The Balanced Opioid Initiative

The Balanced Opioid Initiative

Rates of opioid prescribing tripled in the USA between 1999 and 2015 and were associated with significant increases in opioid misuse and overdose death. Roughly half of all opioids are prescribed in primary care. The challenge remains in implementing guidelines in a way that balances safety and effectiveness when following clinical guidelines recommending opioid prescribing practices.

HIP Investigator, Dr. Andy Quanbeck et al. designed a study to discover the most cost-effective sequence and combination of strategies for improving opioid prescribing practices in diverse primary care clinics. The results of the study promise to help understand how to cost effectively improve the implementation of evidence-based practices.

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Smiling caregiver visiting sick child

Growing Evidence for Successful Care Management in Children With Medical Complexity

Growing Evidence for Successful Care Management in Children With Medical Complexity

In this article, Dr. Mary Ehlenbach and HIP Investigator Dr. Ryan Coller reviewed the success of programs designed to better coordinate care for children with medical complexity. With respect to changes in acute care use, children likely respond to complex care models in different ways. Additionally, what complex care achieves and how it achieves it for any given child is likely not uniform in cross section or over time.

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Senior women in classroom

Reasons Behind Preferences for Community-Based Continence Promotion

Reasons Behind Preferences for Community-Based Continence Promotion

More than 60% of women older than 65 years in the United States have urinary or bowel incontinence. Despite the existence of effective, minimally invasive therapies, more than half of women with urinary incontinence and two-thirds of women with bowel incontinence do not seek medical care.

In this study, HIP Investigator Dr. Heidi Brown et al. sought to understand the potential reach of 3 continence promotion formats: a single lecture, an interactive 3-session workshop, and an online program. Authors found that most incontinent women are willing to participate in continence promotion, especially online.

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Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy, Third Edition

Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy, Third Edition

The third edition of the Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy includes fundamental requirements to be followed when providing medical and other health care services using telecommunication technologies, and any other electronic communications between patients, practitioners, and other health care providers, as well as “best practice” recommendations. These guidelines were co-authored by HIP Investigator, Dr. Yao Liu and aim to assist providers in pursuing a sound course of action in providing safe and effective medical care using telehealth tools based on current scientific knowledge, technological requirements, and patient needs.

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D&I

Building Capacity for Dissemination and Implementation to Maximize Research Impact in a CTSA: The University of Wisconsin Story

Building Capacity for Dissemination and Implementation to Maximize Research Impact in a CTSA: The University of Wisconsin Story

The publication reports results of an 8-year process of stakeholder engagement aimed at building capacity in Dissemination and Implementation (D&I) research at the University of Wisconsin as part of the National Institutes of Health’s Clinical and Translational Science Award (CTSA). HIP Investigators, Dr. Andrew Quanbeck and Dr. Maureen Smith et al. describe how CTSA leaders at UW built a comprehensive system designed to improve the health of the communities statewide by incorporating D&I concepts across the translational research spectrum.

The team also developed a toolkit on HIPxChange that describes resources and activities developed to build D&I capacity at UW’s Institute for Clinical and Translational Research.

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Research doctor team

Systems consultation for opioid prescribing in primary care: a qualitative study of adaptation

Systems consultation for opioid prescribing in primary care: a qualitative study of adaptation

In order to promote guideline-concordant opioid prescribing practices, a blended implementation strategy called systems consultation was pilot tested in four primary care clinics in one US health system. In this study, HIP Investigator, Dr. Andrew Quanbeck et al. described (1) how systems consultation worked during the pilot test and (2) the modifications necessary to adapt this implementation strategy to primary care.

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Doctor at computer

Secure Provider-to-Provider Communication With Electronic Health Record Messaging: An Educational Outreach Study.

Secure Provider-to-Provider Communication With Electronic Health Record Messaging: An Educational Outreach Study.

With increasing electronic health record (EHR) use, providers are talking with one another less. Now, many rely on EHRs, informal emails, or texts, introducing fragmentation and new data security challenges with new communication strategies. HIP Investigator, Dr. Christie Bartels et al. aimed to examine the impact of a physician champion educational outreach intervention to promote electronic provider-to-provider communication in a large academic multispecialty group. Physician champion educational outreach increased the use of the secure provider-to-provider EHR messaging tool.

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Stethoscope and chart

Asset-Based Community Development as a Strategy for Developing Local Global Health Curricula.

Asset-Based Community Development as a Strategy for Developing Local Global Health Curricula.

A significant and growing proportion of US children have immigrant parents, an issue of increasing importance to pediatricians. Training globally minded pediatric residents to address health inequities related to globalization is an important reason to expand educational strategies around local global health (LGH). HIP Investigator, Dr. Ryan Coller et al. developed a curriculum in the pediatric global health residency track at UW to address gaps in LGH education and to increase resident knowledge about local health disparities for global community members.

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Yao Liu with camera

Scaling Up Teleophthalmology for Diabetic Eye Screening: Opportunities for Widespread Implementation in the USA

Scaling Up Teleophthalmology for Diabetic Eye Screening: Opportunities for Widespread Implementation in the USA

Teleophthalmology is an evidence-based form of diabetic eye screening. This technology has been proven to substantially increase diabetic eye screening rates and decrease blindness. However, teleophthalmology implementation remains limited among U.S. health systems. In this paper, HIP Investigator Dr. Yao Liu et al. discuss opportunities to address key barriers to widespread implementation of teleophthalmology programs for diabetic eye screening in the United States (U.S.).

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Checking blood pressure

Connecting rheumatology patients to primary care for high blood pressure

Connecting rheumatology patients to primary care for high blood pressure

High blood pressure is the most prevalent cardiovascular risk factor for rheumatology patients, yet blood pressures are not frequently addressed in specialty visits. Dr. Christie Bartels et al. developed the BP Connect Health protocol to address this issue by training medical assistants and nurses to (1) re-check high blood pressures, (2) advise patients about the link betweeen rheumatic and cardiovascular diseases, and (3) connect patients with timely primary care follow-up using electronic health record orders. In an analysis of the intervention, investigators found that the odds of timely primary care follow-up doubled and the media time to follow-up declined by nearly half, from 71 to 38 days. Additionally, the number of rheumatology visits with high blood pressure declined from 17% to 8% in the 2 years after the protocol was implemented, which suggests that the protocol resulted in population-level declines in high blood pressure. A free toolkit with the BP Connect Health protocol and tools to successfully implement it is available on HIPxChange here.

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