How to get 3 steps closer to PCMH

'EHRs allow us to do things that, in general, paper records can't'
By Jeff Rowe
03:35 PM

Electronic health records are a big investment, so it’s not surprising that many providers are both wary of taking on the burden of a transition from paper to EHRs and skeptical that it’s really going to help them provide better care.

That’s where the patient-centered medical home comes in. More specifically, it’s where the PCMH Quality designation outlined by the National Committee for Quality Assurance comes in, as that program is specifically designed to give providers a road map, and a seal of approval, toward improving patient care.

While the effective utilization of EHRs is only one piece of PCMH designation, some providers have found that ensuring that they’re taking advantage of their new EHR also puts them pretty much in alignment with NCQA’s PCMH program.

In Weatherford, Texas, for example, Nusrat Khan, MD, operates MedPeds, a clinic that serves nearly 10,000 patients, and four years ago he decided it was time to take a walk across the digital frontier, a decision which lead, almost inadvertently, to his clinic being recognized by NCQA as a Patient Centered Medical Home Level 3.

“We recognized we were doing a lot of chronic disease management,” he said recently. “And we knew we had to do a better job both with providing better access to care and better management of the care we delivered.”

After surveying the EHR market, Khan went with Amazing Charts, and in the process of implementing their new system, Khan and his office manager, Robbye Penrod, realized that the steps they were already taking to make optimal use of their EHR essentially mirrored the NCQA measures for the PCMH Standard.

“EHRs allow us to do things that, in general, paper records can’t,” Khan said.

For example, EHRs can help:

  • Cull data on diseases. In NCQA terms, this fits nicely into their PCMH standards category “Identify and Manage Patient Populations.” As Khan explained it, MedPeds’ new EHR enables them to do things like monitor their diabetes patients more closely, and identify hypertensive patients who have visited the clinic but have not met the standards for effective care.
  • Collect data on quality markers. “What you can’t do in a paper world,” Khan said, “is isolate those of your patients whose quality markers don’t meet national standards.” As an example, he cited the ability to query his system to see which of his diabetes patients haven’t had their eyes examined. Again, in NCQA terms, this would fall into the “Plan and Manage Care” standards category.
  • Survey patients to find who needs better delivery of care. “Would our patients like access to the notes of their visits so they can review them? Do they want after hours access to physicians, and would the doctors want access to the patients’ records while visiting with them after hours?” Those questions and plenty of others fall into the “Provide Self-Care Support and Community Resources” category.

Not surprisingly, this doesn’t exhaust the list of ways an EHR can bring providers closer to PCMH designation, but Khan and Penrod agreed that, checklists aside, the most critical element is the proper mindset.

“The provider has to have a culture that supports an enhanced delivery of care atmosphere,” Penrod said. “Every member of the team has to embrace the hands-on, coordinated delivery of care.”

And in the end, Khan said, “it’s important to recognize that it doesn’t matter what IT tool you’re using. The user must use the tool effectively.”

Go down that road far enough, and whether or not you set out with a certification in mind, NCQA just might recognize you for a job well done.

[See also: PCMH model focus of new FQHC demo project]