Helping federally qualified health centers to meet patient centered medical home standards

Background NCQA's Patient-Centered Medical Home (PCMH) standards require primary care practices to use electronic health records (EHR) to improve quality of care. My Own Health Report (MOHR) is a web-based tool that collects patient-reported measures and allows primary care physicians to routinely screen patients for behavioral (e.g., physical activity, nutrition, substance abuse) and mental health conditions. Federally Qualified Health Centers (FQHCs) that are already PCMHs or are seeking PCMH recognition are well positioned to benefit from integrating MOHR into their EHR system to manage and track patient health over time. Methods The NCI, AHRQ, and the NIH Office of Behavioral and Social Sciences Research are working with 8 academic partners to implement the MOHR project in 18 primary care clinics. Eight of the clinics are FQHCs while the other 10 are Practice-Based Research Networks. The MOHR project is a paired, clinic-level randomized pragmatic trial (9 intervention and 9 control clinics) where the control clinics will make up a delayed intervention group. The trial will begin March 2013. The 9 early intervention clinics will integrate MOHR into their normal workflow over a period of 4 months. Patient experience surveys will be administered to at least 150 patients per clinic to assess the impact of MOHR on the quality of patient-provider communication and behavior change counseling between the intervention and control sites. Factors associated with adoption and use of MOHR will be evaluated using a mixed-methods approach that includes collecting process evaluation, contextual, and cost data. Results The extent to which MOHR allows FQHCs to meet PCMH standards such as demonstrating continuous quality improvement and conducting comprehensive health assessments will be reported. We will also share individual and organizational factors that influenced the capacity of FQHCs to integrate MOHR into their EHR system in a meaningful way. We will report on how clinicians used MOHR as a foundation for behavior change and goal setting discussions. In addition, we will discuss how FQHCs used the patient-reported data generated through MOHR to plan, manage and coordinate patient care, especially for patients with chronic illnesses. Conclusion Routine collection of patient-reported measures is important to achieving high quality, patient-centered care. My Own Health Report is a tool that clinicians can use to counsel patients about behavioral and mental health issues in a meaningful way. This is especially important for FQHCs that are trying to provide comprehensive preventive services to patients through the PCMH model.