What is a Medical Home?
By Mallory CyrMPH Candidate, Boston University School of Public Health
Medical home is a buzzword heard frequently in the world of MCH. The reality, however, is that many people do not have a full understanding of what a "medical home" really is.
Once you throw more words into the alphabet soup, like health home, ACO, HMO (and the list goes on), good luck keeping track of what anyone is talking about! This muddled framework of what the ideal health care system is supposed to look like can be especially frustrating for youth, families, or the average consumer trying to gauge the quality of care they really have.
Most of my medical home education came from my work with the National Center on Health Care Transition (Got Transition?), through the Center for Medical Home Improvement. I had the privilege and honor to be mentored by two of the top medical home experts in the country who shared in the genuine belief that no matter what it’s termed as, health care needs to be about quality, and needs to be about the person, not just the diagnosis.
In my "other life," I am a graduate student at Boston University School of Public Health concentrating in Maternal Child Health, and a LEND (Leadership in Neurodevelopmental Disabilities) fellow through UMass Medical School. In both of these settings, we were taught about the "patient centered medical home," and read the works of my former employers. I was surprised at the lack of knowledge people had about these topics. Didn’t everyone know what a medical home was all about? Doesn’t everyone eat, sleep and breathe MCH like I do?
No. They don’t. It was then I began to realize how much I take for granted the knowledge and experience that I have gained as a consumer within the system – as much of a double edged sword as it may be.
So what is a medical home REALLY? As an everyday "consumer," how can you tell if you have one? Well, let me start with what it is not. It’s not a building. It is not one person. It is not a home of people who require a lot of medical care and supplies.
In my experience, a medical home is: consistently receiving care that makes you feel like a person, not a number. It is talking to a provider and instead of leaving the room and feeling like you just can’t do it anymore, breathing a sigh of relief.
It is having a provider who says "let me follow up on that for you," and they DO. It is knowing that when you arrive at the lab to have blood drawn, the proper orders will be there without YOU having to hunt them down. A medical home is having conversations about your goals, your fears and knowing who you can contact in an emergency (and that number connects to an actual person….not a recorded menu of options).
I know this sounds all fine and good, and I can hear all the providers screaming "BUT WE DON’T HAVE TIME FOR THAT! HOW CAN WE BILL FOR IT ALL?" Take a deep breath. Medical home is a team-based approach, with the right people involved, and the providers who really achieve it, somehow find the time. It is not held in the hands of one provider, so they can check a box for their practice quality improvement measures.
A true medical home takes time, patience and care. But with the right people, policy and shared vision – it is an outcome that can be achieved.