New momentum on building a medical home for the child with a chronic health problem

The term "medical home" was introduced in 1967 by the American Academy of Pediatrics to describe a setting that served as a single source of a patient's medical information. In today's pediatric practice, the term refers to a community-based primary care setting that integrates quality and evidence-based standards in providing and coordinating family-centered health promotion in wellness, and in acute and chronic condition management.

All children and youth benefit from quality health care, especially those with a chronic condition. Children and youth with special health care needs account for approximately 15% of patients seen in a primary care practice, but their care represents 42.1% of health care costs.¹ Children with special health care needs may have a common condition, such as recurrent ear infection, asthma, or attention deficit hyperactivity disorder, or they may have a less common but more complex condition, such as cerebral palsy, epilepsy, diabetes, or autism-spectrum disorder.

Three Cs of care: Coordinated, Continuous, Comprehensive

Development of a care plan should involve you or a nurse practitioner, the patient and his (her) family, and other clinicians providing care to the child. All care that is received by the patient from providers outside the medical home (e.g., specialist, early intervention, social services) should be coordinated through the medical home, so that this information resides together with all pertinent medical information, including hospitalizations and specialty care, in a central record or database. If a patient receives specialty care, the medical home provider can evaluate and interpret the consultant's recommendations for the child or youth and family and, in consultation with them and the specialists, implement recommendations that are indicated and appropriate. The medical home also provides information to families about services provided by support and advocacy groups, parent groups, and others involved in the patient's care.