Medical Home Model and Health Information Exchange for Patient-Centered Quality

Background: In this paper, the authors will discuss the development of a patient-centered medical home (PCMH) model and the role that health information technology can play in facilitating a health information exchange (HIE). The PCMH concept is designed to address the lack of care coordination between disparate healthcare providers by centralizing care of individual patients through one provider, usually a primary care physician. The PCMH model for healthcare delivery is not a new idea; the American Academy of Pediatrics (AAP) proposed a medical home model in 1967 for the care of children with special needs. Technology has now made it possible, after more than four decades to achieve the goals of the AAP and other stakeholder organizations over the years who have advocated for the development of medical homes. The role of health information technology in facilitating provider-to-provider communication across silos of care and facilitating the development of the PCMH will be discussed. Conceptualized and implemented in the University of Texas at Houston's School of Health Information Sciences (UT-SHIS), the HealthQuilt project represents a collaborative enterprise including both researchers and practitioners endeavoring to promote the PCMH through a concept called the Quality Health Record (QHR). The QHR adopts an open-source technology solution to support the PCMH and the HIE as well as the collection of quality outcomes, the incorporation of standard clinical treatment protocols, and secure telecommunication among providers across the “silos of care.”