Health Care Home

The Health Care Home is a primary health care model that gives patients more control, the practice team an environment where quality of care and innovation can flourish. It enables truly proactive, coordinated care for those that need it most breaking down the professional and system barriers that we know prevent patients from getting the best care.

The domains and principles

The Health Care Home model improves care over four core domains:

1. managing urgent and unplanned care effectively
2. shifting from reactive to more proactive care for those with more complex health or social needs
3. ensuring routine and preventative care are delivered conveniently, systematically and aimed at keeping people as well as they can be
4. ensuring this is all done with greater business efficiency for long term sustainability.

Core principles of this model of care can include the following.

• Improving access by offering alternative options for patients via email and telephone.
• Targeting of face to face consultations to those that need them most.
• Proactive care planning for all patients.
• Longer appointments for those with more complex needs.
• Valuing patient and clinician time so ensuring both are used effectively.
• Shifting general practice from a reactive service to one where all consultations are planned with the patient.
• Moving to a shared, cloud-based patient information system to enable timely care and effective co-ordination of activity.
• Expanding the primary care team with new roles.
• Removing waste in practice systems and processes that add no value to the patient the practice or the system.

Our journey

Like many primary care systems around the world, New Zealand’s population and workforce demographic data showed us that if we didn’t make changes to how we provided services many of our practices would struggle to maintain offering the level of care to patients that they want to. We could also see how technology is changing the way people manage their lives. We wanted to lead the way in ensuring our people could have more control over their health, more access to technology that helps them stay well and a partnership model of care with their health care team when they need it.

Pinnacle’s Health Care Home journey began in 2008. Knowing general practice needed to respond to the changing environment we made trips to the UK and Europe to explore primary care innovation. In 2010 we visited Group Health in Seattle to hear about their Medical Home innovations and the outcomes they were achieving for patients, their workforce and system. We also visited Boeing and were impressed by the enormous efficiencies they had created building aeroplanes using Lean methodology.

We then took all this learning, held intensive workshops with a wide range of clinicians, providers and a visiting Boeing team. We created our own ‘Model of Care’ sensitive to the New Zealand context that would future proof general practice from the future challenges of rising demand and an ageing workforce. Our first Health Care Home practices were established in April 2011. Whilst implementation and the core model elements have evolved based on experience and outcomes the core principles underpinning the model have not changed.

Health Care Home now sits with Collaborative Aotearoa.

A snapshot of Ernst & Young findings

A snapshot of Ernst & Young findings