While the medical home has become a hot-button issue of late, the idea of the patient-centered medical home (PCMH) has been under discussion for decades. Only in the last few years, however, have practices begun adopting the technology tools, particularly electronic health records (EHRs), that will allow them to effectively, efficiently manage such a practice.

While primary care organizations have known that their members would inevitably need to adopt EHRs – the American Academy of Family Physicians dubbed them “the central nervous system of the New Model practice” way back in 2004 – it’s been a tough sell to get members on board.

Today, however, the majority of primary care practices are diving into EHR use, as they are discovering the benefits of using EHRs to manage the coordination of care, improve decision-making and speed access to patient data. EHRs are allowing PCPs to collect and analyze clinical decisions quickly and efficiently, use the latest evidence at the point of care, and draw on a richer base of information from multiple caregivers. Slowly, surely, physicians are using EHRs to move from cumbersome, error-ridden, uncoordinated care to a fleshed-out PCMH.

 

Momentum for a Decades-Old Idea

While the PCMH model may seem like a new idea, it’s actually got quite a history. In fact, the American Academy of Pediatrics (AAP) introduced the concept in 1967, though their model focused solely on creating a central location for archiving pediatric medical records. More recently, in 2007, the American Academy of Family Physicians, the AAP, the American College of Physicians and the American Osteopathic Association issued a joint statement offering what they saw as the key principles behind a PCMH.

As the groups note, one of the key features of the PCMH is establishing a coordinated, integrated system of care that links all elements of the health system – from subspecialty and hospital care to home health and nursing homes. That includes the ability to create disease registries, share patient records effortlessly and manage their patients at the population. Pulling all of this together is just about impossible without the use of health information technology, especially an EHR, which can manage the huge amounts of data collection, patient tracking and trend analysis involved.

For years, few physicians were ready to get involved, though a few select medical groups (with sophisticated technology in place) took part in PCMH pilots and studies.

Not only were they reluctant to take on new responsibilities, physicians weren’t sure that they would ever be paid for the extra work building a PCMH entailed. And you can be fairly sure they weren’t prepared to buy an EHR – which could change every aspect of their workflow – unless they were more or less forced to do so.