Evaluating A Patient-Centered Medical Home From the Patient's Perspective.

Background: The medical home is an organizational approach for improving care, improving patient experience, and reducing costs. The purpose of this qualitative project was to obtain input from patients that could be used to improve their experiences in the medical home for ongoing disease management and health improvement and to obtain their recommendations for the most effective methods to involve patients in shaping system policies, procedures, and practices consistent with patient- and family-centered care principles.

Methods: We conducted cognitive interviews to complete patient experience surveys, structured focus groups, and exit surveys. A sample of 32 adults participated in cognitive interviews (n=15) and structured focus groups (n=17) using the nominal group technique (NGT). Exit surveys collected demographic information and input from patients about opportunities for their involvement in shaping medical homes.

Results: Cognitive interviews, NGT sessions, and exit surveys revealed patient-perceived strengths and inadequacies within the medical home. Better access to care, including more efficient appointment scheduling and reduced wait times to see a physician once patients arrived for scheduled appointments, was identified as a necessary improvement. Patients' positive perceptions included how the medical home helps them reach their health goals and their overall satisfaction with the quality of care received.

Conclusion: The input received from patients through the methods used in this project was useful in revealing needed improvements within a medical home and, if resolved, will ensure that all patients have access to the kind of care that works for them.