Several years ago, the American Academy of Pediatrics (AAP) and the Maternal and Child Health Bureau of the U.S. Department of Health and Human Resources began promoting the concept that every child in America should have a medical home. The AAP defines a medical home as the following:

"A medical home is not a building, house, or hospital, but rather an approach to providing health care services in a high-quality and cost-effective manner. Children and their families who have a medical home receive the care that they need from a pediatrician or physician whom they trust. Pediatricians and parents act as partners in a medical home to identify and access all the medical and non-medical services needed to help children and their families achieve their maximum potential. . . where care is accessible, family-centered, continuous, comprehensive, coordinated, compassionate and culturally competent."

In other words, every child should have a primary health care provider who knows that child individually, cares about him or her, is aware of his or her medical needs, and is capable of providing culturally sensitive and appropriate medical services. The concept is a little difficult to define in operational terms, and we are still a long ways from achieving the goal that every child has a medical home.

The Maternal and Child Health Bureau, as a part of their efforts to promote universal newborn hearing screening, diagnosis, and intervention, has encouraged that early hearing detection and intervention services be linked with a medical home. In a copy of guidelines for applicants competing for funding, The Maternal and Child Health Bureau outlined that a "medical home" for children with special health care needs and their families should reflect the following elements (American Academy of Pediatrics, 1997):

1. The provision of preventive care;
2. The assurance of ambulatory and inpatient care, 24 hours a day;
   
3. Strategies and mechanisms to ensure continuity of care (from infancy through adolescence);
   
4. Identification of and medically appropriate use of subspecialty consultation and referrals;
   
5. Interaction with school and community agencies; and
   
6. Maintenance of a central record and data base containing all pertinent medical information, including hospitalizations.

Learn more about the concept of a medical home at The National Center of Medical Home Initiatives for Children with Special Needs, housed within the American Adademy of Pediatrics (www.aap.org).

Links to Additional Medical Home Information

• AAP Medical Home Information
• UNHSI Guidelines for Pediatric Medical Home Providers [PDF]
• Examples of State EHDI Physician Guidelines