The idealized view of a doctor-patient relationship in America is perhaps best presented by Norman Rockwell”™s “Doctor and Doll,” with a kindly general practitioner listening to the heartbeat of a little girl”™s doll, while she anxiously awaits the prognosis.
But now a better modern model is emerging, led by the Hudson Valley Initiative, a medical collective whose members are among the fastest in the nation to adopt a care model called the patient-centered medical home (PCMH).
Under the PCMH model, a patient selects a primary care practice that is to be their medical home. This PCMH will oversee their diverse medical needs efficiently through coordinated interdisciplinary care, disease prevention and wellness activities as well as adoption and use of medical information technology such as electronic health records and electronic prescribing.
“The PCMH will broaden access to primary care while enhancing care coordination,” said Dr. A. John Blair III, president of Taconic IPA, a nonprofit physician association instrumental in coordinating medical homes in the region. “Primary care providers such as pediatricians, family practitioners and internal medicine doctors act as the general contractor for the patients. They manage a care team that takes care of the patients”™ preventive health needs in addition to their acute rescue health needs.”
The effort is winning recognition. Practitioners in the Hudson Valley Initiative have received the highest level federal certification available for adopting the medical home model.
The National Committee for Quality Assurance (NCQA) had granted recognition to 51 primary care practice sites as ”˜Level 3 patient-centered medical homes,”™ the top level achievable. This certification was achieved by 11 primary care practice groups (with 236 doctors) at seven medical groups with multiple practice locations and four single-site practices within the Hudson Valley. Though a relatively small area geographically, the Hudson Valley represents 44 percent of total Level 3 clinicians in New York, and nearly 10 percent of all practices at this certification level across the country.
“The Hudson Valley Initiative has really set the bar on a very strategic process to bring a large number of practices up to the state of the art of the medical home,” said said NCQA President Margaret E. O’Kane. “We applaud their success and urge other communities just beginning the journey to look at this demonstrated success and learn from it,”
Over the course of a one-year project, the doctors met monthly as the Taconic IPA Medical Council to collaborate to share best practices and solve problems. The medical home transformation project was managed by the Taconic Health Information Network and Community (THINC), another not-for-profit that links medical providers, payers, employers, public health agencies, quality organizations, consumers and local leaders to improve health care for the community.
“THINC is the Switzerland of the Hudson Valley,” said Blair. “They convene disparate healthcare stakeholders and leadership to align strategy and develop new financial models for sustainability of systems that improve health care.”
As for why the Hudson Valley seems a national leader in upgrading health care, Blair cited old fashioned teamwork coordinated by the Hudson Valley Initiative. “You have the synergistic and complementary aspect of  unique and distinct organizations working together for a common purpose, better health for all the Hudson Valley,” said Blair.
