First-of-its-kind PCMH study: Hudson Valley medical homes outperform peer practices using paper-based or electronic health records

In a novel approach to test the merits of the patient-centered medical home model, research published today in the Annals of Internal Medicine concludes these practices improve care quality at a significantly higher rate than their non-PCMH peers—regardless of whether the comparison practices used paper or electronic health records. The three-year study also found the odds of patients receiving recommended care over time in the medical home were considerably higher.

The paper, "The Patient-Centered Medical Home, Electronic Health Records, and Quality of Care," sheds new light on the effectiveness of the PCMH. Lead author Lisa Kern, MD, MPH, of Weill Cornell Medical College and her colleagues followed 675 primary care providers in three groups over the study period—representing medical homes, paper-based non-medical homes and EHR-based non-medical homes—to test their progress improvement on 10 industry-recognized primary care quality measures. The study was funded by the Commonwealth Fund and the New York State Department of Health

Significantly, the study examines PCMH practices of varying sizes and types—from large group practices to small, solo practices and federally-qualified health centers—in an open medical community, without a large integrated health system. Findings can be applied across varying independent practice types.

Researchers teased out the differences in quality along several lines:

1. The PCMH medical practices in the study performed significantly better: 6 percent better than non-PCMH EHR practices, and 7 percent better than non-PCMH paper record practices.
2. There was no significant difference in rate of improvement between the non-PCMH paper and EHR practices.
3. The advanced level of care provided by the PCMH cohort "is more than a health information technology intervention; changes to organizational culture seem to play a role," the authors conclude.

"These results demonstrate that you're going to get better quality of care if you see a provider that's part of a patient-centered medical home. That's a big deal for patients and purchasers of care," said Susan Stuard, THINC's executive director. "It helps us understand more about the mark of quality you find in these practices. You're 7 percent more likely to get the recommended care you need. And that's powerful."