An Innovative Strategy for Lean Scheduling and Same Day Access (Nelson, Fann)
Guidelines for the Clinical Use of Electronic Mail with Patients

Patient Self-Management    

Partnering in Self Management Support (Robert Wood Johnson)

Helping Patients Manage Their Chronic Conditions (Calif. Healthcare Found.)
Using Telephone Support to Manage Chronic Disease (Calif. Healthcare Found.)
Promoting Self-Management

AHRQ PCMH Resources          

AHRQ PCMH Definition
Engaging Patients and Families in the Medical Home

Integrating Mental Health Treatment into the PCMH

Practice-Based Population Health: I.T. to Support Transformation to Proactive Primary Care

The HITECH Act and Health Information Technology's Potential to Build Medical Homes
AHRQ Innovations Exchange Resource Index (Link)

Alaska Health Care Commission    
Alaska Health Care Commission Website (link)

Members of the Alaska Health Care Commission (2010)
2009 AHCC Report_2010-2014 Strategic Plan (AHCC)
2010 AHCC Report_2010-2014 Strategic Plan (AHCC)

Care Teams      
Building Teams in Primary Care - Case studies (California Health Care Foundation)
Building Teams in Primary Care - Lessons learned (California Health Care Foundation)

A New Approach to Making Your Doctor Nurse Team More Productive (Family Practice Management)

Practiced-Based Care Coordination, A Medical Home Essential (AAP)

Reducing Cycle Time (TransforMed)

Teamwork Is Crucial To New Model of Care (Borgmeyer)

Through The Eyes of Your Patients (Dartmouth College)

Workflow Considerations (Nelson)

Work Relationship Form (FPM)
Continuous and Team Based Healing Relationships (Qualis)

Change Management     

8 Tips for Change Management (TransforMed)

10 Principles of Change Management (Jones, Aquirre, Calderone)

Is Your Practice Ready for Change? (TransforMed)

Cycle of Change (Britten & Associates)

The Key to Implementing Change in Your Practice (TransforMed)
Making change last: How to get beyond change fatigue (Ivey Business Journal)

Managers:  Your Projects Fail Because Your Communication Stinks (Stannard)
Techniques for Managing an Efficient Office in the Midst of Change (TransforMed)

The Passive-Aggressive Organization (Neilson, Pasternack, Van Nuys)

The Road Map for Transformational Change (Power Point) (U.K. National Health Service)

CMS Meaningful Use & EHR Incentive Programs    

EHR Incentive Program - Timeline

EHR Incentive Program - Medicaid Provisions

EHR Incentive Program - Medicaid Questions

EHR Incentive Program - Contact Information
EHR Incentive Program - Clinical Quality Measures
Physicians Guide to EHR Incentives (AAFP)

CMS Guidance to State Medicaid Agencies (CMS)

Alaska eHealth Network Overview (AeHN)

Meaningful Use Criteria, Stage 1

First CMS National Demonstration Project (June 2006 - June 2008)     

Initial Lessons From The First National Demonstration Project (Annals of Family Medicine)

Practices Participating in the First National Demonstration Project (list)

Preliminary Answers to Policy-Relevant Questions from the First NDP (TransforMed)

More Preliminary Answers to Policy-Relevant Questions from the First NDP (TransforMed)

Context for understanding the NDP and the PCMH_S2 (Annals FamMed)

Effect of Facilitation on Practice Outcomes in the NDP of the PCMH_S33 (Annals FamMed)

Implementing the PCMH_Observations of the NDP_S21  (Annals FamMed)
Journey to the PCMH_Analysis of Practice Experiences in the NDP_S45  (Annals FamMed)

Methods for evaluating Practice Change toward a PCMH_S9 (Annals FamMed)
Patient Outcomes_Month 26 of the PCMH NDP_S57 (Annals FamMed)

Transformation is hard work (TransforMed)

Myrtue Medical Center Experience (Kiltgaard)

Other Demonstration Projects & Resources
Nationwide Survey of PCMH Demonstration Projects (2009) (Bitton, Martin, Landon)
Outcomes of PCMH Interventions (PCPCC)
List of state pilot projects (link) (PCPCC)

Qualis Health Safety Net Medical Home Initiative    
Providing Underserved Patients with Medical Homes (Commonwealth Fund)
The 8 Change Concepts
Change Concepts Resource Site (link) (Qualis)
Change Concepts Implementation Guides (link) (Qualis)
Clinical Standards for Empanelment
Engaged Leadership
Patient-Centered Interactions (implementation)
Medicaid and the PCMH
Patient-Centered Interactions (deck)
Patient Centered Medical Home Self Assessment
Team Based Care

Joint Commission Primary Care Home    

Fact Sheet
Expert Panel Members
Primary Care Home Principles (Draft for public comment)
Primary Care Home Standards (Draft for public comment)
Primary Care Home Initiative home page (Link)

PCMH Models and Definitions    

Models

-  NCQA Standards (This is the whole standards document)

