With all the talk about health care reform stalling and restarting on Capitol Hill, it's easy to forget that efforts to change the way patients get care has been under way here in the Islands.

One quiet revolution is a movement known as the "patient-centered medical home" health care model. It's a holistic approach gaining more notice in the medical establishment — deservedly so.

The concept has evolved over several decades since its inception within the American Academy of Pediatrics. In 2002, a coalition of family-medicine organizations settled on a recommendation that every American should be assigned to a "personal medical home," a network of providers for their care. The "home" positions the primary care doctor at the center, coordinating treatment for a patient; data is shared more seamlessly among all the providers, and an emphasis is placed on prevention.

Initial results from the first national demonstration project, published in the Annals of Family Medicine, shows evidence of "higher quality at lower cost and with more equity," according to the report. However, the study adds that transformation is complex and must not be rushed.

That's why it's good to see movement here to start the process in more places. The Queen's Medical Center is discussing a pilot project jointly with HMSA. Proposals for other tests, using federal funds, are still alive in the Legislature and merit another look come January.

Better external regulation is critical, but the medical home model constitutes reform from within. This gradual evolution deserves encouragement, too, as part of any health care rescue plan.