Though it may be pricey and encounter cultural resistance, an EMR and related health IT is a necessary investment for organizations wishing to follow the patient-centered medical home model, suggests a new issue brief by the Deloitte Center for Health Solutions.
According to the report, practices and clinics need EMRs, broadband Internet access, personal health records, clinical decision support and other IT services to facilitate greater access, care coordination and monitoring of patients with chronic conditions. Providers should expect "significant" upfront costs for computer equipment, EMR software and technical expertise, but the payoff could be equally significant in terms of money and quality, Deloitte says.
For the brief, Deloitte studied seven medical home programs, including ones launched by Intermountain Health Care in Utah and Community Care of North Carolina's Medicaid program. They were able to reduce hospitalizations by up to 40 percent, and save up to $640 per patient in treatment costs, thanks to better coordination, disease management and an emphasis on prevention. Of the 38 medical home pilot programs Deloitte says have been launched nationwide since 2006, 54 percent are focused on treating specific chronic diseases.
The report did note there were many cultural challenges to implementation among both physicians and patients. "Practices had to shift from physician-centered to patient-centered care--a difficult transition for physicians used to being responsible for the entire patient encounter," Deloitte says. Yet "patients did not perceive the transformation to be beneficial, likely because of disruption in the practice and a lack of communication about the benefits of a medical home."
Ron Shinkman contributed to this article.