Patient-Centered Medical Home Cyberinfrastructure

Finkelstein, Joseph; Barr, Michael S.; Kothari, Pranav P.; Nace, David K.; Quinn, Matthew

doi:10.1016/j.amepre.2011.01.003

Cited by 36 publications

(16 citation statements)

References 47 publications

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“…Outside the VA, great hope has been placed in the potential of health information technology (HIT), especially EMRs, to enable, if not drive, improvements in quality, efficiency, safety 22,23 and cost reductions, 22,24 and as an essential tool in day-to-day PCMH functioning, if not one of its core principles. 22,25,26 Green has further identified HIT as a key strategy for helping to alleviate the PC physician shortage. 27 However, HIT has also been associated with interrupted work and increased provider burden.…”

Section: Discussionmentioning

confidence: 99%

Challenges Facing Primary Care Practices Aiming to Implement Patient-Centered Medical Homes

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Challenges Facing Primary Care Practices Aiming to Implement Patient-Centered Medical Homes

et al. 2014

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“…Despite the significant advantages of incorporating HITs into primary care practices, a minority of practices actually utilize EHRs because of the multiple barriers that exist. 22 Findings from the 2011 Physician Workflow Study suggest 54% of physicians have adopted an EHR, although one-quarter report their system does not meet meaningful use guidelines. 40 Barriers to adoption of HITs include issues with information exchange and interoperability between information systems, challenges with technical implementation, low acceptance rates by physicians and patients, and patient access issues due to the digital divide.…”

Section: Discussionmentioning

confidence: 99%

“…22 These tools allow patients to easily track blood glucose, medication adherence, and dietary intake to improve self-management. Although eHealth applications are widely available, there is a significant paucity of literature describing and evaluating use of this technology as integrated into clinical practice.…”

Section: Provide Self-care Support and Community Resourcesmentioning

confidence: 99%

“…Patient registries can provide patient and outcome tracking, thereby improving clinical efficiency and identification of high risk patients. 22 For example, a diabetes registry can identify patients most in need of an intervention, such as those with a hemoglobin A1c above their target who have not been seen in 6 months or those with outdated eye examinations, in order to schedule return visits. 23 The Pennsylvania Chronic Care Initiative, a large statewide multipayer-supported medical home effort, involves 102 practices and 518 providers with a focus on diabetes care as the initial target condition.…”

Section: Identify and Manage Patient Populationsmentioning

confidence: 99%

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Role of Health Information Technologies in the Patient-Centered Medical Home

Kraschnewski

Gabbay

2013

J Diabetes Sci Technol

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A national effort to reform primary care, known as the Patient-Centered Medical Home (PCMH), requires fulfillment of six standards determined by the National Committee for Quality Assurance to (1) enhance access and continuity, (2) identify and manage patient populations, (3) plan and manage care, (4) provide self-care and community support, (5) track and coordinate care, and (6) measure and improve performance. Information technologies play a vital role in the support of most, if not all, of these standards. However, given the newness of the PCMH, little is known on how health information technologies (HITs) have been employed to accomplish these objectives. This article will review the role of HITs, including electronic health records, web-based patient portals, telemedicine, and patient registries, with a focus on diabetes care, and how these technologies have been engaged in the establishment of the PCMH. In addition, we will discuss the benefits and potential risks and barriers to employing these technologies, including privacy and security concerns, as well as describe next steps for future work in this important area.

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“…[1][2][3][4][5] The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 authorized nearly $30 billion to support the increased adoption and use of HIT throughout the US health care delivery system. 6 In early 2010, the Office of the National Coordinator for Health Information Technology established a nationwide system of regional extension centers to support adoption and use, particularly among small primary care practices.…”

Section: Introductionmentioning

confidence: 99%

Increased Health Information Technology Adoption and Use Among Small Primary Care Physician Practices Over Time: A National Cohort Study

et al. 2017

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PURPOSE Implementation and meaningful use of health information technology (HIT) has been shown to facilitate delivery system transformation, yet implementation is far from universal. This study examined correlates of greater HIT implementation over time among a national cohort of small primary care practices in the United States. METHODSWe used data from a 40-minute telephone panel survey of 566 small primary care practices having 8 or fewer physicians to investigate adoption and use of HIT in 2007HIT in -2010HIT in and 2012HIT in -2013. We used generalized estimating equations (GEE) to estimate the association of practice characteristics and external incentives with the adoption and use of HIT. We studied 18 measures of HIT functionalities, including record keeping, clinical decision support, patient communication, and health information exchange with hospitals and pharmacies.RESULTS Overall, use of 16 HIT functionalities increased significantly over time, whereas use of 2 decreased significantly. On average, compared with physicianowned practices, hospital-owned practices used 1.48 (95% CI, 1.07-1.88; P <.001) more HIT processes. And relative to smaller practices, practices with 3 to 8 physicians used 2.49 (95% CI, 2.26-2.72; P <.001) more HIT processes. Participation in pay-for-performance programs, participation in public reporting of clinical quality data, and a larger proportion of revenue from Medicare were also associated with greater adoption and use of HIT. CONCLUSIONSThe new Medicare Access and CHIP Reauthorization Act (MACRA) will provide payment incentives and technical support to speed HIT adoption and use by small practices. We found that external incentives were, indeed, positively associated with greater adoption and use of HIT. Our findings also support a strategy of targeting assistance to smaller physician practices and those that are physician owned. Ann Fam Med 2017;15:56-62. https://doi.org/10.1370/afm.1992. INTRODUCTIONI mplementation and use of electronic health records (EHRs) and other health information technology (HIT) has been shown to facilitate primary care practice transformation. [1][2][3][4][5] The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 authorized nearly $30 billion to support the increased adoption and use of HIT throughout the US health care delivery system. 6 In early 2010, the Office of the National Coordinator for Health Information Technology established a nationwide system of regional extension centers to support adoption and use, particularly among small primary care practices.7 Beginning in 2011, the Centers for Medicare & Medicaid Services (CMS) EHR Incentive Program offered financial rewards to practices for implementation and meaningful use of EHRs.8 Yet, despite major efforts to expand the adoption and use of HIT, uptake is far from universal. 9 Understanding the factors that influence HIT adoption and use is critical to inform delivery system reform efforts. 57Recent studies of individual physicians have de...

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Patient-Centered Medical Home Cyberinfrastructure

Cited by 36 publications

References 47 publications

Challenges Facing Primary Care Practices Aiming to Implement Patient-Centered Medical Homes

Challenges Facing Primary Care Practices Aiming to Implement Patient-Centered Medical Homes

Role of Health Information Technologies in the Patient-Centered Medical Home

Increased Health Information Technology Adoption and Use Among Small Primary Care Physician Practices Over Time: A National Cohort Study

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