A high level of responsiveness to patients' needs and preferences is one of the defining features of a high performance health care system. For one of the first projects of the Fund's new Patient-Centered Primary Care Initiative, experts will develop and test measures that enable accrediting agencies and others to determine the extent to which physicians provide patient-centered care—a necessary first step toward establishing a reward or incentive program.

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ne of the defining features of a high performance health system is its responsiveness to patients' preferences and needs. Increasingly, patients expect physicians to provide them with access to their medical information, to treat them as partners in care decisions, and to address their concerns.
Despite being named one of the key components of quality health care by the Institute of Medicine (IOM), "patient-centeredness" has yet to become the norm in primary care. One of five American adults has trouble communicating with doctors, and one of 10 feels they were treated disrespectfully during a health care visit.(1) Moreover, The Commonwealth Fund 2003 National Survey of Physicians and Quality of Care shows that only one-third of physicians receive feedback from patient surveys and just 16 percent communicate with patients via e-mail.(2)
To help address these deficiencies, the Fund in 2005 launched the Patient-Centered Primary Care Initiative, seeking to promote the redesign of primary care physician practices and health care systems. Through a combination of research, outreach, and intervention, the initiative aims to make the IOM recommendation to design care around patients' needs a reality.
The essay, "A 2020 Vision of Patient-Centered Primary Care," published in the Journal of General Internal Medicine in October 2005, outlines what it will take to make physician practices more centered around patients.(3) In the article, the Fund's Karen Davis, Stephen Schoenbaum, M.D., and Anne-Marie Audet, M.D., proposed that the following seven attributes should define a patient-centered primary care practice:
1) superb access to care
2) patient engagement in care
3) clinical information systems that support high-quality care, practice-based learning, and quality improvement
4) care coordination
5) integrated and comprehensive team care
6) routine patient feedback to doctors
7) publicly available information.
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Melinda K. Abrams
Senior Program Officer