Army Medicine is in the process of transitioning from a Healthcare System to a System of Health to better serve our patients and beneficiaries. The central driver to achieving a System of Health is the Patient Centered Medical Home (PCMH). PCMH is a proven model of longitudinal healthcare delivery; its core principles have been endorsed by numerous national medical organizations including the American Medical Association (AMA), American College of Physicians (ACP), American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP), American Academy of Nursing (AAN), American College of Healthcare Executives (ACHE) and Medical Group Management Association (MGMA). A growing body of data in the literature indicates that a system of health built around individual PCMHs results in improved access and continuity of care, higher levels of staff and patient satisfaction, better quality of care (as measured by traditional outcome measures), lower emergency department utilization, lower healthcare costs, and improved Soldier and family readiness. Placing the patient at the center of his/her care and focusing on prevention and education facilitates the transition towards a System of Health.
By 2013 all Army primary care clinics across the Pacific will convert to the PCMH standard. PCMHs are designed to deliver ‘‘total care,’’ utilizing the ‘‘whole-person’’ concept, coordinating and integrating evidence-based primary, specialty and wellness/preventive care in a comprehensive care plan process with the goal of customizing care to the unique needs of each individual patient. Additionally, PCMH providers will optimize communication between the patient and the PCMH team including traditional face-to-face interaction, as well as virtual/remote interface via telephone, video and secure email messaging to improve care.
To compliment the “total care” concept, a patient’s PCMH will consist of a physician, physician assistant or nurse practitioner civilian, military, and contract case managers, registered and licensed nurses, 68 W’s, medical technicians, medical assistants and medical clerks. Extended members of the team may include (but are not limited to) behavioral health providers, pharmacy assets, laboratory assets, physical therapy providers, nutrition care providers, Exceptional Family Member Program (EFMP) case managers, other specialty providers, and administrative services.
Current Patient Centered Medical Homes include: Brian Allgood Army Community Hospital (Korea); Tripler Army Medical Center’s Internal Medicine Clinic, Family Medicine Clinic, and Pediatric Adolescent Clinic; U.S. Army Health Clinic-Camp Zama (Japan); and U.S. Army Health Clinic-Schofield Barracks’ Family Primary Care.
Soldier Centered Medical Homes
The Soldier Centered Medical Home (SCMH) is the Soldier’s version of the Patient Centered Medical Home (PCMH). In this integrated staffing model, the organic unit medical staff, augmented with behavioral health and physical therapy, provides care for their assigned Soldiers. SCMH is designed to improve and enhance both individual and unit medical readiness across the Army.
SCMHs are empanelled with active-duty Soldiers, and are located in close proximity to the Soldier’s primary working area, aligning expert clinical teams with individual Soldiers and their unit command. In this construct the SCMH improves access to care, continuity between Soldiers and providers, recovery time, and communication with the command. Soldiers not aligned under an above listed SCMH will continue to receive care through their respective PCMH at Tripler Army Medical Center, Schofield Barracks Health Clinic, or the Warrior Ohana Medical Home in Kapolei.
Current Soldier Centered Medical Homes include the 2nd Brigade Combat Team, 3rd Brigade Combat Team, and 25th Combat Aviation Brigade, all under the 25th Infantry Division in Hawaii.