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Patient Perspectives on Smoking Cessation and Interventions in Rheumatology Clinics. Chronic Conditions, Older Adults, Patient-Centered Outcomes Research, Quality and Safety
HIP Investigator, Dr. Christie Bartels et al. identified themes and categories of patient and health system-level facilitators/barriers to smoking cessation after implementing a rheumatology clinic protocol that increased tobacco quitline referrals.
Scope and Influence of Electronic Health Record-Integrated Clinical Decision Support in the Emergency Department. Health IT, Patient-Centered Outcomes Research, Quality and Safety
HIP Investigator, Dr. Brian Patterson et al. conducted a systematic review to examine the scope and influence of electronic health record-integrated clinical decision support technologies implemented in the emergency department.
The importance of health insurance claims data in creating learning health systems: evaluating care for high-need high-cost patients using the National Patient-Centered Clinical Research Network (PCORNet) Quality and Safety, Older Adults, Learning Health System, Health IT, Chronic Conditions
HIP Investigator, Dr. Maureen Smith et al. sought to determine whether the evaluation of programs for high-need high-cost patients required claims data to match cases to comparison patients in the paper.
Scaling Up Teleophthalmology for Diabetic Eye Screening: Opportunities for Widespread Implementation in the USA Older Adults, Health IT, Dissemination and Implementation, Chronic Conditions
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.
Broadening Medical Students' Exposure to the Range of Illness Experiences: A Pilot Curriculum Focused on Depression Education Quality and Safety, Children and Young Adults, Patient-Centered Outcomes Research, Mental Health, Chronic Conditions
Dr. Rachel Grob et. al developed, implemented, and evaluated a self-directed online curriculum followed by a small group discussion focused on depression education.
Engaging Patients in Primary Care Quality Improvement Initiatives: Facilitators and Barriers Quality and Safety, Primary Care Transformation (PATH), Patient-Centered Outcomes Research
The UW PATH collaborative used a pilot study to determine the most effective strategies for disseminating a previously successful single-system patient engagement in quality improvement intervention.
Why Physicians Should Trust in Patients Quality and Safety, Patient-Centered Outcomes Research
Dr. Rachel Grob et al. discusses the efficacy of patient-physician partnerships and co-produced care to improve quality and safety of care, patient health outcomes, and patient experience.
What Words Convey: The Potential for Patient Narratives to Inform Quality Improvement Quality and Safety, Patient-Centered Outcomes Research
Dr. Rachel Grob et al. explored the potential of systematically elicited narratives about experiences with outpatient care to enrich quality improvement and found that most narratives convey experiences that are potentially actionable by those committed.
Developing primary care teams prepared to improve quality: a mixed-methods evaluation Learning Health System, Primary Care Transformation (PATH), Quality and Safety
The UW PATH collaborative describes the implementation, mixed-methods evaluation results, and lessons learned from instituting a Microsystems approach across 6 years with 58 primary care teams at a large academic health system.
Content validity of the PROMIS® family relationships measure for children with chronic illness Children and Young Adults, Chronic Conditions
Dr. Elizabeth D. Cox et al. conducted a qualitative study of patients and their parents and found the Patient-Reported Outcomes Measurement Information System® Family Relationships measure reflects the experiences of children with chronic illness.
A simple framework for weighting panels across primary care disciplines Learning Health System, Primary Care Transformation (PATH)
The UW PATH collaborative describes the development and application of a utilization-based weighting system that accounts for patient complexity to help health systems understand patient panels and population characteristics
Medicare shared savings programs: Higher cost ACOs more likely to achieve savings Quality and Safety, Primary Care Transformation (PATH), Learning Health System
In a recent study, the PATH collaborative examined results for 220 ACOs from the Medicare Shared Savings Program and found that ACOs with higher baseline expenditures were significantly more likely to generate savings than lower cost ACOs.
Sociodemographics and hypertension control among young adults Children and Young Adults, Chronic Conditions, Health Equity, HIP Data, Quality and Safety
Dr. Heather Johnson et al. evaluated the role of sociodemographics in hypertension control among young adults with primary care access and found that young men, non-English primary language speakers, & unmarried people had lower control rates.
Variability in care management programs in Medicare ACOs Chronic Conditions, Quality and Safety
In this study co-authored by Dr. Maureen Smith and Peter Nordby, investigators surveyed leaders in 15 care management programs and found high variability across programs and that most programs use cost & utilization measures to determine outcomes.
Connecting rheumatology patients to primary care for high blood pressure Chronic Conditions, Dissemination and Implementation, HIPxChange
Dr. Christie Bartels et al. developed a staff protocol to improve primary care follow-up after high blood pressures were documented in specialty care, and the protocol decreased follow-up time and reduced visits with high blood pressure by 9%.
