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Initial Lessons From the First National Demonstration Project on Practice Transformation to a Patient-Centered Medical Home
Paul A. Nutting , and colleagues
Background The Patient Centered Medical Home (PCMH) is an approach to providing comprehensive primary care based on partnerships between patients and clinicians. This special report from the evaluation team of the National Demonstration Project (NDP) offers early lessons and recommendations for transforming practices to PCMHs.
What This Study Found Early lessons from the NDP include the following: (1) becoming a PCMH requires transformation; (2) incorporating new technology for the PCMH is difficult and time consuming; (3) transformation to a PCMH requires personal transformation of physicians; (4) "change fatigue" is a serious concern; (5) transformation to a PCMH is a developmental process; and (6) transformation is a local process. The authors also provide recommendations for policy makers and practices.
Implications
- The PCMH is an important opportunity to restore a healthy foundation for primary care and better health for the United States.
- The PCMH requires adequate funding, negotiation of hidden agendas, caution against industrial-like schemes and language, a local focus, and respect for variability.
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