This review examined published and grey literature (2013–2017) to identify barriers and enablers to the implementation of a patient centred medical home model. Five central themes emerge: policy settings and funding incentives; transformation and change management; care coordination beyond the practice; health information technology; data and performance measurement. Barriers and enablers are described for each theme. The authors conclude that there is no ‘magic bullet’ implementation. The central challenge remains how to manage a process of change with the thin resources available in primary care settings. Multi-faceted strategies that are sustained over a long period are required. Individual practices need to assess their own situation and determine the strategies best suited to it. Although there are many potential barriers, lessons have been reported in the literature that can help to overcome these challenges.
Pearse J, Mazevska D.
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