Table 1.

Data Sources and Indicators Used to Measure the Principles of the Patient-Centered Medical Home

Principle	Data Source	Indicator
CD = computer disk; PDA = personal digital assistant.
^a 0 = never, 1 = rarely, 2=sometimes, 3 = usually, 4 = always.
^b 0 = no, 1 = yes.
^c 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree.
^d 1 = poor, 2 = fair, 3 = good, 4 = very good, 5 = excellent.
Personal physician: ongoing relationship for first- contact, continuous, and comprehensive care	Patient survey	“When I get sick, I contact this practice first (before going to a specialist or emergency room).”^a  “How often do you see the same doctor when getting care at this practice?”^a
	Chart audit	Number of months seen at practice  Number of visits in past 2 years
Physician-directed team: physician leads team of individuals who care for patients	Director survey	Practice has nurse practitioners or physician assistants^b  Use of nurses or health educators for preventive counseling^b
	Practice member survey	“This practice encourages nursing staff input for making changes.”^c
Whole-person orientation: Care for all stages of life, acute care, chronic care, preventive services, end of life care	Chart audit	Patient has well-visit in last 5 years^b  Patient was treated at practice for acute illness^b  Number of chronic diseases
Care coordination: coordinated/integrated across all elements of complex health system—within practice and between consultants, ancillary providers, and community resources	Practice member survey	“We have a system to make sure results from testing/consultation reports are available during patient visits.”^c  “We have a system for communicating results from testing to patients.”^c
	Director survey	Use of referral system to link patients with community programs for education, support, or preventive counseling^b  Clinicians make hospital or nursing home visits^b
Quality and safety: achieved through physician- patient partnerships, evidence-based medicine, clinical decision-support tools, continuous quality improvement, patient participation and feedback, information technology, voluntary recognition process	Director survey	Use of electronic medical records^b  Use of information technology (PDA, online literature searching, CD or Internet-based knowledge bases)^a  Use of clinical decision-support tools (reminder systems for identifying patients due for screening, prompting clinicians about needed tests, reminding patients about visits, checklists/flowcharts for chronic disease or screening, risk factor chart stickers or electronic flags)^a  Continuous quality improvement (use of patient satisfaction surveys, periodic chart audits)^b
Enhanced access: through systems such as open scheduling, expanded hours, new options for communication	Patient survey	“How long you waited to get an appointment”^d  “Getting through to the office by phone”^d
	Director survey	Use of e-mail with patients^b  Use of Web site for marketing^b