Changing Medical Practices Through E-Learning

Overhauling the way Massachusetts’ medical practices deal with patients is no simple task. Not when you’re considering coordinating all of a patient’s health needs, including managing chronic conditions, handling visits to specialists, dealing with hospital admissions and reminding patients when they need check-ups and tests. Add to it archaic systems that involve stacks of paper medical records and rows of filing cabinets in doctors’ offices.

Many doctors deal with patients’ various medical issues by writing a referral and then maybe hearing about what happened at yearly check-up time.

The Massachusetts’ Executive Office of Health and Human Services hopes to fundamentally change the way medical practices work with the Patient-Centered Medical Home Initiative. The 3-year demonstration project is part online and part in-person. Participants, which include 46 primary care medical practices, receive live coaching from facilitators, help establishing and maintaining patient registries and extensive training through a learning collaborative, managed by e-learning technical provider Talance, Inc. (

The program involves all types of doctors in every corner of the state, including large, urban community health centers and small, rural group practices. Even in a state as small as Massachusetts, where it’s possible to drive from one end to the other – the long way – in a few hours, it’s still a challenge to train a broad range of practices at the same time. That’s why it’s vital for the project to incorporate online learning as a way to help manage the project.

In many cases, e-learning is the only way to effectively push health care management shifts. It’s an industry that naturally drifts toward in-person connection, where doctors talk to people face-to-face in examination rooms. When it comes to reforming office administration on such a large scale, that model won’t work. It’s the reason that 37 percent of training hours involved electronic technology in 2009, according to Alexandria, Va.-based American Society for Training and Development.

E-learning may be key in conforming to the Obama administration’s Health Information Technology for Economic and Clinical Health Act (HITECH), which passed in 2009. Providers will have to adopt health information technology (HIT) starting in 2011, a requirement that includes more than $36 billion in incentive payments to reward providers whose electronic medical records (EMRS) meet the government’s test of “meaningful use”.

The end result is overall cost savings.

“At the heart of our effort to ensure access to care is a commitment to strengthening primary care and reforming how we pay for that care,” said Secretary of Health and Human Services Dr. JudyAnn Bigby. “This new initiative is one of the key building blocks in our strategic work to make all primary care practices in Massachusetts transformed into advanced patient-centered medical homes by 2015.”

The Patient-Centered Medical Home Initiative (PCMHI) was designed by the Executive Office of Health and Human Services in consultation with a multi-payer, multi-stakeholder council of consumer, physician, nurse practitioner, hospital, insurer, state agency and other interested stakeholder representatives. The Council is co-chaired by Secretary Bigby and Dr. John Fallon, Senior Vice President and Chief Physician Executive at Blue Cross Blue Shield of Massachusetts.

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