Evaluation of Patient Centered Medical Home Practice Transformation Initiatives

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The Issue

The patient-centered medical home (PCMH) model is commonly cited as a solution to the shortcomings of primary care in the United States. With numerous PCMH pilot and demonstrations projects under way, there is a vital need for rigorous evaluations that can help to share knowledge and shape future projects.


What the Study Found

Investigators participating in nine different evaluations of PCMHs shared experiences, methodological strategies, and challenges. The group produced the following seven recommendations for future PCMH evaluations:

  • Look critically at and continually reassess models as they are in the process of being implemented.
  • Include qualitative and quantitative data that capture how and why the implementation strategies changed.
  • Capture details concerning how different PCMH components—for example, technology innovations like e-prescribing or work efficiency tools like group visits—interact with each other over time.
  • Describe how and why physician and staff roles do, or do not, evolve, and indicate any need for future training.
  • Demonstrate the effectiveness of individual PCMH components—for example, patient registries and physician dashboards—and how they are used in practice.
  • Identify how primary care practices interact with other entities, such as specialists, hospitals, and referral services.
  • Measure resources required for initiating and sustaining innovations.


Conclusions

Comprehensive, longitudinal evaluations that incorporate both quantitative and qualitative measures are necessary to evaluate PCMH models.

Publication Details

Publication Date: January 6, 2011
Authors: Benjamin F. Crabtree, Ph.D., Sabrina M. Chase, Ph.D., Christopher G. Wise, Ph.D., M.H.A., Gordon D. Schiff, M.D., Laura A. Schmidt, Ph.D., M.S.W., M.P.H., Jeanette R. Goyzueta, M.P.H., Rebecca A. Malouin, Ph.D., M.P.H., Susan M. C. Payne, Ph.D., M.P.H., Michael T. Quinn, Ph.D., Paul A. Nutting, M.D., M.S.P.H., William L. Miller, M.D., M.A., and Carlos Roberto Jaén, M.D., Ph.D.
Summary Writer: Deborah Lorber
Citation:
B. F. Crabtree, S. M. Chase, C. G. Wise et al., "Evaluation of Patient Centered Medical Home Practice Transformation Initiatives," Medical Care, Jan. 2011 49(1):10–16.

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