Question

Select 2 out of three 4 categories listed:

1. financial,

2. legal,

3. political,

4. historical

For each of the 2 selected categories, describe the specific barriers or challenges associated with a Patient-centered medical home

Answer 1

The two challenges I wish to choose are

1. Financial

2. Legal.

Financial -

It is obvious that the expense to create a fully integrated effective health infrastructure is always on the higher end. The cost of achieving the health IT ecosystem with a full fledged clinical decision support and predictive analytics will be very hard to bear. Due to the lack of funds, there are many PCMH taking a longer time for the construction. Even if the providers wish to invest, they will have reluctance to invest on infrastructure. The information systems always lag behind because that is the area which requires Investors, executives and more funds. Getting investors is a difficult task and it will also affect the training provided for the primary care providers and all the members involved in the PCMH. It is indeed a fact that the need for communication, development of new skills and teamwork is inevitable in PCMH. All these factors further financially affects the patients approaching PCMH. To bring about a marked overall improvement, it requires a new system of primary care payment that blends monthly patient panel fees with traditional fee for service payments which inturn increase the expense of the patients.

Legal-

All the PCMH should be a certified and the nurses or all care givers should be trained enough to provide high quality care. There are many physicians who runs the PCMH without proper certification and they will submit practice information online and receive feedback online which is not sufficient to fulfill the legal aspects . Also it matters the health care law and bioethics address the delivery of very expensive and highly specialised professional service rendered in situations of tremendous personal vulnerability. It also matters that there is a legal issue involve physician caring for patients rather than providers serving generic consumers.

Meeting the legal principles are one of the barriers for PCMH. The health law involves mainly four principles such as

1. Quality

2. Autonomy

3. Access

4. Cost

It's a big challenge for the providers to avoid the legal issues by providing high quality low cost care with a wide access and supreme respect for patient autonomy.