The Patient-Centered Medical Home (PCMH) is a model of comprehensive primary care delivery that studies show can improve the quality and efficiency of care and reduce disparities. The PCMH model could be particularly valuable in safety-net clinics, which provide primary care for over 18 million medically underserved patients. However, the available evaluation tools for PCMH adoption do not seamlessly apply to safety-net clinics.
With Commonwealth Fund support, Jonathan M. Birnberg, M.D., of the University of Chicago, and colleagues have developed an evaluation scale customized for safety-net clinics.
Existing tools to measure PCMH adoption are not designed for research evaluation in safety-net clinics. For instance, tools used in PCMH pilots do cover all areas covered by the safety-net setting, such as language services, or are burdensome to complete.
Safety-net clinic administrators
With input from a national advisory committee, investigators at The Commonwealth Fund and the University of Chicago developed the Commonwealth Fund Organizational National Survey of Federally Qualified Health Centers. The survey was designed to provide an overview of health center capability and test questions that could be used in a PCMH evaluation scale. The survey included new questions and questions adapted from previous surveys, such as the NQF-Endorsed Definition and Framework for Measuring Care Coordination, Electronic Health Records in Ambulatory Care.
The survey was distributed from July to December 2009 to participants in the Fund-supported Safety Net Medical Home Initiative, a five-year demonstration project designed to help 65 community health centers in five states transform into patient-centered medical homes.
The survey results were used to create the Safety Net Medical Home Scale, which scores clinics on six domains: Access and Communication, Patient Tracking and Registry, Care Management, Test and Referral Tracking, Quality Improvement, and External Coordination.
See J. M. Birnberg, M. L. Drum, E. S. Huang et al., “Development of a Safety Net Medical Home Scale for Clinics,” Journal of General Internal Medicine, published online Aug. 12, 2011.