The Patient Centered Medical Home (PCMH) model may be the hottest topic in health care especially among healthcare providers. This model will not be the savior of the health care market but if implemented properly, it may solve some of our problems. It is believed that PCMHs can improve the quality of medicine that we practice and cut cost therefore allowing for savings that will help cover the medical operation. Pilot projects across the country have shown good success in validating this theory.
The practices that have been the most successful at becoming PCMHs are those who have the human and financial resources to support the workflow changes, purchases, and new employees that are often required. These are often larger practices and hospital systems which have resources that are leveraged across the clinical operations. Many of the successful practices have seen a return of investment through more efficient clinical and business practices along with better care coordination of patients leading to decreased hospital admissions. Clinically, the significant practice management improvement and better implementation of best practices can lead to better outcomes.
Other practices are finding it more difficult to find the resources to adopt the model. The cost of HIT, additional staff, and other services can be out of reach for the smaller practices. Most providers understand the importance of EHR adoption but it takes more of a cultural change to have a successful PCMH. If you look across the country, the more successful IT teams, no matter what practice size, are teams that are dedicated to the technology and making a change with the new systems that are put in place. A coordinated effort of practice management, quality improvement and HIT adoption is a prerequisite to a successful model.
It is not an easy solution for any practice to adopt the PCMH model and for some it is still out of reach. However, I hope as the technology becomes cheaper and the greater health system becomes more integrated that we build health information exchanges with analysis and intellectual capabilities that are readily available and affordable. This will aid the smaller hospitals and practices to obtain PCMH certification and be successful partners as we build ACOs in Georgia and across the country. Therefore, it is important that providers, practices, health systems, and public health are open to sharing patient information in a private and secure manner. The Relinquishing of territorial, financial and political protective barriers will be necessary to reach the ultimate objectives of the integrated PCMH model. To improve patient care and lower cost throughout the health system will take a cultural change system wide.