Health IT Alone Won't Improve Primary Care
Federal report raises numerous questions about whether electronic health records and other technologies can advance the patient centered medical home model.
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Published last month by the Department of Health and Human Services' Agency for Healthcare Research and Quality, the report, "Necessary but Not Sufficient: The HITECH Act and Health Information Technology's Potential to Build Medical Homes," said available evidence on the ability of health IT to support the medical home is mixed.
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While some evidence suggests that health IT improves the cost effectiveness, efficiency, quality, and safety of medical care delivery, there is not broad evidence of success. "It may take 5 to 10 years to figure out the full unintended effects of health IT on transforming practices into medical homes," the report said.
Opponents of health IT argue that "if you computerize an inefficient system, you will simply make it inefficient faster." These critics warn that health IT alone will not positively transform primary care delivery systems. They say a more realistic approach would be to identify the specific health IT capabilities that could help practices become successful medical homes, the document said.
As the healthcare system undergoes a technological transformation, the report examines the potential effects of the planned accelerated adoption of electronic health record (EHR) and other technologies under the Health Information Technology for Economic and Clinical Health (HITECH) Act and its implications for the five principles that encompass the medical home.
The five principles are:
- A patient-centered orientation toward the "whole person" that requires understanding the patient's and the family's preferences and providing the patient's entire range of care needs.
- Comprehensive, team-based care, which relies on a team of providers to meet the patient's care needs.
- Care coordination across all elements of the complex healthcare system.
- Continuous access to care.
- A system-based approach to quality and safety, such as having a practice use evidence-based medicine and clinical decision-support tools to guide decisions.