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First Jones' practice adopted an electronic medical record, to keep patients' information up to date and help them coordinate necessary specialist visits while decreasing redundancies.
Then came a patient registry so the team can start tracking who needs what testing or follow-up and make sure patients get it on time.
Rolling out next is a custom Web-based service named My Preventive Care that lets the practice's patients link to their electronic medical record, answer some lifestyle and risk questions, and receive an individually tailored list of wellness steps to consider.
Say Don's cholesterol test, scheduled after his yearly checkup, came back borderline high. That new lab result will show up, with discussion of diet, exercise and medication options to lower it in light of his other risk factors. He might try some on his own, or call up the doctor -- who also gets an electronic copy -- for a more in-depth discussion.
"It prevents things from falling through the cracks," says Dr. Alex Krist, a Fairfax Family Practice physician and VCU associate professor who designed and tested the computer program with a $1.2 million federal grant. In a small study of test-users, preventive services such as cancer screenings and cholesterol checks increased between 3 percent and 12 percent.
Pilot tests of medical homes, through the American Academy of Family Physicians and Medicare, are under way around the country. Initial results suggest they can improve quality, but it's not clear if they save money.
Primary care can't do it alone. Broader changes are needed to decrease the financial incentives that spur too much specialist-driven care, says Dr. David Goodman of the Dartmouth Institute for Health Policy and Clinical Practice.
"What we need is not just a medical home, but a medical neighborhood."
On the Net:
American Academy of Family Physicians:
Fairfax Family Practice Centers:
Dartmouth Institute for Health Policy and Clinical Practice: http://tdi.dartmouth.edu/
Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
Copyright 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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