Table 1

The 10 Goals of the Patient Medical Home Model

  1. Patient centeredProvide services that are responsive to patients’ and their families’ feelings, preferences, and expectations
  2. Personal family physicianThe most responsible provider of a given patient’s medical care
Every person in Canada should have a personal family physician
  3. Team-based careOffer a broad scope of services carried out by teams or networks of clinicians; inclusive of nurses, peer physicians, and others
  4. Timely accessTimely access to appointments in the practice
Advocate for and coordinate timely appointments with other health and medical services required
  5. Comprehensive careProvide a comprehensive scope of family practice services by working collaboratively with other professionals
Address public health needs
Taking population health effects into account
  6. ContinuityOffer continuous care over time and in different settings
Advocate on the patients’ behalf for continuity of care throughout the health care system
Preserve constant relationships and continuous medical information for patients
  7. Electronic records and health informationMaintain electronic medical records
  8. Education, training, and researchServe as a model place for training students, residents, and other health professionals
Carry out and/or encourage staff to be involved in primary care research
  9. EvaluationCarry out ongoing evaluation as part of the commitment to continuous quality improvement
10. System supportInternal support through governance and management structures
External support by stakeholders, the public, and other medical and health professionals and their organizations across Canada