Increasing the use of health information technology by both patients and physicians is a key to the success of the patient-centered medical home, two new reports have found.

That includes technologies that increase patient engagement in the patient-centered medical home by boosting people's ability to manage their own health, as well as technology that gets the important information into the hands of physicians when they need it, according to the reports, issued by the Patient-Centered Primary Care Collaborative.

The reports were released Oct. 21 in conjunction with the group's annual summit in Washington, D.C.

Despite 20 years of research and attempts at encouraging patients to participate in managing their own health, rates of obesity, diabetes and other chronic conditions remain stubbornly high, said Dr. Paul Grundy, the group's president and global director of IBM Healthcare Transformation.

"Patients told us they wanted better access to care, care that was better coordinated and better relationships with their providers," Grundy said. "In terms of the technology, there are tools that can help do that in a very profound way."

Those tools include using e-mail to improve the accessibility of physicians and other health care professionals, registries to track how well patients with chronic conditions are managing their disease and patient portals that are easy to use and enable patients to book appointments and view lab results.

"When we ask patients, 'Do you like your doctor?' a pretty high proportion says yes," Grundy said. "But when we ask, 'Do you like the communication with your doctor?' there's a pretty high proportion that say no."

On the physician side, health information technology can help by enhancing physicians' ability to make the best clinical decisions at the time of service, the reports also found. Clinical decision support systems put electronic patient health records, diagnostic tools and the latest information on evidence-based medicine at a physician's fingertips.

Such information might include reminders about routine tests and screenings or potential drug interactions.

"If a patient is on four medications, it's unlikely you can keep, in your mind, the potential interactions straight," Grundy said. "The computer would tell you all the side effects and spit out a warning if you were about to make a mistake."

Grundy said he saw this in action recently. A physician was using a clinical decision support system, or CDS, that was linked to the pharmacy. A patient with asthma came in complaining that he was having trouble sleeping. Instead of prescribing sleeping pills, the physician was able to see that the patient wasn't filling his asthma prescription. Uncontrolled asthma can impact sleep.

Though CDS technology is still in the development stage, CDS systems might one day include information about recommended treatments and procedures for the entire spectrum of diseases and conditions.

"CDS is really trying to help do for doctors' minds what X-ray has done for their vision," Grundy said. "It makes information and data available and easier to use. It puts it together on a dashboard in some way that makes it useful or actionable for the doctor."

The collaborative, founded in 2006, is a coalition of major employers, consumer groups, physician associations, health plans, labor unions, academic centers, hospitals and clinicians who have joined together to improve doctor-patient relations and create a better model for health care delivery. With more than 600 member groups, including the American College of Physicians, it has become a leading advocate for the patient-center medical home concept.

Both the health care reform legislation enacted earlier this year as well as federal legislation known as the HITECH act (for Health Information Technology for Economic and Clinical Health), which was part of the American Recovery and Reinvestment Act of 2009, included substantial support for improving health care technology and building the infrastructure for medical homes, Grundy said.

But many physicians are still sitting on the sidelines, unsure of what technology they should invest in, he said -- not an unreasonable stance, considering many health information technology programs are still something of a work in progress.

But expect that to change in the near future, Grundy said, with health information technology beginning to profoundly affect the way in which health care is delivered.

"Right now we have all these doctors that have pretty basic, pretty primitive technology in their offices and hundreds of different providers of the technology," he said. "But there are going to be huge changes, [compared with] the last 10 or 15 years. The tipping point has been passed."

More information

The collaborative's two new reports are available online: Health IT in the PCMH and Clinical Decision Support in the Medical Home.