Submission #14653

Rural Medical Home Project
Carl Cooley
Chief Medical Officer
Crotched Mountain Foundation
Medical home development
Children/youth with special healthcare needs, Infant (< one year), Toddler (>1 yr to 3 yrs), Preschoolers (>3yrs to 6 yrs), Elementary age children (>6 to 10 years), 6. Tweens (>10 year to 13), Teenager (>13 to 18 years)
Exeter (Core Pediatrics) & Dartmouth Hitchcock Plymouth, and 2 VT clinics.
Project sought to help practices in implementing the very nascent concept of a "medical home". At this time, there were no definitions for a medical home, but wanted to take this hospital-initiated model of care and transcend to out-pt setting. Each practice was required to have a lead physician, a care coordinator, and two parents of children with special healthcare needs. They worked on different medical home aspects (culturally competent, coordinated care, etc). The "med home" team was required to meet every month for 90 minutes. These meetings were facilitated by project staff. Also had two in-person trainings per year. Project supported through Federal funds.
Practice setting
This project evolved into the "Beyond medical care" Project.
Though labor intensive, having a coach to facilitate meetings was very helpful.