EHRs help coordinate patient-centered medical home care, but don't support teamwork

Electronic health records can help clinicians coordinate patient care, but as currently designed don't support teamwork well, according to a new study published in the Journal of the American Medical Informatics Association.

The researchers, supported by a grant from the Commonwealth Fund, interviewed 63 respondents in 27 primary care practices striving to work as patient-centered medical homes from May 2013 through December 2013. They found that EHRs facilitated teamwork by enhancing communication via improved access to patient information, with-in chart notes, task assignments, and the like. Moreover, when combined with revised clinical workflows, the EHRs reduced task duplication and allowed physicians to delegate more to non-physicians.   

However, there were "numerous" challenges with the EHRs that hampered the practices' attempts to work as a team, according to the study. The systems typically lacked care management and population health management functionalities. They ended up creating workarounds or using separate systems. There also was no accountability for standardization or consistency of the EHR data.  

The researchers noted that some of the needed functionalities will be available in EHRs certified for Stage 2 of Meaningful Use, but that practices needed more support and resources to make best use of their systems.

"To maximize the potential synergy between primary care teamwork and EHRs, clinical workflows need to evolve alongside EHR customization and development of new functionalities, where possible," the researchers said. "... A shift in the policy and regulatory environment toward encouraging providers and EHR vendors away from their utilization for billing/administration documentation and tracing each data unit to the person who entered data and toward putting EHRs to work supporting team-oriented care for individuals and populations could bolster that evolution."

Patient-centered medical homes have been found to reduce costs and improve patient care. To that end, CMS just unveiled its plan to accelerate tying payment to value-based and coordinated care models.

However, providers continually have expressed concern that the current design of EHRs does not meet their clinical needs.

To learn more:
- read the study

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