Group Health, (Seattle USA) has implemented a model of general practice care called the Group Health Medical Home (GHMH) that offers a number of key features that may help NZ general practices meet the looming problems of workforce and resource limitations set against an environment of aging population and increasing service demands.

This report  is an outline of the findings of a visit to Seattle during February 2011 in which the authors identified key features of the Medical Home that could be implemented in a typical NZ general practice without requiring the significant total health system redesign that would be required to replicate the model in totality.’  This report focuses on practice level implementation and in no way attempts to address the issue of integration with secondary services and thus is not encumbered with possible difficulties associated with such integration. It is presumptive of the primary care environment outside of the practice being that which can be assured to be universally available in NZ, in other words the lowest common denominator of PHO or IPA services. In regions with substantially better practice support, be it as currently exists in more advanced PHO/IPA environments or the proposed Integrated Family Health Centres, implementation of the Group Health model should obviously be significantly easier assuming that practice support is not restricted to physical premises and that it allows clinical lead system design with appropriate IT support.
Essential preliminary reading is the Midland Health Network Seattle Findings Report of October 2010 which can be found online at
https://provider.midlandshn.health.nz/clinical/uploads/Main/BSMC-MHN-SeattleFindings.pdf

The Midlands report more than adequately outlines the key components of the Group Health Medical Home (GHMC). Part one of this report summarises the same but adds further information on the role of guidelines, evidence and clinical pathways in the GHMH.  Part two is an evaluation of translating the model to a typical New Zealand general practice, based on the authors’ experience not only of the development of their own 5 doctor practice, but also on knowledge gained visiting some 110 practices across the nation as both RNZCGP Cornerstone Assessors and practice consultants.
Therefore this report will be useful for practices planning to address the issues of practice sustainability for the next decade.

For the full report click here