History

The concept of the "medical home" was first described in Standards of Child Care by the American Academy of Pediatrics (AAP) Council on Pediatrics Practice in 1967. It defined

"ideal care" for children with disabilities as a practice that provided care that was accessible, coordinated, family centered, and culturally effective.

The American Academy of Family Physicians (AAFP) used this concept to expand the characteristics based on discussions defining the future of family medicine. These characteristics described the "personal" medical home, which focused on bringing attention to the importance of continuous, relationship-centered, whole-system, comprehensive care for communities (Martin et al., 2004). In 2007 the AAP, AAFP, American College of Physicians (ACP), and American Osteopathic Association (AOA) collaborated to define further the foundational principles of the patient-centered medical home (PCMH; Table 2-1). The goal of the medical home is to emphasize the importance of primary care in improving quality of care, health outcomes, and patient experience, with improved cost-efficiency.

However, the ingredients of the medical home (or "health home") continue to be defined and modified based on the needs of the clinicians and communities who implement them. These ingredients and how they are delivered are key to the achievement of the lofty goals of the medical home and family medicine in general. This chapter discusses the most important ingredients for the medical home and the actions that the family physician must take to create one.

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