The Patient-Centered Medical Home (PCMH) is a primary care model that provides coordinated and comprehensive care to patients to improve health outcomes. This paper addresses practical issues that arise when transitioning a traditional primary care practice into a PCMH recognized by the National Committee for Quality Assurance (NCQA). Individual organizations' experiences with this transition were gathered at a PCMH workshop in Alexandria, Virginia in June 2010. An analysis of their experiences has been used along with a literature review to reveal common challenges that must be addressed in ways that are responsive to the practice and patients’ needs. These are: NCQA guidance, promoting provider buy-in, leveraging electronic medical records, changing office culture, and realigning workspace in the practice to accommodate services needed to carry out the intent of PCMH. The NCQA provides a set of standards for implementing the PCMH model, but these standards lack many specifics that will be relied on in location situations. While many researchers and providers have made critiques, we see this vagueness as allowing for greater flexibility in how a practice implements PCMH. 1. Introduction In response to the increasing demand for an improved healthcare system in the United States, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, and the American Osteopathic Association developed the Joint Principles of the Patient-Centered Medical Home (Table 1 [1]) [2]. The Patient-Centered Medical Home (PCMH) is an extension of internationally employed Edward Wagner’s Chronic Care Model (CCM). The CCM was developed to address the increasing rate of patients with chronic conditions in the United States using team-based care. The rate of chronic conditions is currently estimated to be 2.2 conditions for individuals having 60 years old and up, on average [3]. In its implementation, the CCM has proven to reduce patients’ healthcare costs and improve patient care quality, two elements directly aligned with the goals of the PCMH [3]. The PCMH model strives to provide quality, coordinated, and cost-effective care to patients and to increase access to services. In addition, it aims to increase practice efficiency and subsequently provider and patient satisfaction. Within this paper, we follow the process of implementing the PCMH Model within primary care practices and discuss the difficulties these practices have encountered in the transition as well as potential solutions. Our goal is to provide future PCMHs
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