The so-called "medical home" concept is critically dependent on information technology, said David Howes, MD, president and CEO of Martin's Point Health Care, a not-for-profit healthcare organization based in Portland, Maine.
Howes spoke at the New England HIMSS Chapter Conference on HIT, held in South Portland, Maine on Oct. 17.
He said the medical home concept can lower costs for a nation that is experiencing crises in both the financial and healthcare systems.
"Throughout the country we are facing an aging population and chronic disease epidemic that requires a transformation in the way we deliver healthcare," said Howes, "and it has to start in the primary care delivery system."
The National Committee for Quality Assurance (NCQA) defines the patient-centered medical home as a healthcare setting that facilitates partnerships between individual patients and their personal physicians and, when appropriate, the patient's family. The most dependent NCQA criteria for the medical home is coordinated and integrated care, quality and safety, and enhanced access - all of which, Howes pointed out, need IT.
Howes said team-based care is also integral to the medical home and highly dependent on IT, though it isn't emphasized by the NCQA.
He said IT services create a single source of information that can be electronically shared to support the needs of primary care delivery, whether between providers and health systems or primary care providers and specialists. IT also allows for other types of tools for physicians that improve communication and safety, such as computerized physician order entry, e-prescribing, clinical decision support and disease registries.
Howes noted that not all IT tools are being used to their full potential by physicians. "It requires changing habits and expectations," he said. "And every step is very difficult for physicians, but they recognize where this is going."
There are also tools for patients that improve care, such as online appointment scheduling, virtual office visits, secure e-mail messaging, prescription renewal and educational resources. But Howes said physicians can't always be reimbursed for these services.
Other barriers, Howes said, include a lack of clear return on investment and provider and patient capacity for change and acceptance.
Howes said that initially, there were some complaints from his patients about electronic medical records. He said some were concerned that their doctors no longer looked them in the eye.
But as physicians grew more comfortable with the technology, he said, the complaints fell off, and one patient told him, "It's good now - I think he finally knows how to use that thing."
What in your opinion is critical to the medical home? E-mail Associated Editor Molly Merrill at molly.merrill@medtechpublishing.com.