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Patient Centered Care


The Patient-Centered Medical Home Model of Care

Updated May 31, 2016

Since 2011, all Division of General Internal Medicine primary care practices have been recognized by the National Committee for Quality Assurance (NCQA) as Patient-Centered Medical Homes (PCMH).  In fact, we were one of the first PCMHs in Columbus. 

So, just what is a PCMH?  A patient-centered medical home is a model of care that prioritizes care coordination and communication.  We look at our clinics and our services from the perspective of the patient and ask “what is most important to our patients and how would they want their primary care clinic designed?”  We are constantly looking for ways to improve our operations and be more patient-centered by focusing on improving access, quality and the overall patient experience.

As a result of the high level of commitment that all of our sites have demonstrated to the PCMH model of care, they have all achieved Level 3 recognition, the highest level of recognition given by the NCQA.  In addition, our sites at the Martha Morehouse Medical Plaza and at CarePoint East were re-certified as Level 3 PCMH practices earlier this month! The new certification will last until May, 2019.

Click here to learn more about NCQA’s Patient-Centered Medical Home Recognition program.

PCMH Standards

Enhanced Access and Continuity
Provide enhanced access to a physician directed healthcare team for both routine and urgent needs and offer electronic access during and after regular office hours.

Team-Based Care
Provide continuity of care using culturally and linguistically appropriate services through a team based approach.

Population Health Management
Utilize a comprehensive health assessment, evidence based medicine and clinical decision-support tools to manage the health of the entire population.

Plan and Manage Care
Systematically identify individual patients and plans and manage and coordinate care based on need.

Track and Coordinate Care
Track and follow-up on all lab and imaging results and important referrals; proactively manage the coordination and transitions of care following hospitalization or acute rehab.

Measure and Improve Performance
Utilize performance data to identify opportunities for continuous quality improvement, efficiency and the patient experience.