Patient-Centered Medical Homes: More Than Just Electronic Records Required to Improve Patient Care

Lisa M. Kern, MD, MPH, FACP Associate Professor of Healthcare Policy and Research and of Medicine Associate Director for Research, Center for Healthcare Informatics and Policy Deputy Director, Health Information Technology Evaluation Collaborative Weill Cornell Medical College New York, NY 10065MedicalResearch.com Interview with:
Lisa M. Kern, MD, MPH, FACP
Associate Professor of Healthcare Policy and Research and of Medicine
Associate Director for Research, Center for Healthcare Informatics and Policy Deputy Director, Health Information Technology Evaluation Collaborative Weill Cornell Medical College
New York, NY 10065

MedicalResearch: What are the main findings of the study?

Dr. Kern: We found that primary care physicians participating in Patient-Centered Medical Homes (PCMHs) improved their quality of care over time at a significantly higher rate than their non-PCMH peers.

MedicalResearch: Were any of the findings unexpected?

Dr. Kern: We found that electronic health records (EHRs) alone were not necessarily sufficient for quality improvement.  The PCMH model of primary care combines electronic health records (EHRs) with organizational changes, including changes in the roles and responsibilities of clinicians and staff.  It was the combination of EHRs plus organizational changes that was associated with the greatest quality improvement.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Kern: Clinicians would be interested in knowing that the Patient-Centered Medical Homes in this study made 3 big changes to the culture of their practices:

  • They emphasized becoming more accountable for performance
  • Building teams by defining roles and responsibilities
  • Managing patient groups or populations.Those changes seemed to make a difference and contributed to quality improvement.

Patients would be interested in knowing that they can seek out practices that have been designated as Patient-Centered Medical Homes.  They can ask their doctors if their practices are recognized as PCMHs.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Kern: Practices that transform into Patient-Centered Medical Homes may be well positioned for additional changes to healthcare delivery, such as participation in accountable care organizations and other forms of population health management.  It will be important to measure the impact of those other types of healthcare delivery on quality and on cost.

Citation:
The Patient-Centered Medical Home, Electronic Health Records, and
Quality of Care
Kern LM, Edwards A, Kaushal R. The Patient-Centered Medical Home, Electronic Health Records, and Quality of Care. Ann Intern Med. 2014;160:741-749.

 

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