Patient’s Medical Home practices serve as ideal sites for training medical students, family medicine residents, and those in other health professions, as well as for carrying out family practice and primary care research. The PMH model’s emphasis on research and education is intended to ensure that the knowledge and expertise of family medicine practitioners can be shared with the broader health care community to improve the health care of all Canadians.
Supporting Research Articles
Applequist J, Miller-Day M, Cronholm PF, Gabbay RA, Bowen DS. "In Principle We Have Agreement, But in Practice It Is a Bit More Difficult": Obtaining Organizational Buy-In to Patient-Centered Medical Home Transformation. Qual Health Res. 2017;
Grounding itself in stakeholder theory, this study analyzed interviews with staff, administration, and practitioners from 20 medical practices in a mid-Atlantic state. The analysis revealed three overarching themes: (a) communication among staff that is open, consistent; (b) implementation of reinforcement techniques; and (c) access to a change implementer who encourages successful evolution.
Flieger SP. Implementing the patient-centered medical home in complex adaptive systems: Becoming a relationship-centered patient-centered medical home. Health Care Manage Rev. 2017;
Team-based care offers a robust opportunity to move beyond the structures to focus on relationships and collaboration.
Rosland AM, Wong E, Maciejewski M, Zulman D, Piegari R, Fihn S, Nelson K. Patient-Centered Medical Home Implementation and Improved Chronic Disease Quality: A Longitudinal Observational Study.
Health Serv Res. 2017;
Veterans Health Administration primary care clinics with the most PCMH components in place in 2012 had greater improvements in several chronic disease quality measures in 2009-2013 than the lowest PCMH clinics.
Applequist J, Miller-Day M, Cronholm PF, Gabbay RA, Bowen DS. “In Principle We Have Agreement, But in Practice It Is a Bit More Difficult”: Obtaining Organizational Buy-In to Patient-Centered Medical Home Transformation. Qual Health Res. 2016;
Overall, this study suggests that addressing basic communicative principles among practice team members before, during, and after rollout can increase buy-in when done in an effective manner alongside principles of stakeholder theory. Medical practice members must develop better communicative strategies among providers when undergoing the evolution in order to best benefit from its outcomes.
Cronholm PF, Klusaritz H, Nguyen GT, Kellom K, Kearney M, Miller-Day M, Gabbay R. Resident Engagement in the Patient-Centered Medical Home. Fam Med. 2016;
The presented data describe the complexities of preparing the next generation of providers for practice. Our mixed-methods study illustrated the strengths of participating in the learning collaborative but also areas of focus necessary for improving the experience and educational benefits of PCMH-related curricula involving residents.
Hall barber K, Schultz K, Scott A, Pollock E, Kotecha J, Martin D. Teaching Quality Improvement in Graduate Medical Education: An Experiential and Team-Based Approach to the Acquisition of Quality Improvement Competencies. Acad Med. 2015;
This study evaluates a graduate medical education curriculum to engage family physicians in quality improvement initiatives. The curriculum successfully improved resident compentency to apply quality improvement methods to their practice and research roles.
Shaw, N. (2014). The role of the professional association: A grounded theory study of electronic medical records usage in Ontario, Canada. International Journal of Information Management, 34(2), 200-209. doi:10.1016/j.ijinfomgt.2013.12.007
Summary of Findings: This grounded theory study examines physician’s experiences with electronic medical record use through interviews and surveys. Physicians reported significant benefits such as ease of use, improvement to comprehensiveness of care and more efficient use of clinical resources.
Wald, H., George, P., Reis, S., & Taylor, J. (2014). Electronic health record training in undergraduate medical education: bridging theory to practice with curricula for empowering patient- and relationship-centered care in the computerized setting. Academic Medicine, 89, 380-386.
Summary of Findings: This study discusses the benefits of Electronic Medical Record (EMR) use as part of a physicians undergraduate medical education, exemplified at the Alpert Medical School of Brown University. Graduates of the program are exponetially more confident in intergrating electronic medical records into the patient-physician relationship.
Sukalich, S., Elliott, J., Ruffner, G. (2014). Teaching medical error disclosure to residents using patient-centered simulation training. Journal of Academic Medicine , 89, 136-143.
Summary of Findings: This study evaluates medical error disclosure to patients as a part of medical training as this is an important part of patient-centred care. Residents with training in medical error disclosure show statistically significant improvements in comprehensive care.
Lakbala, P., & Dindarloo, K. (2014). Physicians’ perception and attitude toward electronic medical records. The Journal of Family Medicine, 3, 63.
Summary of Findings: This cross-sectional survey found that physician’s perceptions of Electronic Medical Records are largely positive. Over 85% of physicians surveyed believe EMR’s should be implemented with the help of government and policy makers to provide incentives.
Muller, S. (2014). Electronic medical records: the way forward for primary care research?. The Journal of Family Practice, 31, 127-129.
Summary of Findings: This article suggests electronic medical records may also be used as a valuable medical research tool with patient consent. Research suggests this information may be a valuable quality improvement tool for patient-centred care.
Oswald, A., Czupryn, J., Wiseman, J., & Snell, L. (2014). Patient‐centred education: What do students think? Medical Education, 48(2), 170-180. doi:10.1111/medu.12287
Summary of Findings: In this study, pre-clinical medical students were asked to submit written assignments on patient-centredness. Most students reported seeing illness in the context of patients lives as a primary component of quality care, emphasising the necessity of patient-centredness as a core aspect of a healthcare system.
