full partner in your care.
    • Learn about your health situation and what you can do to stay as healthy as possible.
    • Understand that your lifestyle choices affect your personal healthy.
    • Understand your financial obligations related to your health.
  2. Participate in your care
    • Follow the plan that you and your medical team have agreed is the best for your health.
    • Help us identify any barriers you may have in following your treatment plan.
    • Take medications as prescribed or let us know why you are unable to do so.
    • Keep scheduled appointments or reschedule them if a conflict arises.
  3. Communicate with your team
    • Ask any questions that you may have about your care and be certain you get the answers that you need.
    • Bring your list of medications, herbal supplements and vitamins to your appointment.
    • Tell us if there is any change in your health or well-being since your last visit.
    • Always tell your PCMH Team if you get care from other health professionals, including any hospitalizations, so we can best coordinate your care.
    • Always speak openly of your experience with your care team so we can provide you with the best possible care.