title: Participatory (re)design of a sociotechnical healthcare delivery system: the Group Health Patient-Centered Medical Home.
abstract: This paper describes one organization's interpretation of the Patient-Centered Medical Home concept and the healthcare delivery system that has emerged from their participatory redesign initiative. Group Health, a large integrated healthcare system based in Seattle, Washington, USA initiated a Patient-Centered Medical Home care delivery system transformation in January 2007. Current theories and evidence about the Patient-Centered Medical Home (PCMH), the Chronic Care Model, and effective primary care were interpreted via a facilitated group process and translated into a core set of 5 system design principles. These design principles guided all subsequent system transformation activities. The central organizing principle is supporting and sustaining the patient-primary care physician relationship. The emergent PCMH healthcare delivery system comprises both opportunistic point-of-care and outreach components, many of which leverage and enhance the organization's health information and communication technologies.
authors.affiliation: University of Washington School of Medicine, Seattle, Washington, USA.
authors.forename: James T
authors.initials: JT
authors.lastname: Tufano
authors.forename: James D
authors.initials: JD
authors.lastname: Ralston
authors.forename: Peter
authors.initials: P
authors.lastname: Tarczy-Hornoch
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Reid
mesh_terms: D003299:Cooperative Behavior; D006123:Group Practice; D007407:Interviews as Topic; D008490:Medical Informatics; D019982:Organizational Case Studies; D018802:Patient-Centered Care; D010865:Pilot Projects; D014861:Washington