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

Abstract

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.

ATA Practice Guidelines for Live, On-Demand Primary and Urgent Care

“…These are identified in the primary care medical home model. 27,33,34 The Agency for Healthcare Research and Quality defines the medical home not simply as a location but as an organization that delivers the core functions of primary healthcare. 35 …”

“…Currently there is a growing body of evidence regarding the effectiveness of video-and audio-based interventions for a variety of acute and chronic conditions seen in primary care, such as diabetes, asthma, heart failure, and hypertension. 5,6,[8][9][10][11][12][25][26][27][28][29][30][31]34,[36][37][38] Typically these include conditions for which there is a reasonable level of certainty in establishing a diagnosis and generating a treatment plan, especially when visual information coupled with access to a medical record with diagnostic studies and imaging is available. 5,19,30 In general, conditions that are not suitable for telemedicine are those for which an in-person visit is required to evaluate the patient because of the severity of presenting symptoms, the necessity of haptic information, the need for protocol-driven procedures, or the need for aggressive interventions.…”

Minimally disruptive medicine is needed for patients with multimorbidity: time to develop computerised medical record systems to meet this requirement

“…In the context of the PCMH, some have started to think through how information systems might support this approach to holistic care 14. The information identified in this section identifies information that might be important in measuring the determinants of behaviour – capability (psychological and physical), opportunity (physical and social) and motivation (reflective and automatic), as flagged in the COM-B model (Figure 1).…”

Effect of Physician Participation in a Multi-element Health Information and Data Exchange Program on Chronic Illness Medication Adherence

“…Achieving recognition as a patient-centered medical home (PCMH) potentially improves care coordination and communication, resulting in better health outcomes. [21][22][23] In addition, reducing patient barriers to accessing health care and medications has been shown to improve health outcomes. 24 -26 The labor union considered in this study included in its benefits design a steep reduction of prescription co-pay for members accessing practices recognized as PCMHs to facilitate access to medications prescribed for chronic conditions.…”