A Medicaid project in North Carolina is using a dose of technical ingenuity to enable physicians who lack an electronic health record to successfully launch the medical home model.

About 800,000 of the 1.2 million Medicaid recipients in the state are assigned to a primary care physician who uses the medical home model, says C. Annette DuBard, M.D. She's director of informatics, quality and evaluation for North Carolina Community Care Networks Inc., Morrisville, which provides technical support to 3,000 participating physicians organized into 14 networks.

Participating physicians receive $3 per member per month for their role in coordinating patients' care. As part of that effort, they must submit data on care quality. But because most lack an EHR, DuBard's organization sends out chart reviewers to each site to comb through paper records (or in rare cases, EHRs) and enter quality data into a home-grown system. They prepare quarterly reports analyzing treatment of patients with certain chronic conditions, including diabetes, asthma and heart failure, and assess preventive services, DuBard explains.

Of course, program organizers remain hopeful that most practices will adopt an EHR, spurred on, in part, by federal incentives under the economic stimulus package. "We are trying to move in the direction of practices self-reporting data," DuBard says. But instead of waiting around for EHRs to become ubiquitous, DuBard's organization is gathering data using available resources.

In another data-gathering effort, the organization soon will use another existing source of data - Medicaid claims - to attempt to track patients who are overdue for such procedures as mammograms and eye exams and then alert their physicians.

This article can also be found at HealthDataManagement.com.

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