Cambodian American medical home program: Engaging the community in their own care

The Cambodian American Medical Home Program (CAMPH) is a model developed by Cambodian community leaders from 12 states with the goal of preserving and improving the health of survivors of the Cambodian holocaust. It has 4 core components: an integrated network for sharing data and resources; cross-cultural teams of providers who deliver care on a local level; intensive outreach and case management for patients with complex chronic disease; and access to specialists who are experts on Cambodian American health issues. Tools for collecting data using spoken format Khmer language are administered by community health workers, and aggregate data is analyzed to determine the most cost-effective treatments for a trauma/torture survivor. Polypharmacy and health illiteracy has contributed to a high number of medication-related problems. Intensive medication therapy management provided by pharmacists teamed with community health workers has proven to be cost-effective in optimizing treatment decisions. Case management tools that create checklists and feedback loops from the patient to the provider improve the health care experience and outcomes. Few health care providers in community practices understand how trauma impacts every aspect of health, causing severe mental health problems and chronic disease. Limited English speaking patients need strong support from their communities' leaders and culture brokers; CAMPH provides a full range of experts who develop these relationships. CAMPH components have been successfully pilot tested; through workforce development in community-based organizations, evidenced-based care for this high risk community will be achieved.