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The patient-centered medical home incorporates the relationships and systems required to support more effective care coordination for patients with multiple chronic diseases. As defined by the joint principles:

Care is coordinated and/or integrated across all elements of the complex health care system (e.g., subspecialty care, hospitals, home health agencies, nursing homes) and the patient's community (e.g., family, public and private community-based services). Care is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner.

Quality and safety are hallmarks of the medical home:

• Practices advocate for their patients to support the attainment of optimal, patient-centered outcomes that are defined by a care planning process driven by a compassionate, robust partnership between physicians, patients, and the patient's family.

• Evidence-based medicine and clinical decision-support tools guide decision making

• Physicians in the practice accept accountability for continuous quality improvement through voluntary engagement in performance measurement and improvement.

• Patients actively participate in decision-making and feedback is sought to ensure patients' expectations are being met

• Information technology is utilized appropriately to support optimal patient care, performance measurement, patient education, and enhanced communication

• Practices go through a voluntary recognition process by an appropriate non-governmental entity to demonstrate that they have the capabilities to provide patient centered services consistent with the medical ho
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