title: The Impact of HIT on Cost and Quality in Patient-Centered Medical Home Practices.
abstract: While health IT is thought to play a critical role in supporting new models of care delivery, we know little about the extent to which HIT improves cost and quality outcomes. We studied a large patient-centered medical home (PCMH) program to assess which types of HIT led to improvements in composite performance outcomes: PMPM cost, chronic disease management, medication management, and preventive care. At baseline, registries were associated with lower PMPM spending (-$19.37; p<0.05). Over time, practices that newly adopted EHRs had smaller gains in chronic disease management adherence relative to non-adopters (diff-in-diff: -1.55%; p<0.05). We failed to find a relationship between other types of HIT - ePrescribing and PHRs/Portals - and our composite outcomes. The lack of consistent relationship between HIT adoption and improved performance suggest that these tools may not yet support the clinical activities and approaches to patient engagement that enable PCMHs to deliver higher-quality, lower-cost care.
authors.affiliation: School of Information, University of Michigan, Ann Arbor, MI ; School of Public Health, University of Michigan, Ann Arbor, MI.
authors.forename: Julia
authors.initials: J
authors.lastname: Adler-Milstein
authors.affiliation: School of Public Health, University of Michigan, Ann Arbor, MI.
authors.forename: Genna R
authors.initials: GR
authors.lastname: Cohen
authors.affiliation: Blue Cross Blue Shield of Michigan, Detroit, MI.
authors.forename: Amanda
authors.initials: A
authors.lastname: Markovitz
authors.affiliation: Blue Cross Blue Shield of Michigan, Detroit, MI.
authors.forename: Michael
authors.initials: M
authors.lastname: Paustian
mesh_terms: D057171:American Recovery and Reinvestment Act; D002908:Chronic Disease / Q000628:therapy; D004059:Diffusion of Innovation; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006801:Humans; D008490:Medical Informatics / Q000706:statistics & numerical data; D018802:Patient-Centered Care / Q000191:economics / Q000592:standards*; D011216:Practice Management, Medical / Q000191:economics / Q000592:standards; D011314:Preventive Health Services; D011787:Quality of Health Care; D012042:Registries; D014481:United States