Physician practices using a patient-centered medical home (PCMH) model that relies on electronic health records (EHRs) achieve better quality of care than non-PCMH practices using EHRs or paper health records, according to an article being published in Annals of Internal Medicine.
The PCMH is a model of care that emphasizes a team-based approach to care coordination and management of diseases. This model relies heavily on EHRs. Researchers sought to determine the effect of the PCMH on quality of care. They compared claims across 10 quality measures, such as lipid testing for patients with diabetes, breast cancer screening, and appropriate testing for children with pharyngitis. The researchers found that, over time, practices using the PCMH model improved their quality of care at a rate significantly higher than non-PCMH practices. It was noted that quality improved in some measures, but not others. However, the adjusted odds of receiving recommended care in the PCMH practice were 7 percent higher than in the paper group and 6 percent higher than in the EHR group. The PCMH effect was independent of EHR technology, which, on its own, seemed to be insufficient to achieve improvements in care.
The authors suggest that changes to organizational culture necessitated by the PCMH seem to play a role in improving quality. PCMH transformation requires a changing culture toward population management, building a team by defining roles and responsibilities, and becoming accountable for performance. While none of those changes focus specifically on information technology, at least two - population management and performance accountability - are enabled by it.
Article: The Patient-Centered Medical Home, Electronic Health Records, and Quality of Care, L.M. Kern, A. Edwards, and R. Kaushal, Annals of Internal Medicine, DOI: 10.7326/M13-1798, published 2 June 2014.