As the nation struggles to manage healthcare costs, the deployment of new technology, innovative delivery of care, and revamped payment models are increasingly attractive strategies to help constrain expenditures.
concept receiving significant attention is the Patient-Centered Medical
Home (PCMH), a multi-disciplinary strategy that uses evidence-based
medicine and decision support tools to care for the whole patient. Just
last week, the Centers for Medicare and Medicaid Services (CMS)
unveiled a plan to begin reimbursing primary care physicians for general
care-management of Medicare patients under its Comprehensive Primary
Care Initiative – a move considered by many as an extension of the PCMH
It makes sense that health information technology (HIT) plays a significant role in supporting PCMH, an evidence-based approach to holistic care that rests on a partnership between the primary physician, specialists, multi-disciplinary providers, and the patient.
Around the country, individual PCMH pilots and models rely on electronic health records (EHRs), decision-support tools, and other HIT functionality. For example, when one PCMH in Seattle implemented a secure patient-provider e-mail system, e-mail exchanges rose significantly while adult primary care visits declined. The state of Louisiana launched five medical home pilot programs following Hurricane Katrina in 2005. Each model emphasized different aspects of a medical home, including one that focused on EHRs to improve care coordination and access for those in medically underserved areas.
These single examples are promising, but there is little overarching research on the adoption, implementation, success and future needs of HIT in PCMH environments. To help fill that gap, HITLAB’s Liz Seegert, Ilene Hollin and Stan Kachnowski completed a literature review examining the role HIT may play in improving outcomes in PCMH models and pilot programs, and analyzing the barriers some physicians face in adopting these tools.
Their findings highlight the successful use of technology in pilot projects such as those above, but also illuminate the financial constraints that limit the widespread adoption of HIT. Additionally, they identify several studies that exemplify how HIT can support the ideals of PCMH – in actual PCMH practices and other non-certified but similar settings – to improve outcomes such as patient-provider communication, integration of care, and continuous safety and quality assessments.
find more detail on this topic in Seegert et al.’s paper, “Information
Technology Use in the Patient-Centered Medical Home,” published in the
spring 2011 edition of the Journal of Healthcare Information Management