journal
https://read.qxmd.com/read/37201476/lessons-on-regulation-and-implementation-from-the-first-fda-cleared-autonomous-ai-interview-with-chairman-and-founder-of-digital-diagnostics-michael-abramoff
#21
JOURNAL ARTICLE
Kaushik P Venkatesh, Gabriel Brito
No abstract text is available yet for this article.
May 16, 2023: Healthcare
https://read.qxmd.com/read/37156131/improving-primary-care-team-functioning-through-evidence-based-quality-improvement-a-comparative-case-study
#22
JOURNAL ARTICLE
Helen Ovsepyan, Emmeline Chuang, Julian Brunner, Alison B Hamilton, Jack Needleman, MarySue Heilemann, Ismelda Canelo, Elizabeth M Yano
BACKGROUND: Provision of team-based primary care (PC) is associated with improved care quality, but limited empirical evidence guides practices on how to optimize team functioning. We examined how evidence-based quality improvement (EBQI) was used to change PC team processes. EBQI activities were supported by research-clinical partnerships and included multilevel stakeholder engagement, external facilitation, technical support, formative feedback, QI training, local QI development and across-site collaboration to share proven practices...
May 6, 2023: Healthcare
https://read.qxmd.com/read/37028112/courage-to-quit%C3%A2-rolling-group-implementation-in-an-urban-medical-center-in-primarily-low-income-black-smokers
#23
JOURNAL ARTICLE
Emma I Brett, Abigayle R Feather, Zoe Lee, Daniel J Fridberg, Yasmin Asvat, Andrea C King
BACKGROUND: Continuous "rolling" tobacco group treatments may help reduce cessation disparities by increasing access among underserved people who smoke cigarettes. We evaluated the implementation of a rolling enrollment adaptation of an evidence-based tobacco treatment group intervention, Courage to Quit®-Rolling (CTQ®-R). METHODS: The 4-session CTQ®-R incorporating psychoeducation, motivational enhancement, and cognitive behavioral skills was evaluated by examining feasibility and preliminary program outcomes with a pre-post design using the SQUIRE method in a sample of 289 primarily low-income, Black people who smoke...
April 5, 2023: Healthcare
https://read.qxmd.com/read/37003049/how-alignment-between-health-systems-and-their-embedded-research-units-contributes-to-system-learning
#24
JOURNAL ARTICLE
Michael I Harrison, Amanda E Borsky
BACKGROUND: There is growing interest in the contributions of embedded, learning health system (LHS), research within healthcare delivery systems. We examined the organization of LHS research units and conditions affecting their contributions to system improvement and learning. METHODS: We conducted 12 key-informant and 44 semi-structured interviews in six delivery systems engaged in LHS research. Using rapid qualitative analysis, we identified themes and compared: successful versus challenging projects; LHS units and other research units in the same system; and LHS units in different systems...
March 30, 2023: Healthcare
https://read.qxmd.com/read/36989915/implementing-real-time-prescription-benefit-tools-early-experiences-from-5-academic-medical-centers
#25
JOURNAL ARTICLE
Jing Luo, Rachel Wong, Tanvi Mehta, Jeremy I Schwartz, Jeremy A Epstein, Erika Smith, Nitu Kashyap, Fasika A Woreta, Kristian Feterik, Michael J Fliotsos, Bradley H Crotty
BACKGROUND: Medication price transparency tools are increasingly available, but data on their use, and their potential effects on prescribing behavior, patient out of pocket (OOP) costs, and clinician workflow integration, is limited. OBJECTIVE: To describe the implementation experiences with real-time prescription benefit (RTPB) tools at 5 large academic medical centers and their early impact on prescription ordering. DESIGN: and Participants: In this cross-sectional study, we systematically collected information on the characteristics of RTPB tools through discussions with key stakeholders at each of the five organizations...
March 27, 2023: Healthcare
https://read.qxmd.com/read/36996736/an-equity-focused-approach-to-improving-access-to-covid-19-vaccination-using-mobile-health-clinics
#26
Carlene A Mayfield, Jennifer S Priem, Michael Inman, Trent Legare, Jennifer Snow, Elizabeth Wallace
This article describes the implementation of an equity-focused strategy to increase the uptake of COVID-19 vaccination among communities of color and in traditionally underserved geographic areas using mobile health clinics (MHCs). The MHC Vaccination Program was implemented through a large integrated healthcare system in North Carolina using a grassroots development and engagement strategy along with a robust model for data-informed decision support to prioritize vulnerable communities. Several valuable lessons from this work can replicated for future outreach initiatives and community-based programming: •Health systems can no longer operate under the assumption that community members will come to them, particularly those experiencing compounding social and economic challenges...
