[Patient-Centered Medical Home: Suggestions for the Health Care Delivery System Reform in Japan; Joint principles of the Patient-Centered Medical Home].

Care is coordinated and/or integrated across all elements of the complex health care system (e.g., subspecialty care, hospitals, home health agencies, nursing homes) and the patient’s community (e.g., family, public and private community-based services). Care is facilitated by registries, information technology, health information exchange, and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner.