No abstract

The concept of a medical home is receiving increased attention as a potential means to improve care and reduce costs. This study describes the characteristics and capabilities of practices that have achieved recognition of National Committee for Quality Assurance as a "patient-centered medical home" (PCMH). Both small and large practices demonstrate capabilities related to the goals of PCMH of accessible, coordinated, and patient-centered care; however, practices affiliated with larger organizations achieve higher levels of PCMH recognition compared with unaffiliated small practices. Efforts to support practices to implement medical home capabilities are needed, particularly in the use of data for population management and patient self-management.

The American Recovery and Reinvestment Act (ARRA) of 2009 recognizes that to improve health through the use of electronic health records, smaller medical practices and those serving disadvantaged populations will need support. Some of this support is likely to come from Regional Health Information Technology Extension Centers, which offer technical assistance, guidance, and information on best practices. Such support programs already exist, and ARRA funding will influence how they spread. The National Committee for Quality Assurance surveyed these programs and convened a discussion among program leaders and users. We describe how programs address barriers to adopting electronic health records by assessing readiness, setting expectations, and helping with work-flow redesign. We also highlight challenges.

Electronic health record (EHR) systems support local quality improvement efforts by health care organizations and provide the opportunity to address national priority areas for quality measurement, such as specialty care, overuse and efficiency, coordination of care, change over time and patient- reported outcomes (PROs). However, variations in provider workflow and documentation habits, adoption of advanced EHR functions and exchange of interoperable data, and eMeasure specification standards affect the ability to develop and test measures that target these high priority areas for improvement. Measure developers are working with providers, national standards organizations, and other eMeasure stakeholders to address these challenges and support learning health organizations in using EHR-based measurement to improve quality.

No abstract