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Home|Doctors & Services|PHS Coordinated Care

Coordinating Care for a Healthier You

 

Imagine a whole team of doctors working together for your health. You don’t have to just imagine it – you can experience it, with Presbyterian Medical Group’s innovative Coordinated Care.

Presbyterian Medical Group physicians, nurses, specialists, and other providers work together to better diagnose, treat, and care for patients. Remember singing the childhood song, “Your head bone is connected to your neck bone…”? Shouldn’t healthcare consider all the connections?

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Presbyterian Medical Group considers all the connections, by bringing an entire team of doctors together to provide a complete solution.

In all 10 of our innovative primary care clinics, patients receive care under the Patient Centered Medical Home model. That means

  • Your entire team is located at one clinic – your “medical home.”
  • A primary care physician leads your team and is aware of all the services you receive.
  • If you need it, you may receive group visits and personalized telephone appointments.

Innovating for Better Care

It’s exciting to put innovation into practice and see a positive change in patient health, satisfaction and care. Some of the innovations we’re especially proud of are:

  • Hospital at Home. Presbyterian partnered with the Johns Hopkins School of Medicine to develop our innovative Hospital at Home program in which doctors, nurses and technicians travel to patient homes to provide hospital-level care.
  • Electronic Health Records. Presbyterian’s advanced, comprehensive Electronic Health Record system brings together information about your visits with us, lab results, and immunization schedules in a fully accessible electronic health record.
  • Discharge Call Center. We call each patient discharged from the hospital to make sure the doctor’s instructions are clear, address follow-up care issues, and assist with questions.
  • Secure, Online Collaboration. Using myPRES, patients have secure access to view certain test results, request appointments, refill prescriptions, and view medical records. Patients can also use secure messaging to communicate with their primary care provider or other care team members to ask questions or address concerns.

Find a Patient Centered Medical Home Near You

Albuquerque

Belen

Los Lunas

Rio Rancho