Primary-care practices who rely more on “high touch” principles such as patients seeing the same doctor and scheduling a “well visit” are likely to deliver more preventive services than those that rely on “high tech” principles such as using clinical decision-support tools and performing continuous quality improvement, according to a study in the Annals of Family Medicine journal of the American Academy of Family Physicians.
Researchers examined the records of 568 patients at 24 New Jersey primary-care practices participating in a study on improving colorectal cancer screening and concluded that the “relationship-centered aspects” of the medical home model “are more highly correlated with preventive service delivery” than were “information technology capabilities.” Of the practices in the study, 46% used electronic health records, though it's unknown what functions were used and how long the systems were in place.
The authors noted that the relationship-centered aspects, particularly a planned well visit to the doctor's office, were associated with more frequent mammographies, Pap smears, colorectal cancer screenings, influenza vaccinations, as well as counseling for diet, weight-loss, exercise and smoking cessation. “Seeing the same doctor, having a well-visit in the last five years, and having a referral system to link patients to community programs were significantly associated with higher rates of preventive services,” the authors stated.
They acknowledged, however, that cancer screening and flu vaccinations were still “much lower than optimal,” and that “We evaluated preventive services only, and information technology capabilities may be more important for delivery of chronic-disease care.”