Lessons learned from the US medical home experience

Paul Grundy MD is widely acknowledged as one of the founders of the patient-centred medical home movement in the United States and internationally. We were privileged to have Paul join us for an informal discussion with our group, and later to hear his presentation at the PCPCC conference.  

Primary care works better as a team sport, according to Paul Grundy. But on average, in the practices he has observed, clinicians are only spending a third of their time doing what they are supposed to be doing, with the varied skills and expertise of team members not being used optimally.

Important issues for successful implementation of medical homes according to Paul Grundy include:

*  Involving the whole community, addressing the social determinants of health, and ensuring care is about the whole patient, not just about an illness.

*  Getting payments right: How you pay matters - and you need to pay for what you want, including using fee for service to incentivise providers to deliver particular services

*  Ending medical homelessness: ensuring all patients have a trusted relationship with their primary care provider. Focus should move beyond high risk patients to include the broader population.

*  Using technology wisely. Paul and other speakers at the PCPCC conference acknowledged the integral role of data and technology in making medical homes function effectively.

Paul's presentation followed on from a powerful spoken poetry TED-style talk by Melissa Thomason, a patient advocate - her theme, the impatient patient, and her passion earned her a standing ovation. Twitter followers can check her out @Dissecting_Care