The seven joint principles of the patient-centered medical home provide a framework for implementing the 2007 National Asthma Education and Prevention Program (NAEPP) national asthma guidelines.
A personal physician provides continuity of care in a partnership, eg, scheduling routine follow-up care and monitoring use of beta2-agonist medications.
A physician-directed medical practice coordinates family-centered, high-quality, accessible and affordable services for children with asthma.
The practice has a whole person orientation providing comprehensive, compassionate, culturally-effective care in a family-centered partnership. This holistic approach includes control of environmental triggers such as allergens and irritants—especially tobacco smoke, and treats or prevents co-morbid conditions that affect asthma. It also promotes physical fitness for children with asthma.
Care is coordinated and integrated across the community-based system and facilitated by information technology including asthma registries. Care coordination includes referrals to specialty care, if needed, and eventual transitions to adult care. A medical home with electronic health records improves performance and outcomes measurement and accountability.
Quality and safety are hallmarks of patient-centered and evidence-based asthma care. NAEPP provides guidelines on establishing the asthma diagnosis, providing asthma education on patient self-management, prescribing medications, especially inhaled corticosteroids for persistent asthma, using a stepwise treatment approach for patients of different ages, and developing a written asthma management plan to help families. The AAP Chapter Alliance for Quality Improvement (CAQI), and now the Medical Home Chapter Champions Program on Asthma, offer state and local resources for practices. The AAP Education in Quality Improvement for Pediatric Practice (EQIPP) online courses—for both medical home and for asthma—provide Continuing Medical Education (CME) credits and Maintenance of Certification (MOC) Part 4 support.
Enhanced access to care includes pediatrician availability to assess, classify and monitor asthma severity and control. It also reduces disparities in processes and outcomes in asthma care.
Appropriate payment recognizes the added value provided to patients with asthma who receive care in a medical home as defined above.