A 2020 Vision of Patient-Centered Primary Care

In the essay, "A 2020 Vision of Patient-Centered Primary Care," Karen Davis, Ph.D., Stephen Schoenbaum, M.D., M.P.H., and Anne-Marie Audet, M.D., outlined what it will take to orient physician practices around patients. The authors define a patient-centered primary care practice through seven attributes:

* superb access to care
* patient engagement in care
* clinical information systems supporting high-quality care, practice-based learning, and quality improvement
* care coordination
* integrated and comprehensive team care
* routine patient feedback to doctors
* publicly available information on provider performance.

Ensuring that all Americans have a medical home is a first step toward creating a patient-centered health system, say Davis and colleagues. They argue that a package of patient-centered services—such as e-mail visits, automated patient reminders, access to electronic medical records, and same-day appointments or walk-in hours—could be supported through a fixed monthly fee. In addition, pay-for-performance contracts similar to those employed in the United Kingdom could encourage primary care practices to measure and improve the quality of care they deliver. Demonstration projects could test the viability of such models, helping to develop a "business case" for providing patient-centered care.