March 23, 2023: Healthcare
https://read.qxmd.com/read/36870189/achieving-greater-value-for-veterans-through-full-cost-transparency-in-primary-care
#27
Victor C Agbafe, Nora Metzger, Brittani R Garlick, Tanner Caverly, Sameer Saini, Eve Kerr, Sana Matloub, Jeffrey T Kullgren
The COVID-19 pandemic has led to increased use of telephone and video encounters in the Veterans Health Administration and many other healthcare systems. One important difference between these virtual modalities and traditional face-to-face encounters is the different cost-sharing, travel costs, and time costs that patients face. Making the full costs of different visit modalities transparent to patients and their clinicians can help patients obtain greater value from their primary care encounters. From April 6, 2020 to September 30, 2021 the VA waived all copayments for Veterans receiving care from the VA, but since this policy was temporary it is important that Veterans receive personalized information about their expected costs so they can obtain the most value from their primary care encounters...
March 2, 2023: Healthcare
https://read.qxmd.com/read/36586221/succeeding-in-medicare-s-newest-bundled-payment-program-results-from-teaching-hospitals
#28
JOURNAL ARTICLE
Matthew C Baker, Erin N Hahn, Theresa R F Dreyer, Keith A Horvath
BACKGROUND: In 2018, Medicare implemented a successor to its Bundled Payments for Care Improvement (BPCI) program, BPCI Advanced, with stricter participation rules and new financial incentives to reduce spending. METHODS: Using claims-based episode data from thirteen participants, we compared spending and utilization in the first fifteen months of the new program (October 2018 to December 2019) to hospital- and episode-specific target prices, with a deep dive into clinical correlates for the most commonly-selected clinical episodes, sepsis and congestive heart failure...
March 2023: Healthcare
https://read.qxmd.com/read/36764053/intensive-care-management-for-high-risk-veterans-in-a-patient-centered-medical-home-do-some-veterans-benefit-more-than-others
#29
JOURNAL ARTICLE
Kaylyn E Swankoski, Ashok Reddy, David Grembowski, Evelyn T Chang, Edwin S Wong
BACKGROUND: Primary care intensive management programs utilize interdisciplinary care teams to comprehensively meet the complex care needs of patients at high risk for hospitalization. The mixed evidence on the effectiveness of these programs focuses on average treatment effects that may mask heterogeneous treatment effects (HTEs) among subgroups of patients. We test for HTEs by patients' demographic, economic, and social characteristics. METHODS: Retrospective analysis of a VA randomized quality improvement trial...
February 8, 2023: Healthcare
https://read.qxmd.com/read/36731158/does-use-of-primary-care-based-behavioral-health-programs-differ-by-race-and-ethnicity-evidence-from-a-multi-site-collaborative-care-model
#30
JOURNAL ARTICLE
Benjamin Kovachy, Trina Chang, Christine Vogeli, Suzanne Tolland, Susan Garrels, Brent P Forester, Vicki Fung
BACKGROUND: Collaborative care models (CoCM) that integrate mental health and primary care improve outcomes and could help address racial and ethnic mental health disparities. We examined whether use of these programs differs by race/ethnicity. METHODS: This retrospective study examined two CoCM interventions implemented across primary care clinics in a large health system in Massachusetts: 1) a primary care-based behavioral health program for depression or anxiety (IMPACT model) and 2) referral to community-based specialty care services (Resource-finding)...
January 31, 2023: Healthcare
https://read.qxmd.com/read/36693301/a-matter-of-trust-commitment-to-act-for-health-equity
#31
JOURNAL ARTICLE
Ron Wyatt, Leslie Tucker, Kedar Mate, Fred Cerise, Alicia Fernandez, Sachin Jain, Ignatius Bau, Daniel Wolfson
We believe these recommendations constitute "minimum requirements" for health care organizations to move toward greater health equity. As health systems, standards-setting organizations, national and private purchaser organizations, and thought leaders, we represent organizations in the health care ecosystem that can both advise on strategies for adopting the recommendations and have the power and leverage to cause their implementation. We commit individually and collectively to use our leverage to propel their implementation at our own institutions and across the county...
January 22, 2023: Healthcare
https://read.qxmd.com/read/36566518/perspectives-of-acute-post-acute-physician-and-community-support-providers-on-community-collaborative-efforts-to-improve-transitions-of-care
#32
JOURNAL ARTICLE
Brianna Gass, Lacey McFall, Jane Brock, Jing Li, Christine LaRocca, Mark V Williams
BACKGROUND: Transitional care (TC) involves multiple organizations as patients transition from hospitals. Collaboration to reduce readmissions has been encouraged by government initiatives. As part of Project ACHIEVE, a comparative TC study, we sought provider perspectives on TC improvement efforts. METHODS: We aimed to identify perceived problems that drove improvement efforts, influences on interventions implemented, facilitators or barriers to desired outcomes, and sustainability...
