The value of medical homes: Culture not tech
Patient-centered medical homes already have proven to enhance quality of care, and now new research finds that quality improvement comes from the community and culture created through the program rather than the technology used.
Key features of medical homes include case managers and a team-based approach to patient care. They also usually employ health information technology, including electronic health records and electronic prescribing, according to the study published Tuesday in the Annals of Internal Medicine.
To determine which features have the most impact on medical home success, the study authors compared PCMHs with traditional practices that use paper records and others that use EHRs. They found EHRs alone don't enhance quality care; rather, changes to the organizational culture have the greatest impact on quality improvement.
In fact, medical homes performed 6 percent better than non-PCMH EHR practices and 7 percent better than non-PCMH paper practices.
"These results demonstrate that you're going to get better quality of care if you see a provider that's part of a patient-centered medical home. That's a big deal for patients and purchasers of care," Susan Stuard, executive director of the Taconic Health Information Network and Community, a nonprofit organization that conducted the study, said in a statement.
She added that the study results show medical homes aren't only about implementing a process, they're also about achieving better outcomes. "It is absolutely worth the time, money and energy invested in creating better primary care practices," Stuard said. "The PCMH designation shows that you put in enough training so you can run that marathon and cross the finish line."
However, the study doesn't negate the importance of health IT in medical homes. The authors noted that EHRs greatly enhanced medical homes' ability to manage population health and improve patient health.
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