Patient Centered Medical Home – What is it?

Intro: We're talking wellness at MemorialCare Health System. It's time for Weekly Dose of Wellness. Here's Deborah Howell.

Deborah Howell (Host): Hello there. Welcome to our show. You're listening to Weekly Dose of Wellness brought to you by MemorialCare Health System. I'm Deborah Howell, and today's guest is Dr. Jay Lee, a board-certified family medicine physician at MemorialCare Medical Group's primary care office in Long Beach, California. Prior to joining MemorialCare Medical Group, he worked at community health centers in Southern California and Boston, where he earned a master's in public health at Harvard University. Today we'll be talking to Dr. Lee about the Patient-Centered Medical Home. Welcome, Dr. Lee.

Jay Lee, MD: Hello, Deborah.

Deborah Howell (Host): Always a pleasure to have you on the show. Let's start right off with a question: what is the Patient-Centered Medical Home?

Jay Lee, MD: Well, the first thing I should mention is that the Patient-Centered Medical Home is not a physical home where we put patients. It is rather a philosophy in how to deliver care, and I think the key part of this is the patient-centered aspect. And when we use the word home, it's really to describe the feeling that one would get when they come home. When you come to an office, you want to feel like the members of the office are part of your family. This is something that was originally conceptualized by the pediatric community regarding complex pediatric patients. And in the last 10 years, we've really seen a resurgence of this concept in healthcare as applied to primary care as a means of helping to deliver very personalized care for patients in a very integrated and coordinated fashion.

Deborah Howell (Host): It sure beats the old days where you were just scared to death to go to the doctor because it was so imposing.

Jay Lee, MD: Right, right. And I think I have to give a lot of credit to the healthcare industry. We've taken cues from other parts of the world, such as the hotel industry, around how to make the doctor's office feel a lot more welcoming and a lot more human.

Deborah Howell (Host): Especially for kids, I would imagine.

Jay Lee, MD: Correct, correct. And I think at many of our offices we do have parts of the front office and waiting area specifically designed to feel more like a place where the kids can come and play and there are toys and other materials for kids to take part in.

Deborah Howell (Host): Great. Well, some of the other components or principles of the PCMH model are very interesting. Maybe you could get into that a little bit.

Jay Lee, MD: Sure. I think the best analogy I can think of is sort of the prototypical primary care doctor, Marcus Welby. And there are a lot of positive things about him, you know, he spent a lot of time with patients, he knew their stories, he would go out to their homes. I mean, this is the sort of classic view of what a primary care physician does. And so those elements are still there, and today we call that trying to achieve the Triple Aim. It's looking at how do we enhance the patient experience in the office, and not just in the office, but in terms of the overall care that they're receiving. The other aspect of it is providing value, so that we're not just doing things for the sake of doing things, but that we're doing them because they're important to you as a patient, they're important to your health as a patient, and that they're not just things that we're doing because they're there. And then I think the final piece of that is looking at not just you as an individual but also as a medical group and a health system, how are we going to affect the population around us. How do we get at being able to do that? And part of that is leveraging the technology that we have now, in terms of being all on the same electronic medical record platform. There's a lot of data there that we can look at and utilize for the betterment of people's health. And then the other aspect of it is enhancing communication and efficiency in the office so that when you've had a test done, I don't have to spend or my staff doesn't need to spend 20 minutes hunting it down, that it's easily accessible, that you don't have to repeat or regurgitate everything that a specialist said to you because that information is right at my fingertips.

Deborah Howell (Host): Love it. It's a win-win for everybody. And what are some of the patient benefits of the Patient-Centered Medical Home?

Jay Lee, MD: Right. So I think at the very basic level, I think patients will begin to notice that people are a lot more focused on, I don't know, being friendly and knowing your name and really knowing who you are. And it's not that healthcare is not just a series of transactions, that this is really about the relationship. And the relationship is not just with your doctor, but it's with the team that's supporting the doctor to provide care. And ultimately, really it's about sort of that it's not just that individual doctor in the office, but really it can be a medical group and a health system that are really focused on wanting to provide you and your family and your community great top-notch care.

Deborah Howell (Host): You know, I'm thinking of the person who is so scared to go to the doctor that the blood pressure even goes up. I mean, it really is a physical manifestation.

Jay Lee, MD: Correct. There is something that we call white coat hypertension or white coat high blood pressure. And part of the goal here is to make the office experience feel a lot less intimidating. The other thing that's great about PCMH is that if you don't need to be in the office, that's fine. There are things that we can do like secure messaging and kind of virtual medicine, if you will, that can allow patients to get access to the doctor and the team without actually having to physically be here in the office. And I have a growing number of patients who utilize that service as a way of keeping in touch with me, updating me on things that are going on with them in terms of their goals, questions like, "Hey, should I come into the office for this or do you think this is something that's just going to go away?" And it's not just me responding, it's my nurse, it's my front office, it can be the authorizations folks, the refill folks. It's a way of creating more touch points with the patient, if you will, without having to, you know, sacrifice half a day to come into the doctor's office.

Deborah Howell (Host): And not only half a day, but I focus on the elderly. It is so difficult for some of them to find a ride, to get into, to physically get into a car, to come into an office just to get their blood checked. You know, it's just so wonderful that there are options now.

Jay Lee, MD: Yeah, and I got to say, I'm very impressed with the 65 and older crowd. They have really embraced the use of technology. I have a good percentage of the patients who do email me are above 65. And in fact, the one who impressed me the most was an 89-year-old gentleman who had just moved here and right away he got signed up and he emailed me and it's been a great way for us to get to know each other actually before his first visit.

Deborah Howell (Host): That is awesome. If he could coach his friends, right?

Jay Lee, MD: Exactly, exactly.

Deborah Howell (Host): Oh my. Well, thank you so much, Dr. Lee. It's a great day to be a doctor and a patient, right?

Jay Lee, MD: I agree. And you know, there's a lot of challenges and uncertainty with all the changes that are happening in healthcare, but rest assured, the doctors here at MemorialCare are really focused on wanting to enhance the care that we provide for our patients.

Deborah Howell (Host): Well, you've been a wonderful guest and it makes me want to go to the doctor's office.

Jay Lee, MD: Well, we'll look forward to seeing you there.

Deborah Howell (Host): Thanks so much for being on the program today to talk to us about the Patient-Centered Medical Home. It's a wonderful thing for all. To listen to the podcast or for more information, please visit memorialcare.org. That's memorialcare.org. I'm Deborah Howell. Join us again next time as we explore another Weekly Dose of Wellness brought to you by MemorialCare Health System. Have yourself a fantastic day and don't forget to visit the doctor at least once a year.