Necessary But Not Sufficient: The HITECH Act and Health Information Technology’s Potential to Build Medical Homes

June 2010
AHRQ Publication No: 10-0080-EF
Prepared For:
Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov

Contract Number: HHSA290200900019I TO2
Submitted By: Mathematica Policy Research 600 Maryland Avenue, SW Suite 550 Washington, DC 20024-2512
Authors: Lorenzo Moreno, Ph.D., Deborah Peikes, Ph.D., Amy Krilla, M.S.W.
Table 1. Medical home principles, technological capabilities for supporting the PCMH model, required health IT functionalities, and illustrative health IT applications
Medical Home Principle Technological Capability Required Health IT Functionality Examples of Health IT Applications
Source: Mathematica‘s adaptation from the Patient-Centered Primary Care Collaborative, 2009, pp. 7-14.
Key: CDS = clinical decision support; EHR = electronic health record; PHR = personal health record.
Patient-centered, whole-person orientation - Uniquely identify patients, including language preferences
- Identify the patients’ care preferences and preferred learning mode, and facilitate their self-management with input from providers
- Access to patient health records and preferences
- Support for patient self-management
- EHRs
- PHRs
- Telemedicine
Comprehensive, team-based care - Collect, store, manage, and exchange relevant general medical and behavioral health information - Collect standardized, accurate, and essential data elements
- Facilitate medication reconciliation
- Allow registry views for monitoring by patients
- EHRs
- PHRs
- Patient registries
- Telemedicine
Coordinated care - Collect, store, manage, and exchange relevant general medical and behavioral health information The above, plus:
- Support care coordination
- Incorporate data from outside systems
- Allow linking to other resources
- EHRs
- PHRs
- Patient registries
- Telemedicine
Continuous access to care - Communication among practice team and patients - Allow access via secure Web portal, E-mail, or PHR - Web portals
- Secure E-mail
- PHRs
- Telemedicine
Systems-based approach to quality and safety - Collect, store, measure, and report on the processes and outcomes of individual and population performance and quality of care
- Uniquely identify patients in the practice
- Support providers’ decisionmaking on tests and treatments
- Allow automated quality measurement
- Allow improved interfaces with public health services
- Allow outcomes evaluation
- Allow evidence-based CDS at the point of care
- Allow risk stratification of patients for performance measurement
- EHRs
- Patient and population registries
- Pay-for-performance outcomes databases
- Telemedicine
- PHRs with decision support tools