Patient's Medical Home

The AMA uses the following definition and framework for the Patient’s Medical Home. It is based on the definition developed by the College of Family Physicians of Canada.

Definition

The Patient’s Medical Home (PMH) is a family practice defined by its patients as the place they feel most comfortable to discuss their personal and family health concerns. The goal is to have the patient’s family physician, the most responsible provider of their medical care, work collaboratively with a team of health professionals, which may include nurses, pharmacists, nutritionists and others as required, to coordinate comprehensive healthcare services and ensure continuity of patient care. These professionals can be located in the same physical site as the family physician or linked through different practice sites, telehealth or other enabling communications. The PMH enables the best possible outcomes for each person, the practice population and the community being served.

Framework for the Patient’s Medical Home

Patient-Centered

  • Connected with and responsive to patients' wants, needs and preferences

  • User-friendly options for accessing information and care should be available

Personal Family Physician

  • Every person should have a personal family physician with whom they can trust, to play a key role in coordinating their care (by 2020)

  • Every person should have a personal family physician whose practice serves as a medical home (by 2022)

Team-based Care

  • Teams that are cohesive and that value continuous relationships with patients that offer a broad scope of services carried out by the teams or a network of providers

Timely Access

  • Access 24/7, 365 days a year

  • Timely access and advocacy for coordinated appointments

  • Same-day access

Comprehensive Care

  • Provide a comprehensive range of services to meet the health needs of the patients and the population being served, considering undifferentiated illnesses, complex medical procedures, socioeconomic factors, etc.

Continuity

  • Continuity of caregivers and relationship with the medical home

  • Continuity of medical setting, information, and relationships for patients in various settings, including hospitals, long-term care facilities, the patient's residence, etc.

Electronic Records and Health Information

  • Enhance the capacity of every practice to store and recall medical information

  • All family physicians in Canada should be using electronic medical records in their practice (by 2022)

Education, Training and Research

  • Prime locations for the experiential training of students and residents

  • Encourage and support their health professionals to participate in research

Evaluation

  • All health professional team members participating in an ongoing evaluation as part of continuous quality improvement (CQI)

  • CQI programs that evaluate quality, cost effectiveness and patient satisfaction

System Supports

  • Sufficient system funding

  • Blended payment models introduced as preferred options

  • Internally, through governance and management structures defined by each practice

  • Externally, by all stakeholders; the government, the public, health professionals, etc.

The Alberta Medical Association stands as an advocate for its physician members, providing leadership & support for their role in the provision of quality health care.