Healthcare Reform and IBM

The Patient-Centered Primary Care Collaborative

In 2005, IBM began to question the very foundation of the healthcare we buy and reached a significant conclusion: compared to other industrialized countries, the healthcare "system" in the U.S. fails to deliver comprehensive primary care, partly because of the way that care is financed and well-documented quality issues which contribute to rising costs. Poor quality care accounts for 35 to 45 percent of healthcare expenses and has been estimated to cost employers approximately $2,000 per covered employee annually.

The concept of a medical home was first introduced by the American Academy of Pediatrics in 1967. At that time, the goal was to provide a specific place for children to receive care. During the past several years, however, this model has been evolving into a system for providing continuous comprehensive care for all age groups. Studies from all over the world have validated the importance of such patient-centric primary care, especially when it is continually updated through electronic medical records, email consultations, e-prescribing, and e-tools, all of which help to enhance clinical decision-making with evidence-based guidelines.

It is believed that such a model can ultimately lead to better medical care for patients and lower overall cost. IBM has been leading the way towards such a shift in healthcare reform, which has now become a national movement that is driving the transformation in healthcare delivery. The goal is the establishment of a "medical home" for every patient, centered on strong patient-physician relationships and comprehensive primary care.

IBM's initiative and work with primary care physician groups led to the formation of the Patient Centered Primary Care Collaborative (PCPCC) in 2006. PCPCC membership includes most of the major primary care physician associations, large national employers, health benefits companies, trade associations, profession/affinity groups, academic centers and health care quality improvement associations. In all, the collaborative represents more than 50 million Americans.

In 2007, with IBM's leadership, the PCPCC released the Joint Principles of the Patient Centered Medical Home. They are as follows:

Personal Relationship: Each patient has an ongoing relationship with a personal physician who is trained to provide first contact, continuous and comprehensive care.
Team Approach: The personal physician leads a team of individuals at the practice level who collectively take responsibility for the ongoing patient care.
Comprehensive: The personal physician is responsible for providing for all the patient's healthcare needs at all stages of life or taking responsibility for appropriately arranging care with other qualified professionals.
Coordination: Care is coordinated and integrated across all domains of the healthcare system, facilitated by registries, information technology, health information exchange and other means to assure that patients get the proper care when and where they need it.
Quality and Safety: Quality and safety are hallmarks of the medical home. Electronic medical records and technology provide decision-support for evidence-based treatments and patient and physician involvement in continuous quality improvement.
Expanded Access: Enhanced access to care is available through systems such as open scheduling, expanded hours, and new options for communication among patients, physicians, and practice staff.
Added Value: Payment adequately represents the added value provided to patients who have a patient centered medical home. (Source: www.pcpcc.net (link resides outside of ibm.com)

The PCPCC has created an open forum in which healthcare stakeholders can communicate and work together to improve the future of the American medical system. The Collaborative has developed model language for inclusion in health reform proposals to include the Patient Centered Medical Home (PCMH) concept. It also acts as a key source for the continued education of congressional representatives, federal and state governments, and individual practices — promoting the PCMH model as a superior form of health care delivery.

See: The Patient Centered Medical Home… Reforming Health Care for Quality Patient Care

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