Frequency and predictors of communication about high blood pressure in RA visits Chronic Conditions, HIP Data, Quality and Safety
Dr. Christie Bartels et al. conducted a study of patients with rheumatoid arthritis and found that although there is heightened cardiovascular disease risk among patients with RA, most RA clinic visits lacked documented communication about blood pressure.
Assessing unwanted variations in rheumatology clinic previsit rooming Chronic Conditions, Quality and Safety
Edmond Ramly et al. conducted a cross-sectional time-study and work-system analysis to measure rooming workflows in rheumatology clinics and found significant variations across clinics, prompting clinic leaders to modify their policies.
Primary care colorectal cancer screening correlates with breast cancer screening Cancer, Chronic Conditions, HIP Data, Older Adults, Quality and Safety
Dr. Jennifer Weiss et al. examined whether PCPs' colorectal cancer screening practices correlate with several other preventive & chronic care metrics and found that PCP CRC screening rates strongly correlate with breast cancer screening rates.
Hypertension control after an initial cardiac event among Medicare patients with diabetes Chronic Conditions, HIP Data, Older Adults
In this study co-authored by Drs. Heather Johnson and Maureen Smith, investigators examined EHR and Medicare data to determine rates & predictors of achieving hypertension control among patients with diabetes after hospital discharge for a cardiac event.
Using the Hendrich II inpatient fall risk screen to predict outpatient falls after ED visits Health IT, Older Adults, Quality and Safety, Transitions in Care
Dr. Brian Patterson et al. found that using a fall risk screening instrument during ED visits can predict future ED visits for falls, but is most useful when combined with routinely collected data on other fall risk factors.
Can claims data algorithms identify the physician of record? Health Equity, Health IT, HIP Data, Older Adults
Using HIP's claims and EHR data, this study found that algorithms based on claims data are less likely to identify a patient's PCP among vulnerable populations and those experiencing fragmented care.
Hospitalizations for ambulatory care-sensitive conditions among children with chronic and complex diseases Children and Young Adults, Chronic Conditions, Quality and Safety
In this article, Dr. Ryan Coller et al. evaluated the predictors of ambulatory-care sensitive hospitalizations for children, as well as the influence of medical complexity and ambulatory care characteristics on hospitalization rates.
Stratifying patients with diabetes into clinically relevant groups by combination of chronic conditions Chronic Conditions, HIP Data, Public Reporting
Using HIP data, investigators evaluated the relationship between diabetes quality metrics and patients' combinations of chronic conditions and found that patients in less severe chronic condition classes were less likely to achieve diabetes metrics.
Bridging clinical researcher perceptions and health IT realities: A case study of stakeholder creep Health IT, Stakeholder Engagement
In an article co-authored by Edmond Ramly and Christie Bartels, investigators describe the cause and effects of stakeholder creep in a health information technology implementation project and present a stakeholder planning tool to plan for engagement.
Implementing a mobile health system to integrate the treatment of addiction into primary care Chronic Conditions, Dissemination and Implementation, Health IT, Quality and Safety
In this study, Dr. Andrew Quanbeck et al. describe the implementation of a mobile health system to treat addiction in primary care and discuss the effect of the mHealth system on patients and clinicians.
Survival of sepsis survivors admitted to skilled nursing facilities Older Adults, Quality and Safety, Transitions in Care
Using HIP's Chronic Conditions Warehouse data, investigators found that discharge to a SNF, cognitive impairment, and activities of daily living dependence were each strongly associated with shortened survival for sepsis survivors.
30-day readmission & mortality among Medicare beneficiaries discharged to SNFs after vascular surgery Transitions in Care, Surgery, Older Adults
Using Chronic Conditions Warehouse data, investigators identified several predictors of readmission or death at 30 days for vascular surgery patients discharged to SNFs.
The importance of frequent return visits and hypertension control among young adults Children and Young Adults, Chronic Conditions, Quality and Safety
In a recent study, HIP investigators found that frequent visits are associated with increased hypertension control in young adults with hypertension.
Risk prediction for heterogeneous populations with application to hospital admission prediction Chronic Conditions, HIP Data, Quality and Safety
This article co-authored by Menggang Yu and Maureen Smith discusses risk prediction for hospital admission in heterogeneous populations for diverse and complex patients with chronic conditions.
Validation of an instrument to assess barriers to care-seeking for accidental bowel leakage Chronic Conditions, Older Adults
Dr. Heidi Brown et al. developed and validated a survey instrument to assess barriers to seeking care for accidental bowel leakage in women. The instrument had excellent criterion validity and test-retest reliability.

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