Patient-Centered Medical Home Implementation in Indian Health Service Direct Service Facilities

This report summarizes strategies Indian Health Service (IHS) clinics have used to implement the Patient-Centered Medical Home (PCMH) model of care, challenges they faced during implementation, and lessons learned that might benefit IHS clinics that have not yet received PCMH recognition.  Common strategies to address challenges include use of telemedicine and partnerships with academic medical centers, and engaging tribal leaders and publicizing PCMH-related changes to the community to secure buy-in on major changes. Many IHS clinics face PCMH implementation challenges broadly consistent with those of small and rural clinics outside of the IHS.