Patient Centered Medical Home
Welcome To Your Medical Home
The Patient Centered Medical Home (PCMH) is a model for providing comprehensive primary care for children, youth, and adults. The PCMH model aids partnerships between individual patients, their personal physicians and when appropriate, the patient’s family.
The PCMH will enable:
- Each patient to have an ongoing relationship with a Sunset primary care provider (PCP) who provides continuous and comprehensive care;
- A PCP directed team of Sunset staff, who together, care for each patient;
- Sunset staff to take a whole-person approach to caring for patients.
- Patient to join a team that includes health care professionals, trusted friends or family members (if you wish), and— the most important—you.
How can a Medical Home help you?
Quality and safety are important in the medical home model. Below are some ways how this is accomplished:
- Sunset staff advocates for their patients to achieve health outcomes through a compassionate partnership between physicians, patients, and the patient’s family.
- Evidence-based medicine and clinical support tools guide decision making (PCP’s use the latest health care practice to treat patients).
- Primary care providers in the practice encourage quality improvements (Patients receive calls/letters reminding them to come in for specific care).
- Patients actively participate in the decision-making and feedback is sought to ensure patient expectations are being met (Patients complete surveys).
- Patients are encouraged and actively referred by the PCP to in-house health educational, prevention and self-management sessions (by Community Health Workers as part of their care team and support).
- The patient, a behavioral health team member, and their primary care physician will work in tandem, transforming current habits and barriers that contribute to poor health outcomes, into realistic, manageable steps towards healthier lifestyle choices.
- Information technology is utilized appropriately to support optimal care, performance measurement, patient education, and enhanced communication (Electronic Health Record).
Why are we changing?
The health care system can be confusing. Many people visit a lot of doctors and feel lost in the system. The medical home team will listen to your questions and can help you find your way through the system. The medical home model care is a way of saying the patient is the most important person in the health care system. You are at the center of your health care. Your Sunset Community Health Center, believes this model enhances positive outcomes. Through this model, working together with their health care team, patients are able to achieve their best quality of life. To learn more about this care model, visit www.ncqa.org
Medical Home Patient and Provider Roles and Responsibilities
As a patient, I will:
- Bring all questions I have to my appointments
- Tell you how I am feeling and how it affects my life
- Ask you about things I do not understand
- Help you create my care action plan and track my progress
- Let you know when I get care somewhere else
- Bring a list of all medicines, supplements, and herbal or holistic products I use
- Fill my prescriptions on time, use them as prescribed, and tell you of any problems
- Ask for support services when I need them
- Ask you if I need any tests or shots
As my provider, you will:
- Respect me and my family values and needs
- Ask me to take part in my health care
- Respect my culture and use language I understand
- Help me set health goals and create an action plan
- Track the care I get from other providers
- Ask for my ideas on how we can improve my care
- Offer appointments at times when I can come in
- Explain test results and what will happen next
- Help me get support services when I need them
- Stay in contact with me as my partner in care