Veteran Patient Perspectives and Experiences During Implementation of a Patient-Centered Medical Home Model.
Background
The Veterans Health Administration (VA) has implemented the largest shift to a patient-centered medical home (PCMH) model of care in the United States to date.


Objective
We interviewed veterans about their experiences of primary care to understand whether they observed changes in care during this period as well as to learn which characteristics of care mattered most to their experiences.


Method
Qualitative interviews were conducted with 32 veterans receiving primary care at 1 of 8 VA clinics in the northwest United States. Interviews were analyzed using an inductive-deductive hybrid approach by an interdisciplinary team that included a veteran patient.


Result
Participants noticed recent positive changes, including improved communications and shorter waits in clinic, but rarely were aware of VA's PCMH initiative; a strong relationship with the primary care provider and feeling cared for/respected by everyone involved in care delivery were key components of quality care. The needs of the veteran community as a whole also shaped discussion of care expectations.


Conclusion
The PCMH model may provide benefits even when invisible to patients. Veteran awareness of population needs suggests a promising role for veteran involvement in further PCMH transformation efforts.
['Tuepker|Anaïs|A|', 'Newell|Summer|S|0000-0001-7876-5693', 'Nicolaidis|Christina|C|', 'Reyes|Marie-Elena|ME|', 'González-Prats|Maria Carolina|MC|', 'Skaperdas|Eleni|E|', 'Kansagara|Devan|D|']
clinician–patient relationship patient expectations patient perspective /narratives qualitative methods relationship in health care team communication trust wait times