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Patient-Centered Chronic Condition Management
A technology-enabled medical home transforms the healthcare experience for both patients and physicians
The University of Missouri-Columbia School of Medicine is refocusing on chronic disease management to ensure successful medical practice.This paradigm shift from acute disease to chronic disease management is an enormous challenge for the healthcare system. However, the needed changes can be made because the necessary technology and expertise are available to transform the present system.
By Dr. William M. Crist
Hugh E. and Sarah D. Stephenson Dean
University of Missouri-Columbia School of Medicine
Dr. Harold A. Williamson Jr.
Professor Jack and Winifred Colwill Endowed Chair
Family and Community Medicine Department
University of Missouri-Columbia School of Medicine
Partnerships between academic medical centers, industry, and ultimately the practicing healthcare delivery system, are critical to devising successful solutions to effect healthcare advances, just as they have done over the past 100 years. Recently, the University of Missouri School of Medicine and Cerner Corporation partnered to address some of the specific changes in the healthcare system that are required for transformation. Together, we are working to create a specific innovation that we call the “medical home page,” which should prove highly useful to all practitioners who manage patients with chronic illnesses.
Our idea is based on the experience of our family medicine residents and faculty working at five teaching clinics, including two that serve rural populations in mid-Missouri. Patient visits at these clinics total nearly 100,000 per year. Our practitioners witness first hand a national trend in healthcare: The steady decline in the proportion of patients with acute illness and the rapid rise in those with chronic diseases resulting from people living longer.
Today, 45 percent of the U.S. population has a chronic medical condition and about half of those (60 million people) have multiple chronic conditions.1 Chronic conditions can lead to disabilities, such as hip fractures and stroke, that erode the ability of elderly people to care for themselves. For this reason, our physicians, who are practice-area leaders, propose creating a special page within the electronic medical record (EMR) of an individual patient with a chronic disease. The page presents only the specific information that practitioners need to provide quality care.
Though not curable, illnesses such as diabetes, heart disease and chronic pulmonary disease can be managed effectively to enhance the quality and length of life. Evidence-based treatment
protocols ensure quality care because medical innovations occur so rapidly that busy practitioners are challenged to remain abreast of standards of care. The traditional approach to patient care—in which doctors typically have a 15-minute appointment to interact with the patient, note symptoms and recommend treatment—does not adequately support practice needs.
To meet the challenge of caring for an aging population with chronic conditions, we need a fundamental shift in how healthcare is delivered. That is why MU has adopted a new approach to care which we refer to as the medical home for patient-centered care. Patients have personal physicians who are responsible for their care throughout their lifetimes wherever possible. The personal physician, in turn, leads a team of healthcare professionals who all play important roles in delivering total care to meet all patient healthcare needs efficiently and at the lowest possible cost.
Excerpt from "Patient-Centered Chronic Condition Management," The Cerner Quarterly, Vol. 3 No. 3 2007. Copyright 2007 Cerner Corporation, Kansas City, Mo. |
