Healthcare Quality: Medical Homes and EMRs

Healthcare quality issues are typical concerns in health policy. There are long-standing problems associated with the administration of healthcare, such as racial and ethnic health disparities, and the geographic variation in the quality and quantity of care provided, that are important for the healthcare industry to address.¹

Medical Home Model

The medical home is the patient-centered philosophy that provides primary care that is comprehensive, continuous, team-based, coordinated, accessible, and focused on quality and safety. The medical home is a model for gaining primary care excellence to ensure that care is delivered in the right place, at the right time, and in a way that best suits patients’ needs.² The medical home model emphasizes care coordination and communication, and cultivates engaged patient relationships.³ Medical homes strive to enhance the efficiency, effectiveness, and quality of care they deliver while answering every patient’s needs and respecting their preferences, which is recognizing their moral rights to choose their actions.⁴

Health Information Technology

Electronic medical records (EMRs) are the main source of data for healthcare providers to monitor patients and improve quality of care. The most common benefits of EMRs include increased delivery of guideline-based care; enhanced organization, accessibility, accuracy of patient documentation; and capacity to perform surveillance and monitoring; reduced medication errors; increased access and control over health information; reduced liability through better decision making and documentation; greater cost savings and efficiencies; reduced the number of redundant procedures; improved efficiency and effectiveness of workflow; and reduced wait time for treatment.⁵

Electronic health records (EHRs) are the longitudinal electronic records of patients’ health information from all the clinicians involved who are authorized personnel to have access to the electronic infrastructure and provide care to those patients. EHRs have the capacity to share information with other healthcare providers, including laboratories, and specialists across the country. EHRs contain medical information that include diagnosis, medications, immunizations, past family medical histories, laboratory test results, and healthcare provider contact information.⁶ The powerful framework of the computer-based individual’s life time health status and record optimizes the collection, presentation, and communication of patients’ data resulting in time and cost savings for all involved in the healthcare delivery process.⁵ The use of the EHR can help analyze, document, and communicate basic care elements among healthcare professionals to enhance the quality of health information and patient safety.⁷ Patients have the ability to access their medical history and medications, manage relevant health information, promote health maintenance, and add new information to their profile that may ultimately help in their treatments.⁸

EHRs improve continuity of care when clients move between different healthcare facilities and they have the potential to reduce medical errors as clinicians’ illegible handwriting will be eliminated. They facilitate patient tracking, including their vaccinations, test results, and prescriptions and allow for better analysis and evaluation of care delivered. In addition, sharing of data with other healthcare providers could facilitate the identification of new treatments at a faster pace.⁶

Encouraging Utilization of Electronic Infrastructure

Quality care concerns must be investigated and reduced in order to promote high-quality care. EHRs have the potential to become the core tool in healthcare delivery, integrate all pertinent patient information into one record, which can be accessed by authorized interdisciplinary professionals at any time. It is imperative to have a good system management to promote the growth and effective use of digital health and advance the design and evaluation of information technology. Organizations need to properly train employees and ensure that only authorized personnel have access to the electronic infrastructure. Additionally, it is a great idea to provide incentives to physicians and hospitals to purchase and use new technology.

Financial incentives to adapt and deploy electronic infrastructure can be quite effective when used appropriately. Policy makers have an obligation to mobilize the community to solve maldistribution. It is imperative for government to invest in healthcare adequately and healthcare leaders must identify their own boundaries and advocate for appropriate social change to provide care and use appropriate resources that benefits society in the best possible way.

References

1. Teitelbaum JB, Wilensky SE. (2013). Essentials of health policy and law (2nd ed.). Boston, Mass: Jones & Bartlett Learning.
2. Patient-Centered Primary Care Collaborative. (2014). Defining the medical home: A patient-centered philosophy that drives primary care excellence. Retrieved from https://www.pcpcc.org/about/medical-home. Accessed December 6, 2016.
3. National Committee for Quality Assurance. (2014). Patient-centered medical home recognition. Retrieved from http://www.ncqa.org/Programs/Recognition/Practices/PatientCenteredMedicalHomePCMH.aspx. Accessed December 6, 2016.
4. American Academy of Family Physicians. (2015).The patient-centered medical home. Retrieved from http://www.aafp.org/practice-management/transformation/pcmh.html. Accessed December 6, 2016.
5. Hebda T, Czar P. (2009). Handbook of informatics for nurses & healthcare professionals (4th ed.). Upper Saddle River, NJ: Pearson Prentice Hall.
6. Ardito SC. (2014). Electronic health records. Online Searcher, 38(6):38-44.
7. Englebright J, Aldrich K, Taylor CR. (2014). Defining and incorporating basic nursing care actions into the electronic health record. Journal of Nursing Scholarship, 46(1):50-57.
8. Wynia M, Dunn K. (2010). Dreams and nightmares: Practical and ethical issues for patients and physicians using personal health records. Journal of Law, Medicine and Ethics, 38(1):64-73.