title: Transitions, realignments, and focus shifts: possibilities for biopsychosocial care in the electronic health record era.
abstract: The healthcare system in the United States is currently evolving in response to a diverse range of inter-related economic and political pressures. In this article, we discuss three important macro-level transitions (volume to value, clinician-centric to patient-centered care, and individual to population) and their implications for the practice of medicine, health information technology (HIT), and clinical training. Specifically, challenges and opportunities for advancing the use of the biopsychosocial model in clinical practice and teaching in this new, electronic health record (EHR) era of medicine are highlighted. While much work needs to be done to leverage the potential of EHR/HIT systems, their potential to improve population health and patient experience while controlling the costs of care is great. As primary care clinicians and behavioral scientists navigating this changing healthcare landscape, we should continue to strive to deliver high-quality, patient-centered care. Insisting that future generations of EHR/HIT systems support a biopsychosocial approach is part of this mission.
authors.affiliation: MetroHealth Medical Center, Cleveland, Ohio.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Raddock
authors.affiliation: MetroHealth Medical Center, Cleveland, Ohio Case Western Reserve University, Cleveland, Ohio.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Lawson
authors.affiliation: Case Western Reserve University, Cleveland, Ohio.
authors.forename: Samantha
authors.initials: S
authors.lastname: Smith
mesh_terms: D003695:Delivery of Health Care / Q000592:standards*; D057286:Electronic Health Records / Q000592:standards*; D006801:Humans; D008490:Medical Informatics / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D014481:United States
keywords: behavioral medicine; biopsychosocial model; delivery of health care; electronic health records; health care reform; medical education; medical informatics; patient-centered care; primary health care; quality of health care