For a primary care practice to become a medical home, radical changes are needed not simply in health care delivery, but in other areas like patient engagement, office infrastructure, and billing and reimbursement. In a special supplement to the Journal of General Internal Medicine, authors Charles Homer and Richard Baron outline 10 critical elements necessary for such transformation. They are: committed, competent, and passionate leadership; financial resources; transformed relationships among provider teams, and between those teams and patients and families, communities, and the medical "neighborhood;" active and engaged patients and families; competent management; improvement methods and techniques; expert external support; health information technology; support for care coordination; and staff development. Each of these factors, the authors say, can facilitate success so that primary care transformation "becomes mainstream rather than the province of the innovative few."
This research was supported by The Commonwealth Fund, the Agency for Healthcare Research and Quality, and the American Board of Internal Medicine Foundation.