The concept of the “medical home” has been kicking around since the 1960s, but how best to define the model for primary care is still the subject of intense debate. No matter how they precisely describe the model, however, many proponents say that information technology is vital to this patient-centered approach to care.
Three key technologies that support the model are electronic health records, personal health records and health information exchanges.
Under the medical home model, “A primary care physician is the orchestrator of care for individuals, especially for those with chronic diseases,” says Mitch Morris, M.D., national leader, health information technology for Deloitte Consulting, New York.
The model also calls for “bringing together all the different resources in the community to advance the wellness of an individual and the community,” he says. That means a primary care physician is the hub or “home,” carefully coordinating care with a team of specialists. “I.T. is the glue that holds it all together,” Morris says.
Paul Grundy, M.D., president of the Patient-Centered Primary Care Collaborative, a Washington-based group that advocates the medical home model, shares that view. “I.T. is really the key to supporting the doctor/patient relationship and making it more efficient, safer and more effective,” he says. “This is simply about restructuring the way health care is delivered to catch the efficiency of technology.”
Grundy, who’s also director of health care transformation at IBM Corp, Armonk, N.Y., predicts that the federal government’s definition of “meaningful use” of electronic health records that will be used to determine who qualifies for Medicare and Medicaid EHR incentive payments likely will support goals very similar to those of the medical home model.
Many observers say that a missing link for achieving the goals of the medical home model is a new method of paying physicians that rewards them for keeping patients, especially the chronically ill, healthy and out of the hospital. But rather than wait for such a payment mechanism to go beyond experiments and become ubiquitous, a growing number of physician group practices are moving ahead with implementing elements of the model.
Those elements include using EHRs equipped with decision support, providing PHRs with patient self-monitoring features and enabling data exchange among primary care physicians and specialists involved in a team approach to treatment.
To read a feature story on I.T. and the medical home model, click here.
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