Transforming healthcare has never been more important, given the current state of the worldwide economy and the downward pressure exerted on the U.S. healthcare system. Medical home practices nationwide increasingly help address fundamental problems with the healthcare system. They can improve healthcare accessibility, consistency and quality of care for consumers as well as contain rising costs and curb abuse in the system.

Benefits of the Medical Home
The medical home - an enhanced care model - provides comprehensive and timely care and payment reform, emphasizing the central role of primary care. At the core of the medical home is preservation of the patient's personal, long-term relationship with a primary care physician. Patients who have a personal physician will incur less healthcare expenditures and lower mortality rates.

Another key component of the medical home is the team approach to care. Under this model, the patient is at the center of the healthcare experience, supported by a team of care givers who are practicing at the "top of their licenses." The physician, nurse, nurse practitioner, patient educator, pharmacist and other care givers all have a role to play in a team-based approach to care with a sense of responsibility for the patient. A PCP-led care team becomes the patient's confidant, coordinator, and advisor for all aspects of healthcare, including prevention and wellness.

Where evidence-based guidelines are available and implemented, often with the support of information technology tools, physicians would be able to deliver more personalized and safer care. Patients benefit from more flexible scheduling and from improved communication channels, such as e-mail, phone, or even computer portals where patients can manage their personal health records, monitor their own issues, and even make appointments.

Why We Should Care
The study indicates that all stakeholders - individual/patient, primary care provider, specialist, nurse, hospital, health plan, employer, pharmaceutical organization, government, society and others - can benefit from participating in the medical home.

Employers, for example, are able to purchase healthcare base on value and can potentially see cost savings associated with more efficient healthcare. Evidence shows that primary care has the potential to contain costs, improve quality of care and increase employee satisfaction with the medical coverage. Primary care is the site of the most treatments for chronic conditions and has the potential to produce better patient outcomes and reduce the absenteeism and low productivity associated with chronic diseases.

"It's a new world - and healthcare organizations are key players in an economy that demands increased value, better outcomes, sustainability and accountability," said Paul Grundy, IBM Global Director of Healthcare Transformation. "A smarter healthcare system can improve the level of care by enhancing doctor-patient communication which is the basis of any healthcare system. It also can place appropriate emphasis on wellness and prevention. It changes everything from how healthcare organizations do business to how they enable providers and patients to better collaborate and innovate."

Technology infrastructure
The study emphasizes that medical homes should leverage fully functioning, secure interoperable electronic health records with powerful decision support capabilities connected to their own practice management system and other information sources, such as health information exchanges or other providers' systems. Many physicians who participate in medical homes have electronic medial record systems, but they are out of date with limited functionality and interoperability. In addition, information exchanges are still in the early stages in most parts of the country.

In addition, practices may need other IT-related capabilities such as disease registries, e-prescribing, quality reporting, patient portals to facilitate e-visits, online appoint scheduling and other capabilities, or portals to facilitate physician-to-physician communication for care coordination. The study emphasizes that it is important to have a standards-based technology infrastructure to support larger implementations.

The study concludes that, while the medical home is not a "silver bullet", it can provide a workable foundation piece for overall healthcare transformation. However, to succeed on a large scale, PCMH will require significant changes among other key stakeholder, including consumers, clinicians, and health plans, as well as an integrated digital, openly accessible infrastructure to support coordinated care.

IBM Survey Methodology
To continue tracking both end-user consumer behavior and leading industry expert opinions about the medical home, the IBM Institute for Business Value conducted extensive primary and secondary research. This primary research included over 50 interviews of leading business and thought leaders representing consumer groups, clinicians, hospitals, health plans, employers, pharmaceutical organizations, government, medical home initiatives, and other groups from January through May 2009.

For further information, please visit:
http://www.ibm.com/healthcare/medicalhome.

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