The ability to overcome a lack of EHR interoperability through the use of complementary health IT tools will help determine the success of patient-centered medical homes, according to report published by the Patient-Centered Primary Care Collaborative (PCPCC).
“Health systems and practices must utilize a combination of technology to provide data for population management along with practice changes that will enable the allocation of resources and personnel to patients when needed,” the authors of the report explain. “There is sizable demand in the health care marketplace for the development of compatible and functional products to meet these needs.”
The PCPCC review of peer-review studies, state government program evaluations, and industry reports between 2013 and 2014 indicates the patient-centered medical homes are improving cost, utilization, access, and satisfaction.
Of the 28 reports serving as evidence in the annual review, PCPCC found that:
- 17 found improvements in cost
- 24 found improvements in utilization
- 11 found improvements in quality
- 10 found improvements in access
- 8 found improvements in satisfaction
PCMHs, however, are likely to face challenges moving forward related to care integration, financial support, personnel, patient and patient engagement, and technology.
Despite increasing levels of EHR adoption, the PCPCC report highlights the limitations of this technology in a healthcare environment where numerous EHR platforms are in use. Enter the challenge of EHR interoperability:
Electronic health records (EHR) are the foundational documentation and work flow tools in ambulatory practices. However, many PCMH practices are in networks with multiple EHRs. The data acquisition and interoperability challenges in such heterogeneous networks, and the lack in most, if not all, EHRs of sophisticated population health functionality results in the need for other complementary solutions.
To develop a successful health IT strategy, PCMHs will need to look beyond EHR technology if they are to address clinical documentation and workflow, population health management of chronic disease and high-risk patients, and manage the risks associated with value-based contract.
“Clinical data from EHRs is optimal but, given data acquisition challenges, an opportunistic and pragmatic approach leveraging practice management system data (pre-adjudicated claims) and lab data provides an opportunity to get started,” the report states.
The solution to non-interoperable EHR systems is expected to come in the form of network registries to ensure that all members of the PCMH have access to the most accurate and timely health data:
Unlike the health maintenance reminders in an EHR, a network registry solution gathers data from across the network and serves as a collaboration platform among providers across the continuum to drive compliance with preventive and chronic care guidelines and, most importantly, serves as a single source of “truth”.
PCMHs are making inroads in delivering high-quality care within a risk-based model. However, the complexity of their patient populations moving forward will require a health IT infrastructure sufficient to meet this complexity head on.