Summary
Empower the Primary Care Physician (PCP). Primary care is in serious jeopardy -- doctors are frustrated and a national shortage is worsening. The 'fix': a medical home concept to strengthen the primary care physician's ability to manage care for patients. The solution, supported in medical practices to include high quality information shared across all of stakeholders in the health ecosystem -- into the home, including patient and family. Provide pro-active, collaborative, coordinated care. Today's fragmented and non-communicative health care system requires us to coordinate our own care -- or do without it -- including prevention, wellness, acute, chronic, and long-term care. Such care can be provided with or without visits to the physician's office. Medical home strategies include enhancing linkage of enhanced electronic medical records with 'robust' decision support capabilities.
Analysis
Is the PCP the right hub or another information spoke? I wonder if things are too far gone, entirely too fragmented to put the primary care doctor at the center of the information sharing and process improvement efforts. With so many people lacking PCPs, and so many PCPs lacking infrastructure and incentives -- perhaps the better cornerstone for change is take a look at other edge participants in the chain.
Why not the pharmacy? doesn't that seem like an obvious platform that is central to the process of care -- like CVS clearly believes. Link prescription information into and out of a PHR, accessed at point of prescription and augmented with new prescriptions and check-ins with kiosks of diagnostic devices in the pharmacy. Of course, pharmacies may not want the liability associated with this role -- but as in any supply chain, assigning the hub role is often based on frequency and information quality -- not desire.
