Practice Transformation and the Medical Home

Practice Transformation and the Medical Home


Our current NCQA Patient Centered Medical Home recognition expires in February of 2014, and it’s time to begin round 2. I’ve been ignoring this looming task all summer hoping someone would magically take over the daunting project of my practice’s re-application process. The first question for my entire staff was, why are we here? Nine years ago when I left my group practice to venture out on my own, my goal was to “combine traditional care and modern technology in partnership with families.” Have we done that? Does it accomplish what we originally intended?


The conversation was very interesting. Some of my staff pointed out that our original goals were the basis of a technology and patient driven medical home. Does it matter? Everyone around the table felt that they would never work in a practice that was run any differently, and many of the staff wished their personal physician practices would run like ours.


Next we looked at the processes. Did jumping through the NCQA-PCMH hoops make us better at what we do? Reluctantly, we admitted that defining processes, looking at performance and making adjustments to our procedures made us begin the transformation of true continuous quality improvement.  Having documentation is helpful when staff ask questions about how to handle certain issues.  We referred back to our internal documentation at several critical times over the past few years when we hired new staff or there was disagreement among current staff about our policies.  And, we have become less change averse. No one even thinks to mutter “well, because we always have done it that way” as a solution to a problem. Team members begin to think about change as an integral part of being a progressive, thriving practice in which everyone makes a difference.


My favorite part of the NCQA analysis is always the data.  Have our quality metrics improved? You bet. Has that translated to improved P4P bonuses from some of our insurers? YES! Has it translated to better care for our patients? Definitely.


So as we begin our journey toward medical home recognition, round two, I will try to keep my focus on the end results–improved processes and better patient care. I have made a promise to myself that I will also practice the art of cooperative delegation and teamwork this time, now that my entire office has embraced what it means to be a true Medical Home.