Patient-centered medical home and secure messaging

As technology and technology access continues to advance, I believe that the patient-centered medical may take advantage of new health and behavioral informatics innovations.

Consider the following principles that are sometimes linked to the patient-centered medical home, and examples of how behavioral informatics could help...


Patient-driven
Lots of opportunities here. Behavioral informatics applications have been created to provide patient reported outcomes (see NIH PROMIS) and some on patient reports of care provided. Systems could be further developed to provide decision support based on provider and patient input to facilitate shared decision-making.

Team-based
The patient should be considered a part of the medical team and not the object of action. In this context, applications that increase engagement of patients and families in the system are applicable. Secure messaging systems that allow patients to communicate with the team are an excellent example. A well-researched system in the Comprehensive Health Enhancement Support System (Gustafson, Brennan et al).

Efficient
Many Behavioral Informatics interventions allow asynchronous communication (reducing telephone tag), or provide computer-tailored education. Computer-tailored systems in general have considerable sunk costs, but the marginal costs (per user/patient) are low. Thus, where these systems can effectively offset human resources, efficiency is created.


Comprehensive
Patient-facing technologies can provide adherence and health promotion reminders using patient registries, thus increasing the comprehensiveness of care.

Continuous
Again, web and mobile technology interventions are key to overcoming episodic care.

Coordinated
Patient-centered goals can be communicated to all providers through personal health records, so the all on the team are aprised.


Enhanced communication
All of the above apply here.