In this issue: testing characteristics of patient-centered medical homes, patient self-care, predicting outcomes, and practical clinical information.

Testing Specific Characteristics of Patient-Centered Medical Homes Use of electronic health records (EHRs) is taking off. They are intuitively appealing, but they are not always better than the paper version. One aspect that electronic records should help with is the availability of test results; another possibility is more appropriate and timely orders with the use of prompting. After implementing an EHR, Metz et al identified improvements in both of these areas for routine prenatal studies in a family medicine residency, and very good rates for both ordering and charting were improved to near perfect. Pandhi et al try to tease out whether the accessibility aspect of medical homes increases preventive services beyond what occurs when there is continuity between a physician and an insured patient. The answer is yes. Even for the patients with continuity, those who rated accessibility of their continuity of care office as very good or excellent on all 8 evaluative questions received more preventive services. Getting it all done is not easy. Sloane et al present their findings on primary care practices that took on quality in a big way, leading to sustainability of data measurement and changed processes. They provide helpful information about just how hard it can be to make needed quality changes, as well as helpful insights for others trying to leap the quality chasm.