What is a Patient-Centered Medical Home?
SEMO Health Network was the first recognized PCMH in the state of Missouri. We have been nationally recognized as a Level III Patient-Centered Medical Home (PCMH). A PCMH is a team-based model of care led by a personal physician who provides continuous and coordinated care throughout a patient’s lifetime following evidence-based guidelines of medical care to maximize health outcomes. The PCMH practice is responsible for providing for all a patient’s health care needs or properly arranging care with other qualified professionals. The PCMH model is a partnership between the patient, his or her medical provider, and a health care team.
What are the benefits of a Patient-Centered Medical Home?
The Patient-Centered Medical Home model provides benefits to both patients and providers. The model allows for increased one-on-one time for the patient and medical provider as well as the access to a team of providers, nurses, and many other healthcare professionals within SEMO Health Network’s practices.
These providers and healthcare professionals include optometrists, community health worker, dietitian, dentists, behavioral health consultant, nurse care managers and patient care coordinators just to name a few.
Another added benefit is that this team of professionals can be found in one facility. The primary focus of your healthcare team is you, the patient. Medical Homes provide comprehensive and coordinated care in the context of individual, cultural, and community needs based upon medical, behavioral, and related social service needs and supports are coordinated and provided by provider and/or arranged.
The Medical homes place an emphasis on education, activation, and empowerment through interpersonal interactions and system-level protocols. At the center of the health/medical home are the patient and their relationship with their primary care team.
Improved Communication and Access to Information
Patients can communicate with a Medical Home team member anytime during normal working hours by calling his or her clinic of choice as well as accessing the patient portal. The portal allows patients to send messages to nursing staff asking questions about medication or medication refills. The patient portal has been implemented into our practice to allow our patients to learn about a particular medical condition, electronically communicate with the healthcare team, and receive electronic reminders about personal conditions. Please contact your clinic of choice to gather more information on the patient portal as well as to enroll.
How will I contact my Medical Home Team?
Patients may contact his or her Medical Home Team directly to arrange an appointment or to discuss a healthcare need by calling the clinic of choice during regular business hours (see below). Outside of normal clinic hours, for urgent matters you can call your clinic and the on-call service will contact your on-call provider and your call will be returned within a timely manner. Please call 911 for all medical emergencies. It will be necessary for you or a family member to let the Medical Home Team know if you are seen by another provider outside of SEMO Health Network which will allow us to coordinate your healthcare needs in a seamless manner.
Tracking Logs for Help With High Blood Pressure and Diabetes
Blood pressure log:
American Heart Association: https://www.heart.org/-/media/files/health-topics/high-blood-pressure/pe-hbp-bloodpressuretracker-ucm_305157.pdf
Blood glucose log:
American Diabetes Organization: http://www.diabetes.org/assets/pdfs/community/stop-d-at-work/employer-resources/lifestyle-tips/blood-glucose-log.pdf