Technology changes needed for PCMH-N model to work, says internist

Technology needs to change so that information can be accessed quickly, easily, and safely if the Patient-Centered Medical Home–Neighbor (PCMH–N) model is going to be successful, writes Christine A. Sinsky, MD, a general internist, in the January 3 issue of Annals of Internal Medicine. Her editorial was in response to a position paper released by the American College of Physicians (ACP) in October.

The ACP describes the PCMH–N as the interaction of the subspecialist practice and the Patient-Centered Medical Home. The PCMH is a clinical practice that functions as the central hub of patient information, primary care, and care coordination.

ACP’s position paper provided a framework to categorize the different types of interactions between the PCMH and subspecialty practices. It also defined a set of principles to facilitate coordination and integration between the practices to provide efficient, high-quality patient care.

When it comes to technology, Sinsky writes, “We desperately need information tools that support coordination across time and place. Information overload, information chaos, and information scatter . . . are part of the modern medical landscape.

“There should be a single source for coherently displayed synoptic information. This task goes beyond the interoperability among 350 proprietary vendors of electronic health record systems. When a patient’s cardiologist adds a prescription, the medication list in the general internist’s record should automatically reflect this. When the PCP orders computed tomography, the results should be available to all other physicians involved in the care - not through faxing, filing, and manually transferring digital data, but through real-time, single-source information transfer.”