The Future Of Health Information Technology In The Patient-Centered Medical Home

Abstract

Most electronic health records today need further development of features that patient-centered medical homes require to improve their efficiency, quality, and safety. We propose a road map of the domains that need to be addressed to achieve these results. We believe that the development of electronic health records will be critical in seven major areas: telehealth, measurement of quality and efficiency, care transitions, personal health records, and, most important, registries, team care, and clinical decision support for chronic diseases. To encourage this development, policy makers should include medical homes in emerging electronic health record regulations. Additionally, more research is needed to learn how these records can enhance team care.

Promoting Access Through Complementary eHealth Technologies: Recommendations for VA’s Home Telehealth and Personal Health Record Programs

“…VA is a leader in the use of eHealth applications to improve healthcare access and ultimately, health outcomes. The patient-centric healthcare model that VA has recently adopted, with its focus on information technology and coordination, team-based practice, routine patient feedback, and improved access to care (e.g., 63 ), underscores the importance of embracing the kind of complementary vision of the CCHT and MHV programs that we have articulated here. To do so will require a paradigm shift to go beyond the organizational construction and management of eHealth tools into "programs" and reconsider eHealth features as a repertoire of tools available to patients and their healthcare teams.…”

Challenges Facing Primary Care Practices Aiming to Implement Patient-Centered Medical Homes

“…28 Given VA's long HIT track record, VA PC experience with the overwhelming volume of EMR-based reminders and alerts in the context of inadequate clinical informatics support should raise caution for those assuming that "plugging in" an EMR will be a "fix all" for healthcare delivery challenges. More research is needed to improve PCMH-centric HIT functions supporting team-based care, care transitions, chronic disease management, 29 and patientcentered care. 25 Given that the VA provides care for a high volume of patients with multiple chronic conditions, 30 the complexity of VA patients may invoke special challenges during PCMH implementation.…”

Opportunities to Increase the Effectiveness of EHR-Based Diabetes Clinical Decision Support

“…Multiple studies suggest that non-use is the reason that most EHRbased CDS have thus far failed to improve intermediate outcomes of diabetes care [5][6]. Providers may be more inclined to use CDS when it saves them time, is not overwhelming in its detail, appears early in the encounter, and offers a number of options designed to supplement, rather than supplant, clinical judgment.…”