Many patient-centered medical homes today are using outdated IT that, if updated, could improve their monitoring and reporting capabilities.
Patient-centered medical homes, primary care practice sites that have implemented structural and process changes to better coordinate care, are a growing presence in long-term care. Health IT is a significant part of these homes to best monitor the care of patients, especially those with multiple chronic conditions, but the systems may be lacking, according to a study in the Journal of the American Medical Informatics Association.
The study examined IT use in three patient-centered medical homes through phone calls with the homes, their EHR vendors and associated stakeholders. Because the study was conducted through New York's Healthcare Efficiency and Affordability Law for New Yorker's Capital Grant Program, the researchers largely focused on that state and the northeastern region of the U.S.
They found that most respondents expressed a need for the inclusion of interoperable electronic collaboration platforms that support both individual patients and patient populations. The researchers suggested five major improvements:
∙ Improve monitoring by developing tools that filter patients by condition and target clinical interventions that mitigate or prevent poor outcomes.
∙ Provide real-time notifications to patient-centered medical homes whenever a designated patient interacts with the healthcare system, particularly during transitions.
∙ Integrate messaging applications that help patient-centered medical home clinicians to identify care gaps among generalists, specialists and patients.
∙ Invent data extraction tools that enable patient-centered medical homes to report performance and quality metrics to stakeholders more efficiently.
∙ Investigate ways that EHRs and HIEs can reduce interface costs to encourage interoperability.