| Medical Home Update |
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Many families, when asked if their child has a Medical Home do not understand the phrase. There is often a mistaken belief that it refers to a structure, their child’s pediatrician’s office. Yet a Medical Home is to the world of healthcare, what your home is to you. It is far more than a structure or any single individual. It is a state of being, a coordinated and respectful health care partnership between a child, his or her parents, and the child’s primary care doctor.
The American Academy of Pediatrics
has developed guidelines for Medical Homes including a list of elements
that helps to define the philosophy (see sidebar). One of the keys
to a Medical Home is that the parents and pediatricians act as partners
in the care of the child. This includes ensuring the family is knowledgeable
about the resources in the community and able to access all medical and
non-medical services necessary to help the child and family achieve their
goals.
What are
the benefits of a Medical Home?
Some parents may question
why they and their children might want or need a Medical Home. A
Medical Home provides an opportunity to develop a long-term relationship
with the same doctor, nursing and office staff. This means there
is someone who knows your family and child, knows how to communicate effectively
with you, and appreciates the exchange of knowledge that happens in a long-term
relationship.
A Medical Home can help you get connected to information, resources and family support organizations. It is an atmosphere where you can raise any issue, even if it is non-medical. Your family feels supported in all stages of growth and development of your child and helps you prepare in advance for the challenging transition to an adult health care provider.
Tips for
families to build Medical Home partnerships
You may already have a Medical
Home. If so, please take a minute at your next visit to thank your
child’s provider and office staff for providing a Medical Home. To
help determine if you do, review the checklist and trust your own instincts.
How you feel about the care your child receives speaks volumes.
Checklist:If you answered yes to all of these questions, you are likely to have a Medical Home. If you answered yes to some, your pediatrician may be on the road to becoming a Medical Home. Take a moment to acknowledge those components of a Medical Home that are already in practice, and encourage him/her to work with the Vermont Medical Home Project on the other elements. Parents can and do make a big difference in the development of a Medical Home. Kim Daniels is a parent partner, a kind of “parent consultant” for Dr. Lou DiNicola’s practice. She found it was “validating to be considered an ‘expert’ in what would make this place a home.”
Yes | No
__ | __ Do you think the pediatrician’s style fits your needs and those of your child?
__ | __ Can you talk easily with this provider? Are there language or cultural barriers?
__ | __ Do you feel heard and respected for your knowledge?
__ | __ Is the office location convenient and accessible?
__ | __ Is there someone available to help with questions and concerns 24 hours a day/7 days a week?
__ | __ Does this provider accept your health insurance?
__ | __ Do you get connected to resources and supports in your community and to statewide organizations?
Regardless of whether you have a Medical Home for your child or not, there are easy steps you can take to enhance your relationship with your child’s provider. When you visit your child’s doctor office, be prepared. Bring a list of questions or concerns to discuss. Share information on how your child is changing. Ask about resources that may help your child and family and find out how to get care after hours if needed.
Take the time to meet with the staff that will be working with you and your child. Be prepared to express what resources you may need help finding, any special challenges you and your child are facing, and be ready to partner with your child’s pediatrician. You both have valuable knowledge and information to share that will result in better outcomes for your child.
Medical
Homes in Vermont
Although it may seem like
a new concept, Vermont has been part of the Maternal and Child Health/AAP
Medical Home Initiative for the past six years. Carl Cooley, MD and
Jeanne McAllister, Co-Directors of the Center for Medical Home Improvement
at the Hood Center for Children and Families at Dartmouth Hitchcock Medical
Center were part of the first wave of funded Medical Home Projects in the
country. In 1997 the Center began working with pediatricians and their
practices in both Vermont and New Hampshire. Dr. Lou DiNicola in
Randolph and Dr. Mark Harris in Bradford have both been part of this initiative
since its inception – four more practices in Vermont are now part of the
Hood Center Medical Home Expansion Project. All six sites are well
underway and have parent partners incorporated into their practices.
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The Vermont Medical Home Project
is an initiative of the Vermont Department of Health and the American Academy
of Pediatrics – Vermont Chapter. Kim Aakre, MD is the Medical Director
of the project and has the ambitious and fulfilling job of introducing
the Medical Home concept to all Vermont pediatricians and helping them
move towards becoming a Medical Home. After an initial round of letters
and informational materials, Kim is now heading out for site visits and
is working with a few interested sites to develop some key components.
Parents have an important
role to play in the development of Medical Homes. Participate in
a focus group (see details at right). Get involved and engage your
pediatrician in a discussion about what is helpful in his/her practice
and what elements of a Medical Home might be missing. Take a moment
to explain what a Medical Home would mean to your family.
Kim Daniels offers some final
words of encouragement: “To other parents who would like to develop a Medical
Home, I would encourage them to take ownership in making this happen.
Parents are the experts and when they are not at the table the real change
cannot happen.”
©
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Fall
2003 - In this Issue:
Board
& Staff Update
Family
Support Report
Supporting
Parent Honor
Family
Voices of Vermont
Partners
In Care Conference '03
Inn
Raffle #2!
Family
Story Update: Demeritt
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