-  TransforMed Model

-  Qualis Medical Home

-  URAC's PCHCH
-  Oregon PCMH Standards

-  Medical Home Models Summary (Mathematica)

-  IowaCare Medical Home Model

Definitions

-  Joint Principles of the PCMH (AAFP, AAP, ACP, AOA)

-  Joint Principles of the PCMH, Addendum 2 (AAFP)

-  AHRQ's Defintion of a Medical Home (AHRQ)

-  NCQA PCMH Overview (NCQA)

-  URAC's PCHCH Definition (URAC)
- Principles for Patient and Family Centered Care (National Partnership)

Commonwealth Fund Documents  

Building Medical Homes in State Medicaid and CHIP Programs

Initial Lessons from PCMH National Demonstration Projects

Sharing Personnel and Resources to Support PCMHs

Structuring Payment for Medical Homes

Survey of PCMH Demonstration Projects

Lean Practices       

Lean Healthcare (Graban)

Using Lean Methodology in a Critical Access Hospital (CFMC)

NCQA Documents   
NCQA PCMH brochure   
Recognizing Physician Practices as Medical Homes (NCQA)
NCQA Must Pass Elements (list)
NCQA Programs to Evaluate Patient-Centered Medical Homes (NCQA)
PCMH Glossary (NCQA)
PCMH Overview (NCQA)
The NCQA PPC-PCMH Recognition Process (NCQA)
PPC-PCMH Content and Scoring (NCQA)
Standards & Guidelines for PPC-PCMH (NCQA) (This is the whole standards document)
NCQA PPC-PCMH Companion Guide
NCQA PCMH 2011 Documents
Planned evolution of NCQA PCMH Standards
PCMH 2011 Draft Standards
NCQA Public Comment Standards_PCMH 2011 (Due by June 28,2010)
NCQA 2011 Standards White Paper

NCQA PCMH 2011 Standards (whole standards document)

NCQA PCMH 2011_Appendix-scoring

NCQA PCMH 2011_Appendix-Meaningful use

NCQA PCMH 2011_Appendix-Glossary

Dartmouth College - Advanced Microsystems Toolkits & Resources  

Access workbook (Dartmouth College)
Measuring Access Improvement (Dartmouth College)
Partnering in Self-Management Support (New Health Partnerships)
Shared Medical Appointments flyer (Dartmouth College)
Through the eyes of your patient form (Dartmouth College)

Primary Care Development Corporation (PCDC) Documents     

Addendum 1: Outcomes of Implementing PCMH
Addendum 2: Slide template for communicating with staff

Addendum 3: Slide template for communicating with board

Addendum 4: Team Selection Grid
Addendum 5: Project Team Charter Template
Addendum 6: Baseline PCMH self-assessment tool
Addendum 7: Project Calendar Template

Addendum 8: Documentation & Data Needs

Addendum 9: Additional elements to implement grid

Addendum 10: Additional HIT needs grid

Addendum 11: Action Plan Template
Addendum 12: Reference grid by element
Addendum 13: NCQA PPC-PCMH Comparison Guide

Master Manual: Obtaining PCMH Recognition: A How-To Manual

2011 NCQA Self Assessment Tool

General PCMH Articles & Information     

What MA's Can Do For Your Practice (AAFP)

A Team of Doctors Will See You Now (Parade Magazine)

AAFP Board Chair Makes Case for PCMH (AAFP)
The Advanced Medical Home: A Patient-Centered, Physician-Guided Model  (ACP Policy Monograph)

How To Talk to Your Patients About Health and Wellness (Weiss)
Transforming Your Practice: What Matters Most (Southcentral Foundation)
Joint Principles of the PCMH (AAFP, AAP, ACP, AOA)

Joint Principles of the PCMH, Addendum 2 (AAFP)
Medical Home Improvement Guide, Volume 1 (Health Intelligence Network)

A Hidden Cost of Health Care: Patient Time (Krueger)
10 Steps to a Patient Centered Medical Home (APM, Kuzel)
The Case of the Disappearing Patient

The PCMH  Movement - Promise and Peril for Family Medicine (Rogers)

What Patient-Centered Should Mean: Confessions of an Extremist (Berwick)
Blue Cross Blue Shield of Michigan fact sheet (BCBSM)
Blue Cross Blue Shield Michigan: PCMH Is Working (BCBSM)
Commonwealth Fund: Closing the Divide_Medical Homes (Commonwealth Fund)
Financing Community Health Centers as C and PCMHs (Commonwealth Fund)
The Safety Net Medical Home Initiative

Balanced Measures for Patient Centered Care (Journal of Ambulatory Care Management)
Primary Care Practice Development-Relationship-Centered Approach_S68 (Annals FamMed)
PCMH and Meaningful Use (Dr. J. Hummel)

AHRQ's Defintion of a Medical Home (AHRQ)
PCMH Still Work In Progress (AAFP)

Medical Home 2.0, the Present, the Future (Deloitte)