Robust and lasting clinician-patient relationships are at the heart of every medical home, says a new report from the Commonwealth Fund that proposes 8 characteristics of the patient-centered medical home (PCMH). The report aims to provide general guidance for transforming a practice into this new model of care.  

The broad "change concepts," as the report calls them are: engaged leadership; a quality improvement strategy; empanelment or linking patients with specific providers to ensure the continuity of the patient-provider relationship; continuous and team-based healing relationships; organized, evidence-based care; patient-centered interactions; enhanced patient access to clinical information after office hours; and care coordination.  

For each of the 8 concepts, the authors suggested 2 to 6 specific practice modifications called key changes. For example, under organized, evidence-based care they propose that providers:

• use planned care according to patient need
• identify high-risk patients and ensure they receive appropriate care and case management services
• use point-of-care reminders based on clinical guidelines
• enable planned interactions with patients by making up-to-date information available to providers and the care team prior to the visit

Within the descriptions of the 8 characteristics, the report illustrates how the care of patients would differ between a fully transformed PCMH and a more typical primary care practice as seen through the health care experiences of 2 fictitious sisters—Ms G and Ms H.