Across the divide: primary care departments working together to redesign care to achieve the Triple Aim
Across the divide: primary care departments working together to redesign care to achieve the Triple Aim
Primary care departments at academic health centers face many challenges in achieving the Triple Aim. This article by the UW PATH collaborative describes the collaboration they formed between the departments of internal medicine, general pediatrics and adolescent medicine, and family medicine to redesign primary care in pursuit of the Triple Aim. A primary care leadership team adopted a common vision to find solutions to shared problems.
Difference in receipt of preventive services by race/ethnicity in Medicare Advantage plans: tracking the impact of P4P
Difference in receipt of preventive services by race/ethnicity in Medicare Advantage plans: tracking the impact of P4P
Daniel Jung et al. studied whether pay-for-performance (P4P) incentives have affected racial/ethnic disparities in Medicare Advantage plans. The authors studied data from the Medicare Health Outcomes Survey and found similar racial/ethnic differences in receipt of preventive healthcare before and after the introduction of P4P.
Does first-contact access to primary care differentially benefit those with certain personalities to receive preventive services?
Does first-contact access to primary care differentially benefit those with certain personalities to receive preventive services?
Dr. Nancy Pandhi and team used Wisconsin Longitudinal Study data to examine utilization of preventive care services in patients with certain personality characteristics. They found that certain personality characteristics, such as lower conscientiousness, lower agreeableness, and lower openness to new experience predicted receiving fewer of one or more preventive care services. For those with less agreeableness, improved first-contact access mitigated this effect.
Strange bedfellows: A local insurer/physician practice partnership to fund innovation
Strange bedfellows: A local insurer/physician practice partnership to fund innovation
In this article by the UW PATH collaborative, investigators describe a novel program that funds ambulatory care improvements through a partnership between an academic health system and an insurance firm. The program is designed as a competitive grant program and both organizations benefit from completed improvement projects. Factors contributing to success as well as lessons learned are discussed to inform the development of similar programs in other markets.
Are waiting rooms passé: A pilot study of patient self-rooming
Are waiting rooms passé: A pilot study of patient self-rooming
Timeliness of care after patients arrive at the primary care office has received little focus. In this article, the UW PATH collaborative describes an intervention at 2 community family medicine clinics that allowed patients to direct themselves into exam rooms. After the intervention, 95% of patients said they preferred rooming themselves and patient satisfaction remained high. Others interested in redirecting staff time toward value-added patient care should consider trialing this intervention.
Approaches and challenges to optimising primary care teams' electronic health record usage
Approaches and challenges to optimising primary care teams' electronic health record usage
The UW PATH collaborative examined the approaches used and challenges perceived by analysts supporting the optimization of primary care teams' EHR use at a large U.S. academic health system. Analysts and their supervisor were interviewed and data were analyzed for themes. Dedicated optimization analysts can add value to health systems through playing a mediating role between health information technology leadership and care teams. EHR optimization should be performed with an understanding of workflow, cognitive and interactional activities in primary care.
PAs and NPs perform effective roles on teams caring for Medicare patients with diabetes
PAs and NPs perform effective roles on teams caring for Medicare patients with diabetes
Christine Everett et al. used Medicare claims and EHR data from a large physician group to compare outcomes for patients with diabetes with various levels of complexity. Outcomes were generally equivalent for care teams with PAs or NPs and those with physicians only. Findings suggest that patient characteristics as well as goals should be considered when determining how to deploy PAs and NPs on primary care teams.
Predictors of colorectal cancer screening variation among primary care providers and clinics
Predictors of colorectal cancer screening variation among primary care providers and clinics
Dr. Jennifer Weiss et al. used EMR data and a survey of primary care providers (PCPs) to evaluate patient, provider, and clinic factors that predict variation in colorectal cancer (CRC) screening among PCPs and clinics. They found that screening rates varied from 51-80% among clinics from 51-82% among PCPs, and identified significant predictors of completing CRC screening at the patient, provider, and clinic level, indicating that quality improvement interventions addressing CRC screening should be addressed at multiple levels of the health care system.
Publicly reported quality-of-care measures influenced Wisconsin physician groups to improve performance
Publicly reported quality-of-care measures influenced Wisconsin physician groups to improve performance
Investigators analyzed 14 publicly reported quality of care ambulatory measures for the Wisconsin Collaborative for Healthcare Quality to learn whether the reports impact quality of care for patients. Physician groups in the collaborative improved their performance during the study period and when surveyed, reported that the public measures motivated them to act on some, but not all, of the quality measures.