Medical Home Model

What is a Medical Home?

A Medical Home is how you and your family receive health care services. A Medical Home can be the doctor’s office, community clinic, or local health department where you take your children for all their health care needs.

The American Academy of Pediatrics (AAP) describes the medical home as a model of delivering care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective.(1)

What does Accessible mean?(2)

Accessible means that the:

  • Care is provided in your community
  • Doctor’s office accepts your insurance
  • Location meets the Americans with Disabilities Act (ADA) requirements
  • Family has access to health advice or care around the clock, 365 days per year
  • Office is accessible by public transportation, if needed.

What does this mean for a family with a child who has an Autism Spectrum Disorder (ASD)?

This means that:

  • A family doesn’t have to travel more than twenty miles to an appointment
  • The family’s insurance is accepted - including MaineCare, no matter what,
  • The hours of the doctor’s office is more than just 9 – 5 Monday– Friday, some hours are after 5 and on weekends so families don’t have to use the emergency room; and the doctor’s office is open to making changes for your child’s sensory needs.

What does Continuous mean?

Continuous means that the family has:

  • The same doctors for their child from infancy through adolescence
  • Communication occurs between doctors and specialists to ensure the family’s and child’s needs are met at any age
  • Assistance provided to secure a medical home for adolescents as they transition to adult care

What does this mean for a family with a child who has an Autism Spectrum Disorder (ASD)?

This means that:

  • The family has a doctor that knows their child from infancy through adolescence which is very helpful for a child who struggles with change and new faces
  • When a family is referred to a specialist, the specialist and the doctor talk before the appointment and the specialist is made aware of the needs of the child.
  • The family has the opportunity to visit the specialist’s office prior to the actual appointment to help the child become familiar with the office and surroundings
  • Once the child begins the transition to adulthood, the family is provided with information about how, when, and where to start the process.
  • There are many things that parents should know prior to their child turning eighteen and a doctor’s office should help the family navigate those changes.

What does Comprehensive mean?

Comprehensive means that the:

  • Family receives both preventive and primary care
  • Child receives growth and development assessments, when appropriate
  • Family receives care that is coordinated across all doctors, therapists, and treatment settings for their child
  • Referrals to specialty – care services are available and offered when needed
  • Family/child has access to counseling and health education as part of visits or is available upon request
  • Doctor is knowledgeable about community resources and shares information

What does this mean for a family with a child who has an Autism Spectrum Disorder (ASD)?

This means that:

  • Families feel welcome and the office environment meets the needs of their child (sensory)
  • When a child is not meeting their milestones the doctor or nurse explains what that means in terms families can understand and they offer families options about what can be done to help improve the child’s skills
  • If the doctor has to refer your child to a specialist, the practice makes sure that it’s an office that understands the family and child’s needs
  • The doctor’s office accepts their insurance
  • The doctor’s office has hours that can accommodate the family
  • The medical practice connects parents to agencies in their area where they can get support, help, information, or just a place they can call and talk with someone who knows how they feel.

What does Coordinated mean?

Coordinated means that the:

  • Family is linked to appropriate educational, and community services and supports
  • Doctor’s office staff communicate and work with all agencies to ensure all your child’s needs are met
  • There is a centralized record containing important information on your child’s care and this record is maintained by the family, the doctor and office staff

What does this mean for a family with a child who has an Autism Spectrum Disorder (ASD)?

This means that:

  • The doctor’s office knows about every aspect of your child’s treatment
  • The doctor’s office is familiar with what home support is and how your family can get it
  • The doctor’s office is familiar with what and Individualized Education Program (IEP) is and understand the information it contains
  • The doctor’s office is familiar with the school evaluations and knows why they are important.
  • The doctor’s office ensures that treatment makes sense for the child and family and that services are coordinated to maximize outcomes for the child
  • The doctor’s office provides an electronic document that can be sent to a provider who needs it to support families from having to repeat their story each time they see a new provider.

What does Compassionate mean?

Compassionate means that the:

  • Doctor shows concern for the well being of the child and the family as a whole
  • Doctor shows understanding for the variety of emotions a family with a child with special health care needs may experience
  • Office staff is flexible and responsive to your requests and needs
  • Office staff offer privacy when requested
  • Appointment times are scheduled with consideration of you and your family’s needs

What does this mean for a family with a child who has an Autism Spectrum Disorder (ASD)?

This means that:

  • The doctor will recognize not only your child’s needs but also the needs of the family
  • Office staff works with the family to make their child’s visit successful, for example the child is permitted to wait in an examination room instead of waiting in the waiting are. This can help reduce stress, prevent a meltdown, and prevent the child from becoming over stimulated
  • Office staff consult with the doctor about any special requests from the family, rather than saying “No we can’t do that”

What does Culturally Effective mean?

Culturally Effective means that:

  • Your family’s cultural background is recognized, valued, and respected
  • Office staff are sensitive to stereotypes and cultural assumptions
  • Multi-language materials and translation services are made available as needed

What does this mean for a family with a child who has an Autism Spectrum Disorder (ASD)?

This means that:

  • Office staff and physicians are knowledgeable about a family’s culture and understand how to phrase medical advice to the family
  • The doctor’s office has someone on hand to translate if the family speaks a different language.
  • This helps the family understand the doctor better and it show that the doctor values the family for who they are
  • The doctor’s office gets material written in the family’s native language whenever possible

What does Family Centered mean?

Family Centered means that:

  • Office staff recognize that your family members are the principle caregivers and the center of strength and support for your child
  • Your doctor and family share the responsibility in decision making

What does this mean for a family with a child who has an Autism Spectrum Disorder (ASD)?

This means that:

  • A medical practice works closely with a family so that ideas can be shared and respected

Sources

1. American Academy of Pediatrics, Patient-Centered Medical Home Consensus statement.
   www.pcpcc.net/files/preamble_joint_preamble_0.pdf

2. Adapted from: What is a medical home? And what does it mean for you and your child? University at Chicago, Division of Specialized Care for Children, publication 40,16,2003.

 

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