mHealth: The True Patient Centered Medical Home?


The patient centered medical home (PCMH) has been defined as ‘an approach to providing comprehensive primary care for children, youth and adults.  The PCMH is a health care setting that facilitates partnerships between individual patients, and their personal physicians, and when appropriate, the patient’s family.’  Its principles (a personal physician, a physician-directed medical practice, whole person orientation, and coordinated or integrated care) define a care program centered on the primary care physician (PCP) as the coordinator for medical services. The stated hallmarks of the PCMH are safety and quality. These principles were laid out in a joint statement by the American Academies of Family Practice, Pediatrics, Physicians, and the American Osteopathic Assn in 2007.

Mobile health technologies support the aims of the PCMH.  Patients may need to see specialists less to adjust their medications for chronic diseases if appropriately tested algorithms in wireless programs are effective. The data may be sent to the PCP’s EHR as a central data bank instead of to multiple specialists’ EHRs (providing HIEs aren’t perfected).  Ideally the programs are operating on an actionable alert basis, thereby decreasing the need for routine specialist follow-up. Certainly there are remote monitoring tools that will require the specialist to be the follow-up physician (those involving implantable cardiac devices, for example).  mHealth goes, I believe a step further and focuses on the patient as the home.  It shifts the focus further away from the PCP and has the patient take more responsibility for healthcare, specifically regarding medication adherence, lifestyle modification, and coordination of care with a caregivers and providers. So in a way, proponents of mHealth embrace the same goals and principles of the PCMH, but take them further, involving the patient more and removing the provider as the focus.  Some advocates of the PCMH might see mHealth as inconsistent with their vision, but I see it as the most useful ally and the only way the goals of PCMH can succeed, given the present and increasing shortage of PCPs.  Is mHealth a shorter road towards the PCMH?Let us all, as providers, embrace the tools that improve our delivery of healthcare.

For more information on the PCMH see:http://www.pcpcc.net/content/joint-principles-patient-centered-medical-home

 

 

 

Advertisements

About davidleescher

David Lee Scher, MD is Founder and Director at DLS HEALTHCARE CONSULTING, LLC, which specializes in advising digital health technology companies, their partners, investors, and clients. As a cardiac electrophysiologist and pioneer adopter of remote patient monitoring, he understood early on the challenges that the culture and landscape of healthcare present to the development and adoption of digital technologies. He is a well-respected thought leader in mobile and other digital health technologies. Scher lectures worldwide on relevant industry topics including the role of tech in Pharma, patient advocacy, standards for development and adoption, and impact on patients and healthcare systems from clinical, risk management, operational and marketing standpoints. He is a Clinical Associate Professor of Medicine at Penn State College of Medicine.
This entry was posted in Healthcare IT, healthcare reform, medical devices, mHealth, mobile health, smartphone apps, technology, telehealth and tagged , , , , , , , , , , , , , . Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s