September 11, 2015|Categories: Models of Care
I entered family medicine 15 years ago, convinced that I could heal not just my patients, but health care. Primary care physicians are this country’s comprehensive caregivers – its eyes and ears for total health. We offer our patients long-term relationships in a system that often favors an episodic approach to coordinated care. I know that empowered primary care providers have the ability to create the highest levels of health and well-being this country has ever seen. But our country’s primary care infrastructure is under enormous strain. The idea of converting my practice into a patient-centered medical home (PCMH) came into focus as we, like many, struggled with flattening reimbursement, limited time with patients, and a payment system that rewards volume rather than value. As my practice applies for Level 3 recognition through the National Committee for Quality Assurance (the highest level a practice can attain) this year, we’ve embraced PCMH not just as a stepping stone towards payment transformation but as a noble recasting of our essential care delivery model. It is a radical shift, but one worth making.
Restructuring a practice into a PCMH is a big task requiring the reorganization of some of its most basic organization. How do you get providers thinking in terms of teamwork, to focus on outcomes, and to do it in a financially accountable manner? Do you have the funds to pay for care coordinators or quality program managers, or for midlevel practitioners? One overlooked question, but arguably one of the most important, is: How will your health IT services support you?
PCMH requirements are inherently IT-oriented, from the way an encounter is documented to how that patient can access it electronically. But this is a shallow approximation of the full value health IT has to offer for aspiring PCMHs. Intelligent, cloud-based IT supports communication, clinical decision-making, and patient engagement. Many other features of a PCMH, such as coordination and collaboration, are outlined in my practice’s cloud-based EHR, whose workflows are pre-validated by the NCQA to help us capture points towards formal recognition. Simply click a button, and our EHR prints out reports we can use to apply. Many practices have already invested in their EHRs because of the Meaningful Use program. Engaging in the PCMH recognition process is a critical occasion for physicians to reconsider how – and if – the IT tools they’re using are backed by the services necessary to help them thrive through industry change.
Continue reading Dr. Apostol’s Medical Economics piece on PCMHs and how they put patients – and intelligent IT – at the center of care.