by Candi Helseth
Rural providers must embrace information technology to successfully implement a medical home program. Yet, only 10 percent of American primary care providers currently use electronic medical records, according to Dr. Ted Epperly, president of the American Academy of Family Physicians.
“One of the most unfair ironies of a health care system that now spends $2.3 trillion per year—over $7,000 per citizen on health care—is the burden it places on patients to transfer their medical information among their health care providers,” Epperly asserted. “Electronic medical records provide the ability to coordinate and track a person’s health over time. This is essential to patient-centered medical homes (PCMH) where the focus is no longer on treating an acute condition, but rather keeping patients well and healthy.”
Research has demonstrated that patients are not trained in medical language and it is difficult for them to remember all their symptoms, history and medications. This is particularly true for patients with multiple or chronic illnesses, which constitute the majority of PCMH patients. Paper records may be inadequate or unavailable when patients travel outside their immediate care network, and patients living in rural areas are more likely to travel to tertiary centers for specialty care. When those patients return home for follow-up care, paper data is less likely to be transferred to the primary care provider. With electronic records, patient health information from multiple, diverse sources is pulled together into a single electronic system that is easily accessible for all patient providers, Epperly noted.
Research data indicates that 40 percent of primary care visits do not require a physical visit to a physician’s office, according to Paul H. Keckley, executive director of Deloitte Center for Health Solutions in Washington, D.C. “Patients welcome more technology,” he added. “Our data shows that non-urban patient populations with chronic conditions want more use of technology in coordinating their care.”
In addition to electronic medical records, information technology may include physician-patient interaction such as email visits and prescription emails to better coordinate and integrate a patient’s care, Epperly said, noting, “Family medicine physicians are ahead of the curve here. Forty-seven percent of family medicine physicians incorporate electronic technology into patient care. Family medicine strongly emphasizes overall care coordination rather than focusing on acute care only.”
Deloitte Center’s research also indicates that rural primary care providers without electronic medical record systems cite cost as the primary barrier to PCMH implementation. Keckley said the federal government’s stimulus package allocates significant funding for physician practices, community health centers and critical access hospitals in rural areas to purchase electronic medical record systems.
“The money is there now so there is no excuse for rural-based physicians and providers not to be moving toward electronic medical records,” he asserted. “Access to primary health services can be delivered in a variety of ways and information technology can greatly augment conventional care in rural areas where there are already provider shortages.”
In rural Minnesota where Lakewood Health System at Staples implemented its medical home program in 2008, the new electronic medical system is critical in managing patient care, said Medical Director Dr. John Halfen. “With electronic records, we access patient information that would be virtually impossible if we were still using a paper system,” Halfen said. “Communication between all providers and having all the information in electronic medical records is absolutely necessary to make the medical home program work.”
Back to: Spring 2009 Issue