Former House Speaker Gingrich, Others Endorse Medical Home Concept

The medical home will become a major component of managing patient health care as the nation's health care system moves toward integrating innovative technologies and places a greater emphasis on preventive care, said former Speaker of the House Newt Gingrich and others during a Capitol Hill briefing for health care industry leaders on April 23.

Gingrich, founder of the Center for Health Transformation, or CHT, said during a briefing on personal health records, or PHRs, that the nation's health care system is moving from an acute care, post-crisis model to a preventive health care paradigm in which patients will be aware of their propensity for certain diseases long before they are stricken.

In this type of environment, patients will need the advantages of a medical home to help manage their health care, said Gingrich, who served as House speaker from 1995-99. He likened the medical home to a health care coordinator capable of helping patients "fully understand the implications" and impact that genetic testing and other health care advances would have on their health care.

"I personally think there is a lot of usefulness to the (medical home) model as developed by the family practice groups," said Gingrich.

Another panelist at the briefing, Karen Ignagni, president and CEO of America's Health Insurance Plans, or AHIP, said managed care plans providing coverage under Medicare's Advantage program lead those providing coverage under the traditional Medicare program in five out of seven federally endorsed quality measures because of their concentration on care coordination and medical homes. The best strategy for Medicare is to "develop early intervention and care coordination" to prevent health care problems from becoming acute and catastrophic, said Ignagni.

"The concept of the medical home is integral to that," she said.

Gingrich and Ignagni were joined on the panel by Alissa Fox, vice president, legislative and regulatory policy for the BlueCross BlueShield Association; Archelle Georgiou, M.D., EVP of the UnitedHealth Group; and Charles Kennedy, M.D., vice president of clinical informatics, WellPoint. Four of the presenters -- Fox, Ignagni, Georgiou and Kennedy -- represent plans that cover more than 225 million lives, according to Gingrich.

Not surprisingly, all of the speakers endorsed PHRs as the "building blocks" for a fully connected health information system that will improve the safety, quality and efficiency of the health care industry, transforming it in the process. Gingrich denounced paper medical records as a major source of "medication errors and medical errors."

"As I have said for years, paper kills," he said.

More than 1.1 million paper health care records were destroyed in Louisiana and other Gulf Coast states as a result of Hurricane Katrina in 2005, he noted. In contrast, the health records of more than 50,000 military veterans in those areas that were maintained electronically by the U.S. Department of Veterans Affairs were not damaged, according to Gingrich. In the event of a terrorist attack on the United States, a reliance on paper health care records would "lead to the death of many Americans unnecessarily," he predicted.

Fox, meanwhile, focused on a different aspect of individuals' health records, saying, "PHRs are an important tool for helping consumers get the information they need to take charge of their health care and make more informed decisions."

"Offering personal health records to our customers makes sense," she said. "It is a natural extension of what we already do."

Fox and others said patients should "own and control" their PHRs, deciding whether to share their health information and with whom to share it.

"There should be universally adopted standards for personal health records that everyone uses," Fox stressed. And the PHRs need to be portable, meaning patients should be able to take the records with them, she added.

Georgiou said PHRs should be based on the following principals in order to create consumer buy-in:

"At the end of the day, the patient needs to perceive that their health care is better overall because they are using their personal health records," said Georgiou.