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Background <p>The patient-centered medical home (PCMH) model is increasingly being recognized as the standard of care in primary care settings. Emerging evidence from large academic hospitals found supports for extending the concepts behind the PCMH to specialist-led integrated care models such as the specialty medical home (SMH), where a team of multidisciplinary specialists work together to care for patients with specific conditions.</p> Objectives <p>To explore the scalability of the SMH model to other medical conditions and clinical settings.</p> Methods <p>We conducted semi-structured interviews with 10 patients and 11 providers of chronic and costly, immuno-inflammatory conditions (rheumatologic conditions and endometriosis) to understand relevance and feasibility of scaling the SMH model. Two coders iteratively analyzed the interview transcripts using a codebook, then summarized codes into themes.</p> Results <p>All patients found the SMH model to be relevant to their care, while providers believed the resource-intensive model may only be necessary for a subset of patients. Patients and providers discussed disease complexity, specialists involved, social determinants of health, and disease/life stages as factors they would consider when deciding the relevance of the model to other conditions. Providers and patients also discussed practical implementation factors such as strength of evidence, cost of care, need for specialty staff, geographical access, and technology as factors that would influence the scaling the SMH model.</p> Conclusions <p>The SMH model is of interest to patients and providers. Findings illustrate key factors that needed to be addressed by future research to build a case for scaling the SMH model.</p>

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Scalability of the specialty medical home model to treat patients with inflammatory disease: qualitative interviews with patients and providers

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月17日

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  • Elaine Kwok,
  • Ashley Taylor,
  • Jane Kogan,
  • Benjamin L. Cohen,
  • Stephen Lupe,
  • Eva Szigethy,
  • Laurie Keefer,
  • Cara Nikolajski

摘要

Background

The patient-centered medical home (PCMH) model is increasingly being recognized as the standard of care in primary care settings. Emerging evidence from large academic hospitals found supports for extending the concepts behind the PCMH to specialist-led integrated care models such as the specialty medical home (SMH), where a team of multidisciplinary specialists work together to care for patients with specific conditions.

Objectives

To explore the scalability of the SMH model to other medical conditions and clinical settings.

Methods

We conducted semi-structured interviews with 10 patients and 11 providers of chronic and costly, immuno-inflammatory conditions (rheumatologic conditions and endometriosis) to understand relevance and feasibility of scaling the SMH model. Two coders iteratively analyzed the interview transcripts using a codebook, then summarized codes into themes.

Results

All patients found the SMH model to be relevant to their care, while providers believed the resource-intensive model may only be necessary for a subset of patients. Patients and providers discussed disease complexity, specialists involved, social determinants of health, and disease/life stages as factors they would consider when deciding the relevance of the model to other conditions. Providers and patients also discussed practical implementation factors such as strength of evidence, cost of care, need for specialty staff, geographical access, and technology as factors that would influence the scaling the SMH model.

Conclusions

The SMH model is of interest to patients and providers. Findings illustrate key factors that needed to be addressed by future research to build a case for scaling the SMH model.