Study results suggest growing support for the management of care focused on patient

Study results suggest growing support for the management of care focused on patient -

primary care physicians practicing in a coordinated care model in team operates the health information technology are more likely to give patients recommended preventive screening and appropriate tests that doctors working in other contexts, according to a study published today in the Annals of Internal Medicine . The study comparing the quality of care by physicians using a model known as home medical benefit patient-centered (PCMH) care physicians in non-PCMH practices provides evidence that the model previously unproven but popular effectively provides care for patients.

"The study showed that primary care physicians participating in PCMHs improved their quality of care over time to a significantly higher rate than non-PCMH peers," said lead author Dr. Lisa Kern, associate professor of health policy and research at Weill Cornell Medical College. "the PCMH model combines electronic health records (EHRs) to organizational changes, including changes in the roles and responsibilities of clinicians and staff It was the combination of EHR and organizational changes that have been associated with greater improvement in quality ;. DSE alone are not enough. "

The PCMH is an organizational model that has attracted more attention since the Affordable Care Act encouraged, and in some cases, providers incentives to improve the quality of care they provide while reducing its cost. It is based on a personal relationship between being a patient, the doctor and the patient care team, which coordinates care across the health system, specialized practices in hospitals, skilled nursing facilities, the community health and home care services. Electronic health records (EHRs) and other technologies to monitor the health of patients over time to ensure that patients receive appropriate and necessary care. In 2012, there were over 0 commercial health plans, 42 states and three federal initiatives test the PCMH model.

Although PCMH could function without EHR technology has been shown to improve communication among providers, patients and their care teams. It keeps patients better informed about medical choices about their health providers and guides. To become a PCMH, medical practice must undergo a rigorous certification and demonstrate competence in a wide range of performance standards.

"This is an important study of a model of delivering health care that has been widely distributed, but has not been widely proven to improve health care. Practices that turn in PCMHs can be well positioned for additional changes to the delivery of health care, such as participation in responsible care organizations and other forms of health management of the population, "said the lead author, Rainu Dr Kaushal, Chair of the Department of policy of health care and research and Frances and John L. Loeb Professor of medical informatics at Weill Cornell.

the prospective cohort study evaluated health Hudson Valley of New York, where providers and payers operate independently. the researchers looked at how the quality of care has changed over three years (08-2010) in 13 primary care practices using EHRs and became PCMHs during the study, compared to 64 practices using EHRs, but are not PCMHs and 235 non-PCMH practices the paper-based system that is used to store patient health information.

The researchers compared the medical claims of more than 140,000 patients commercially insured through 10 quality measures, such as eye exams, hemoglobin A1C tests to monitor levels of blood glucose, and lipids tests for patients with diabetes; breast cancer and colorectal cancer screening; and tests recommended for children with sore throat. They found that, over time, doctors practices using the PCMH model scored between 1 and 9 percentage points higher than non-PCMH practices on four of the 10 measures. Overall, the likelihood of receiving recommended care in PCMHs was 6 percent higher than in the group that used EHRs and 7 percent more than in the group that used the paper documents.

The PCMH effect was independent of EHR technology, which, itself, appeared to be insufficient to achieve improved care. The authors suggest that changes in organizational culture required by the PCMH appear to play a role in improving the quality of care. PCMHs require suppliers to take responsibility for their performance, build teams by defining roles and responsibilities, and manage groups or patient populations rather than individuals. Although none of these changes specifically focus on information technology, it is at least the management of two people and the most easy-responsibility performance for providers to achieve.