Kamrul, R., Malin, G., & Ramsden, V. (2014). Beauty of patient-centred care within a cultural context. Canadian Family Physician, 60, 313.
Summary of Findings: This journal article discusses the importance of patient-centred care, primarily in a Canadian culturally diverse context. The researchers encourage a level of cultural competency as a powerful component in comprehensive, patient centred care.
Sibbald, S. L., McPherson, C., & Kothari, A. (2013). Ontario primary care reform and quality improvement activities: An environmental scan. BMC Health Services Research, 13(1), 209. doi: http://dx.doi.org/10.1186/1472-6963-13-209
Summary of Findings: This study evaluates current quality improvement initiatives in Ontario, Canada and recommends an organized framework to ensure Patient’s Medical Home goals are met.
Daniel, D., Wagner, E., Coleman, K., Schaefer, J., Austin, B., & Abrams, M. (2013). Assessing Progress toward Becoming a Patient‐Centered Medical Home: An Assessment Tool for Practice Transformation. Health Services Research, 48, 1879-1897.
Summary of Findings: This study provides a Patients Medical Home implementation guide to monitor clinic progress in transitioning to patient-centred care. It highlights the importance of clinic quality improvement to ensure the best possible patient outcomes.
Hilts, L., Howard, M., Price, D., Risdon, C., Agarwal, G., & Childs, A. (2013). Helping primary care teams emerge through a quality improvement program. Family Practice, 30.
Summary of Findings: This study measured the relationship between healthcare team perceptions on their care roles and patient health outcomes. Healthcare teams with a better understanding of their role tended to see higher positive patient health outcomes.
Giordano, C., Arenson, C., Lyons, K., Collins, L., Umland, E., Smith, K. (2013). Effect of the health mentors program on student attitudes toward team care. Journal of the American Board of Family Medicine , 42, 120.
Summary of Findings: This study evaluates the effects of a longitudinal study on an education program to train future health professionals skills for efficient team-based care. The program resulted in a significant improvement in attitudes toward team care in addition to a higher quality of care.
Henschen, B., Garcia, P., Jacobson, B., Ryan, E., Woods, D., Wayne, D, et al. (2013) The Patient Centered Medical Home as Curricular Model: Perceived Impact of the "Education-Centered Medical Home". Journal of general internal medicine : JGIM, 28, 1105-1109.
Summary of Findings: This study tests the effectiveness of a program called the Education-Centred Medical home, which implements patient-centred care oriented goals into the final years of medical training. Students reported significantly higher levels of confidence in practicing continuity of care and patient centred care.
Fawole, O., Dy, S., Wilson, R., Lau, B., Martinez, K., Apostol, C., et al. (2013). A Systematic Review of Communication Quality Improvement Interventions for Patients with Advanced and Serious Illness. Journal of General Internal Medicine: JGIM, 28, 570.
Summary of Findings: This study evaluates the impact of various quality improvement methods on physician-patient communication. It finds that patient-centred consultative care is the most effective quality improvement intervention, especially among the chronically ill.
Brown, A. E., & Pavlik, V. N. (2013). Patient Centred Research Happens in Practice-Based Research Networks. Journal of the American Board of Family Medicine, 26, 481-483.
Summary of Findings: This article discusses the benefits of conduting medical research in a clinic setting in order to obtain the best patient-centred results. Research suggests that policy makers invest in patient-centred research in these settings for outcomes that can be applied to actual medical practice.
MacCarthy, D., Kallstrom, L., Kadlec, H., & Hollander, M. (2012). Improving primary care in british columbia, canada: Evaluation of a peer-to-peer continuing education program for family physicians. BMC Medical Education, 12, 110. doi: http://dx.doi.org/10.1186/1472-6920-12-110
Summary of Findings: This study determines a Practice Support Program (PSP) in British Columbia, Canada is an effective way to improve physician office efficiency, strategize wait time reduction methods. Additionally, after participating the PSP program, over 82% participants felt more comfortable diagnosing and treating mental health conditions.
Klemenc-Ketis, Z., Vanden Bussche, P., Rochfort, A., Emaus, C., Eriksson, T., & Kersnik, J. (2012). Teaching quality improvement in family medicine. Education For Primary Care, 23(6), 378-381.
Summary of Findings: This research report discusses the importance of teaching quality improvement measures throughout medical education. System performance, professional development and patient outcomes significantly benefit from consistant quality improvement systems so that policy makers can make informed decisions on the best practices for patient-centred care.
Uijen, A., Schers, H., Schellevis, F., & van den Bosch, W. (2012). How unique is continuity of care? A review of continuity and related concepts. The Journal of Family Practice , 29, 264-271.
Summary of Findings: This study examines the universality of the realtionship between the patient and their personal family physician, communication between healthcare professionals. Researchers recommend health policy makers prioritize these aspects of the Patient’s Medical Home as it has proven to be instrumental to high quality care.
Zhou YY, Kanter MH, Wang JJ, Garrido T. Improved quality at Kaiser Permanente through e-mail between physicians and patients. Health Aff. 2010;29(7):1370-1375.
Summary of Findings: Implementing secure patient to physican e-mail as part of their EMR system, the clinic saw a statistically significant improvement in the overall health of diabetic patients.
Soklaridis S, Oandasan I, Kimpton S. Family health teams: can health professionals learn to work together? Canadian Family Physician. 2007;53(7):1198-1199.
Summary of Findings: This study finds the need for more effective opportunities in academic primary care settings for future primary physicians are able to practice teamwork and collaboration with other health professionals.