December 23, 2022: Healthcare
https://read.qxmd.com/read/36543011/changes-in-spending-and-quality-after-aco-contract-participation-for-dually-eligible-beneficiaries-with-mental-illness
#33
JOURNAL ARTICLE
Carrie H Colla, Valerie A Lewis, Chiang-Hua Chang, Maia Crawford, Kristen A Peck, Ellen Meara
BACKGROUND: Fragmented care and misaligned payment across Medicare and Medicaid lower care quality for dually eligible beneficiaries with mental illness. Accountable care organizations aim to improve the quality and value of care. METHODS: Using Medicare fee-for-service Part A and B claims data from 2009 to 2017 and a difference-in-differences design, we compared the spending and utilization of dually eligible beneficiaries with mental illness that were and were not attributed to Medicare ACO providers before and after ACO contract entry...
December 19, 2022: Healthcare
https://read.qxmd.com/read/36508993/building-bi-directional-referral-and-communication-pathways-across-the-community-clinic-divide-experiences-from-a-systems-informed-innovation-project-in-los-angeles
#34
Amelia R DeFosset, Noel C Barragan, Gabrielle Green, Janina L Morrison, Tony Kuo
Bi-directional communication and referral pathways (BCRPs) between clinics and community-based organizations could promote well-being among vulnerable populations with complex and overlapping health and social needs. While BCRPs are promising, establishing them is complex, involving system and process changes across diverse organizational settings. To date, few models have been implemented or empirically tested. This article describes an innovation and planning project to build a BCRP, linking patients in safety net primary care clinics to a comprehensive suite of community-based health and wellness supports in Los Angeles...
December 9, 2022: Healthcare
https://read.qxmd.com/read/36375356/the-effect-of-remote-scribes-on-primary-care-physicians-wellness-ehr-satisfaction-and-ehr-use
#35
JOURNAL ARTICLE
Mark A Micek, Brian Arndt, Jeffrey J Baltus, Aimee Teo Broman, Joel Galang, Shannon Dean, Matthew Anderson, Christine Sinsky
BACKGROUND: Physician burnout is a major problem in the United States. Small studies suggest scribes can improve clinician satisfaction, but scribe programs have not been evaluated using separate control groups or structured measures of electronic health record (EHR) use. METHODS: We conducted a pre-post, non-randomized controlled evaluation of a remote scribe pilot program introduced in September 2019 in an academic primary care practice. Scribes were paired with physicians via an audio-only cellphone connection to hear and document in real-time...
November 11, 2022: Healthcare
https://read.qxmd.com/read/36270180/quality-of-race-and-ethnicity-data-in-medicare
#36
JOURNAL ARTICLE
Rachael B Zuckerman, Wafa W Tarazi, Lok Wong Samson, Victoria Aysola, Steven H Sheingold, Nancy De Lew, Benjamin D Sommers
No abstract text is available yet for this article.
October 18, 2022: Healthcare
https://read.qxmd.com/read/36252526/the-case-for-unlearning-health-systems
#37
JOURNAL ARTICLE
Joseph H Joo, Joshua A Kim, Joshua M Liao
No abstract text is available yet for this article.
October 14, 2022: Healthcare
https://read.qxmd.com/read/36228470/the-art-of-asking-what-if-in-life-science-exploring-flagship-pioneering-s-model-of-innovation-with-senior-partner-michael-rosenblatt
#38
JOURNAL ARTICLE
Nathan Mallipeddi, Kaushik P Venkatesh
No abstract text is available yet for this article.
October 10, 2022: Healthcare
https://read.qxmd.com/read/36191489/care-teams-misunderstand-what-most-upsets-patients-about-their-care
#39
JOURNAL ARTICLE
Alana L Conner, Beatrice V Podtschaske, Mary Carol Mazza, Dani L Zionts, Elizabeth J Malcolm, Carey C Thomson, Sara J Singer, Arnold Milstein
BACKGROUND: Negative healthcare delivery experiences can cause lasting patient distress and medical service misuse and disuse. Yet no multi-site study has examined whether care-team members understand what most upsets patients about their care. METHODS: We interviewed 373 patients and 360 care-team members in the medical oncology and ambulatory surgery clinics of 11 major healthcare organizations across six U.S. census regions. Patients deeply upset by a service-related experience (n = 99, 27%) answered questions about that experience, while care-team members (n = 360) answered questions about their beliefs regarding what most upsets patients...
October 1, 2022: Healthcare
https://read.qxmd.com/read/36201996/innovation-pathways-to-preserve-rapid-healthcare-innovation-and-dissemination-during-the-covid-19-pandemic
#40
JOURNAL ARTICLE
Danielle Voke, Amanda Perry, Shoshana H Bardach, Nirav S Kapadia, Amber E Barnato
During the COVID-19 pandemic, healthcare systems rapidly responded to challenges in healthcare delivery with innovation. Innovations developed during the COVID-19 pandemic have filled needed gaps in medical care and many may be sustained long term. The unique conditions and processes that facilitated such rapid, successful, and collective innovation should be explored to support future change in healthcare. Decentralized decision making, crowdsourcing, and nontraditional information sharing may be valuable for ongoing innovation in healthcare delivery...
September 29, 2022: Healthcare
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