The Roger C. Lipitz Center for Integrated Health Care

A multi-disciplinary team of researchers from the Lipitz Center for Integrated Health Care at the Johns Hopkins Bloomberg School of Public Health developed Guided Care, a form of a patient-centered medical home for people with multiple chronic health conditions. A Guided Care nurse, based in a primary care practice, works in partnership with several physicians to provide coordinated, patient-centered, cost-effective care to 50-60 of their chronically ill patients. Results from a randomized controlled trial indicate that Guided Care improves the quality of patients’ care, reduces family caregiver strain, improves physicians’ satisfaction with chronic care, and tends to reduce the use and costs of health care, especially in health care systems that are well managed. Primary care practices can fully implement Guided Care in 6-to-9 months. Through a grant from the John A. Hartford Foundation, several forms of technical assistance are available for free to practices that wish to adopt Guided Care or the principles of Guided Care as they transform into patient-centered medical homes.