Two recent studies focused on diabetes patients reveal that the saying "There's no place like home" may be true — in this case, it's a patient-centered medical home (PCMH).
The PCMH model of care has always focused on improving care quality and reducing costs for the chronically ill. Now, the PCMH has been found to increase the percentage of diabetes patients who achieve goals that reduce their sickness and death rates, according to health researchers.
A report from the eHealth Initiative found that using electronic health records (EHRs) in medical homes to coordinate care resulted in numerous process improvements for patients with Type 2 diabetes and heart disease in a medical home.
The initiative reported improvements in provider-patient communications, intra-office coordination, EHR use, care planning, patient coaching, specialist referrals and several other areas. The care plan enabled by the EHR allowed researchers to streamline the care process for the patients and more efficiently track their progres:
At one site, six separate cardiology referral forms were used before the project began. Following the intervention a single form was developed and formatted within the EHR, said Victor Villagra, MD, president of Health and Technology Vector.
In a second study, Pennsylvania researchers say the key of the PCMH is to make physicians not only look at individuals, but at their patient population in general.
In PCMH, medical practices learn to work together as a team, coordinating care centered on the patients' needs. The researchers report a significant improvement in adherence to evidenced-based care guidelines and in clinical outcomes. In one year, the number of patients with better LDL levels, better blood pressure and or lower A1c levels increased. The number of patients receiving yearly foot exams, eye exams and pneumonia and influenza vaccines also increased, according to a Penn State College of Medicine press release.
Pennsylvania leads the nation in implementing the PCMH, based on the chronic-care model (CCM) of care, which promises to improve health and reduce costs of care. This type of care attempts to move from a reactive approach to a focus on long-term problems in healthcare delivery.