Implementing a Medical Home — Akin to Do-It-Yourself Brain Surgery?

This morning the Disease Management Care Blog brought an interesting toolkit to my attention. It was published by AHRQ in August 2008, so it’s very recent.

This toolkit describes how to implement the Chronic Care Model (CCM) in your medical practice. The CCM is embedded in the Patient Centered Medical Home (PCMH) model and can be consider a foundational element of the PCMH.

I would call this toolkit “The Medical Home for Dummies, Vol. I”, but then I’m sure the Dummies copyright police would knock on my front door, so I won’t.

Here are a few more details:

• The toolkit is 120 pages, 61 of which are Appendices with web links to specific tools and more in-depth information. I’d guess by the time you print out all the appendices you’ll have thousands of pages in front of you.
• The toolkit truly is a “do it yourself” manual — there’s virtually nothing here about information technology (IT) options and/or vendor options for IT or services to support the PCMH.
• Remember that this is only Volume I.  Volume II presumably would include additional instructions on how to become a full fledged PCMH.

Pardon me for asking the obvious question, but “Who’s actually going to DO all this? Who’s going to ‘bell the cat’ in a typical medical practice and make this happen?’”

It struck me that handing a medical practice this PCMH toolkit is akin to handing me a 1,000 page manual on neurosurgery, saying “Hey, it’s not all that complicated…first you cut at point A1, then at point B2, and by point ZQ64 you’re done.”

I’m eagerly anticipating Vol. II.

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