Thursday, October 31, 2013
Medical Home or Health Hub: A New Health Reform Paradigm Needs New Language
The Affordable Care Act has put forth the concept of a "medical home". The intention of this concept is that health costs could be reduced by having a central place where a multidisciplinary healthcare team would address the multifaceted health needs for you and your family.The purpose in a "medical home" is to address multifaceted issues that can become illness before they happen. While the intended focus of a "medical home" implies an effort toward primary care, that is, identifying risk factors before symptoms appear. The word "medical" still implies the presence of symptoms. Why would you go to a medical home, if you didn't have a medical condition?In order to change the paradigm toward the intended focus on health promotion, wellness and disease prevention, a change in language is required. This author proposes the term "health hub" as a more appropriate alternative.The word "health", changes the focus toward factors known to improve health instead of symptoms of a medical condition. The word "hub" brings to mind the image of a wheel with many spokes or facets contributing to health that could be addressed to improve health. At the center of the wheel (the hub) is the person or family whose health is the center of attention. Thus, "health hub" describes a place where the family or person as the center of focus is assessed holistically toward maintaining or improving health.Ideally, your health hub would be the place where you can learn skills to improve your health, obtain screenings and assessments that identify health issues early, get referrals for appropriate treatment as needed and have your care coordinated through one central location. The spokes of the wheel represent the various facets or aspects that might need coordination for optimum health. These might include medical care, dental care, social services, vocational or school concerns, nutrition, physical therapy, health information, psychological care, hospital or acute care, management of chronic conditions, public health concerns and more.The benefits of ongoing health assessment and coordinated care at a "health hub" include reduced health costs, reduced complications due to medical errors or fragmented care and overall improved health. This fulfills the intention of the medical home concept more effectively and efficiently because the language more accurately focuses attention of the multidisciplinary team on the "health" of the person and family who are at the "hub" of the system.Your health hub could be located in a community health center, wellness center, school, or family focused employee health program. What's important is that the health coordinator at the "health hub" is educationally qualified and equipped with the tools to assess the contributing factors which are known to improve or restore health through the lifespan, has effective relationships with the providers you may need, and an effective system for following up and coordinating your care.Using the term "medical home" continues to imply that you have a medical concern requiring a medical professional, i.e., a physician or nurse practitioner to address. This does not change the paradigm our current health care system. Using the term "health hub" implies a proactive approach to maintaining, improving, and coordinating health care, which is the known antidote to rapidly rising healthcare costs and chronic conditions in America today.Continuing to focus on curing symptoms of medical conditions by using the term "medical home" does not support the primary intention of the Affordable Care Act. Changing the terminology to "health hub" more accurately supports a changing paradigm toward better health at an affordable price by encouraging early "health" assessment at the "hub" of coordinated care.