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The TransforMED Medical Home Model

In much the same way that primary care treats the whole person, the TransforMED Medical Home Model recognizes that all the elements of a successful Medical Home practice are interrelated, thus the TransforMED approach "treats the whole practice."

The benefits of this TransforMED Medical Home Model are even now emerging from the National Demonstration Project.

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a full-color PDF of the
The TMED Medical Home Model


The TransforMED Medical Home Model

A Patient-Centered Personal Medical Home
A continuous relationship with a personal physician
caring for the whole person

  1. Mindful clinician-patient communication:
    trust, respect, shared decision-making
  2. Patient partnership
  3. Cultural competency
  4. Continuous relationship
  5. Whole person care
 
Practice Management
• Disciplined financial management
• Change management
• Optimized office design/redesign
• Cost-Benefit decision-making		   • Revenue enhancement
• Optimized coding & billing
• Personnel
• Facilities management
Information Systems
• Electronic health record
• e-Lab and e-Prescriptions
• Disease registries
• Evidence-based decision support
• Population-based mgm't software
• Best practice point-of-care reminders
• Website / Patient portal		   Quality and Safety
• Evidence-based best practices
• Medication management
• Patient satisfaction feedback
• Evidence-based outcomes analysis
• Quality improvement
• Risk management
• Regulatory compliance
Access to Care & Information
• Same-day appointments
• After-hours access coverage
• Lab results highly accessible
• Online patient services
• e-Visits
• Group visits
• Culturally sensitive care		   Team-Based Care
• Physician leadership
• Inter-disciplinary care team
• NP / PA
• Effective staff communication
• Task delegation by skill set
• Front/Back office shared vision
Continuity of Care Services
• Comprehensive care
• Coordinated care
• Collaborative relationships
• Hospital care
• Behavioral health care
• Maternity care
• Hospice care
• Community-based services
• Specialist care 		  Point of Care Services
• Acute and chronic care
• Disease prevention & mgm't
• Wellness promotion
• Procedures
• Ancillary services

 
IN THIS SECTION
About the Nat'l Demonstration Project
The TransforMED Medical Home Model
Participating Practices
Selection Process
Evaluation Team
Methods & Measures
Data Collection

 

“Piecemeal approaches to improving health care are unlikely to improve quality or enhance value over the long term. Rather, the key lies in profoundly transforming health care delivery and financing to promote more effective and efficient care for all. With this effort, TransforMED is moving our country toward a high-performance health system.”

James C. Martin, MD, board chair of TransforMED and past chair of the Future of Family Medicine Project Leadership Committee.


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