Medical Neighborhoods

 
 

 

Integrated Medical Communities:

Establishing new patterns and capacity to facilitate active collaboration and coordinated care. 

At the heart of an integrated medical neighborhood are fully functioning PCMH primary care practices working with other providers on the care continuum. Some industry experts encourage official recognition for collaboration, suggesting the establishment of standards that qualify a practice as a Patient-Centered Medical Home Neighbor. 

An effective Medical Neighborhood relies on organizational flexibility and expertise in coordinating care. Patients experience seamless transitions between providers and facilities and achieve the greatest possible benefit. The patient and family participate in the Medical Neighborhood, collaborating and communicating to assist care coordination. 

HealthTeamWorks can help you and your organization begin to build that capacity to make and maintain critical Medical Neighborhood linkages.    
 

Medical Neighborhood Overview
 

A patient’s Medical Neighborhood comprises those who share the care to meet her/his health needs, including:

  • Family members
  • Primary care providers
  • Specialty care providers
  • Mental health providers and social workers
  • Schools/school nurses
  • Dental and eye care providers
  • Hospice care 
  • Hospitals
  • Pharmacists
  • Home and community-based long-term care services
  • Community resources
  • Home health care
  • Complex-case managers and patient navigators
  • Peer programs
  • Other ancillary services