Asking the Patient About Patient-Centered Medical Homes: A Qualitative Analysis

In the Journal of General Internal Medicine, Jaya Aysola and colleagues, including Rachel Werner and Judy Shea, assess patients’ perspectives of the patient-centered medical home (PCMH) model and compare responses by degree of practice-level PCMH adoption and patient race/ethnicity. The authors interviewed 48 patients with diabetes and/or hypertension enrolled in PCMHs within the University of Pennsylvania Health System. They purposively sampled minority and non-minority patients from the four highest-ranked and four lowest-ranked PCMH-adopting practices to determine whether responses varied by degree of PCMH adoption or patient race/ethnicity. In phone interviews they asked participants about their experience with delivery of care at their PCMH as well as their perception and understanding of the PCMH model overall. They find that patients uniformly lacked awareness of the PCMH concept, and the vast majority perceived no PCMH-related structural changes, regardless of the degree of practice-reported PCMH adoption or the patient's race/ethnicity. Despite this lack of awareness, patients overwhelmingly reported positive relationships with their provider and positive overall experiences. The authors conclude that as primary care is redesigned with an emphasis on patient experience as a performance metric, it is important to better understand what, if any, aspects of practice structure relate to patient experience and satisfaction with care.