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PCMH study shows care trumps technology in patient outcomes

June 9, 2014
by Richard R. Rogoski
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While electronic health records are supposed to make the delivery of healthcare more efficient, cut down on medical errors and ultimately result in better patient care, a new study calls into question whether it's the technology or the care model that leads to better patient outcomes.

To test the merits of the patient-centered medical home model (PCMH), researchers compared the quality of care provided by physicians in PCMHs with that provided by physicians using paper medical records and physicians using EHRs who were not in PCMHs.

A team of researchers, led by Lisa Kern, MD, MPH, of Weill Cornell Medical College, followed 675 primary care providers in 312 practices in the Hudson Valley area of New York over a two-year period.

Results of the study appeared in a paper entitled "The Patient-Centered Medical Home, Electronic Health Records, and Quality of Care" published in the Annals of Internal Medicine.

According to a press release, the researchers noted that the PCMH medical practices in the study performed significantly better: 6 percent better than non-PCMH EHR practices, and 7 percent better than non-PCMH paper record practices; that there was no significant difference in rate of improvement between the non-PCMH paper and EHR practices; and that the advanced level of care provided by the PCMH cohort "is more than a health information technology intervention; changes to organizational culture seem to play a role," the authors said.

"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," said Susan Stuard, executive director of the Taconic Health Information Network and Community (THINC). "It helps us understand more about the mark of quality you find in these practices.

"We're showing that the PCMH is not just a process, it's about better outcomes," she added. "It is absolutely worth the time, money and energy invested in creating better primary care practices."