The patient-centered medical home (PCMH) is an effort to redesign, refinance and revitalize primary care across the United States. Based initially on Chronic Care Model, the concept has evolved to mean addressing the needs of all patients through organizing health care delivery systems to be patient-centered, evidence-based, culturally & linguistically appropriate, and accountable for the care provided as assessed by quality, cost and patient experience metrics. In-depth information about the PCMH is posted in several places, including the American College of Physicians and the Patient-Centered Primary Care Collaborative.
A critical component of the PCMH is the appropriate use of health information technology. However, just implementing electronic health records will not result in a well-functioning practice or a medical home. Offices must first evaluate their existing work flows and processes, bottlenecks, patient care activities, staffing, and existing software/computer programs. Then, based on an objective assessment of what works and what doesn’t work as well as it could, the practice should consider how best to improve office functions and patient care given the capabilities of the technology being considered.
In the April 2010 Health Affairs issue, Rushika Fernandopulle and Neil Patel document their experience with one EHR, writing in their abstract, “Limitations in the technology gave rise to medication errors, interruptions in work flow, and other problems common to paper systems.” Of course, each situation is unique, but my reaction to the article is that there will always be limitations of the technology currently available. We experience that every day with our “smart” phones, laptops, MP3 players, etc. Knowing the limitations and accounting for them (until the technology catches up to our expectations) – and not adding to the complexity by trying to mimic paper-based processes using electronic health records – can help mitigate the unintended consequences of health IT adoption.
The AmericanEHR Partners Program is designed to help physicians, nurse practitioners, physician assistants and their practices work through the identification, selection, implementation, and optimization of electronic health records. The content and features of the site will evolve over time based on your feedback and interests. To that end, what issues would you like to see discussed on this site? What guidance would you find helpful? What functions you would like to see added to the site?
On this particular topic relating health IT and the patient-centered medical home, what limitations of technology have you experienced or anticipate given the options currently available?
(This post is the personal opinion of the author and does not necessarily reflect the official policy or position of the American College of Physicians (ACP). ACP does not endorse a
specific EHR brand or product and ACP makes no representations, warranties, or assurances as to the accuracy or completeness of the information provided herein.)