Informatics Systems and Tools to Facilitate Patient-centered Care Coordination

Abstract

SummaryIntroduction: There is a growing international focus on patient-centered care. A model designed to facilitate this type of care in the primary care setting is the patient-centered medical home. This model of care strives to be patient-focused, comprehensive, team-based, coordinated, accessible, and focused on quality and safety of care. Objective: The objective of this paper is to identify the current status and future trends of patient-centered care and the role of informatics systems and tools in facilitating this model of care. Methods: In this paper we review recent scientific literature of the past four years to identify trends and state of current evidence when it comes to patient-centered care overall, and more specifically medical homes. Results: There are several studies that indicate growth and development in seven informatics areas within patient-centered care, namely clinical decision support, registries, team care, care transitions, personal health records, telehealth, and measurement. In some cases we are still lacking large randomized clinical trials and the evidence base is not always solid, but findings strongly indicate the potential of informatics to support patient-centered care. Conclusion: Current evidence indicates that advancements have been made in implementing and evaluating patient-centered care models. Technical, legal, and practical challenges still remain. Further examination of the impact of patient-centered informatics tools and systems on clinical outcomes is needed.

From programme theory to logic models for multispecialty community providers: a realist evidence synthesis

“…Even in the Netherlands, where internet usage is extremely high, patients showed a lack of awareness and motivation to hold their own health records, and there were usability problems in the systems for accessing them. 85 There have been similar experiments in Sweden, with mixed success. 23 …”

“…103 These contradictory findings may be explained by the slow uptake of personal health records, and a lack of studies connecting personal health records to patient outcomes. 85 Another study (reported in Bauer et al…”

“…Causal link 4:12 -if culture changes occur in the participating organisations, then there will be better patient experience and outcomes Demiris and Kneale's 85 narrative literature review found that implementation of patient-centred care depended on culture change in health-care organisations and among health-care consumers. In their SR, Busetto et al 114 reported a study by Borgermans et al in which the presence of interdisciplinary diabetes mellitus care teams was associated with significant improvements in HbA 1C and low-density lipoproprotein (LDL)-cholesterol levels, and increased statin and anti-platelet therapy use, which were attributed to the quality and task orientation of the teams, shared leadership and shared group norms.…”

“…Two different studies 85,114 reported in SRs found that effective EHR use enabled teams to increase quality of care for diabetes mellitus patients. Several studies 85,118,121 have also found that electronic patient registries can improve patient quality outcomes.…”

“…One SR 85 found very little evidence that an electronic personal health record (accessible by patients) increased care outcomes, care co-ordination or patient engagement. By contrast, another found that patients had very positive responses to a patient portal.…”