Tag Archives: patient-centered care

Special Issue of Medical Care: Implementation and Cost of evidence-based, patient-centered programs

By | November 30, 2023

As part of its partnership with the Patient-Centered Outcomes Research Institute (PCORI), Medical Care has published its first PCORI-sponsored article collection, which provides specific information about the costs that healthcare systems can expect to incur in promoting the uptake of specific evidence-based programs. In September’s special issue, five project teams that received Implementation Award funding from PCORI… Read More »

Improving treatment adherence with evidence-based approaches

Over the last 25 years, researchers have documented the broad impact of behavioral interventions on a range of psychological and physical health outcomes. Despite the promise of evidence-based treatments, a common challenge for practitioners is ensuring treatment adherence to maximize benefits. This is especially challenging for most chronic conditions. Integrating research and recommendations from medication… Read More »

Centering measurement on patients and family caregivers while developing two novel quality measures

In healthcare, what gets measured gets done. This is particularly true as the use of value-based purchasing, alternative payment models, and consumer tools to compare quality expand in the U.S. Centering measurement on patients, and focusing on their needs, preferences, and values, ensures that what we measure really matters, not only to patients and their… Read More »

Measuring what matters to patients and their family caregivers: Measure development isn’t just for measure developers

In today’s healthcare system, measurement influences everything from quality improvement to payments. So it matters greatly what gets measured. Measuring what matters to patients and their family caregivers will focus healthcare on their needs, preferences, and values. In a recent measure development effort, we brought lived and professional experience together at every stage. We found… Read More »

Is Something Going Wrong With the Patient Centered Medical Home?

By | January 27, 2022

Like others working at the intersection of public health and medicine, my faith in primary care has long been unshakeable. Increasingly actualized as the Patient-Centered Medical Home (PCMH), primary care has experienced a decade plus of attention thanks to efforts at retooling and rebranding the field. But in the last week, a tiny crack formed… Read More »

Patient-Centered Transitional Care

By | August 12, 2021

How is research on patient-centered transitional care going? A supplement on this topic funded by the Patient-Centered Outcomes Research Institute (PCORI) was recently published in Medical Care. Care transitions are “ripe with hazard,” as discussed in an editorial from Amy Berman. As pointed out by Berman, figuring out what works and what doesn’t is critical to… Read More »

Social determinants of health: Language nuance matters

The World Health Organization (WHO) defines social determinants of health (SDOH) as the non-medical factors that influence health outcomes. They are the “conditions in which people are born, grow, work, live, and age.” Currently, SDOH is a hot topic as stakeholders try new ways to improve individual and population health, achieve health equity, and reduce… Read More »

CMS Launches Compare Website Replacement: How does it measure up?

This fall, CMS launched two new websites: Care Compare and the Provider Data Catalog (PDC).  Both tools replaced the eight existing Compare tools and data.medicare.gov, which were sunset last year. The data included on Care Compare is intended to help Medicare beneficiaries make informed decisions about their care. While there have been articles and press releases… Read More »

Timing is Everything: Defining the Serious Illness Population for Palliative Care

The current healthcare system is not built for individuals with serious illnesses. These individuals can benefit from palliative care, which focuses on quality of life and symptom relief. Alternative payment models that incorporate palliative care are in development. Yet, the challenges of expanding these models of care are substantial. Betsy recently died after a sixteen-year… Read More »

Identifying Team-Based Primary Care is a Major Challenge

By | October 2, 2019

I have written a lot about primary care. I’ve covered its role in reducing ED visits, discussed the benefits of one of its most unique facets (coordination of care), and described the challenges of younger adults moving away from traditional models of primary care. It is hard to overstate just how important this field of medicine… Read More »

Medication Overload: The drug epidemic that no one is talking about

The opioid crisis has captured America’s attention, becoming an official “national emergency” and prompting swift action from government agencies, patient advocates, and health care providers. This is as it should be. Over the past decade, opioid overdoses have led to millions of hospitalizations, more than 100,000 deaths, and caused great harm in communities all across… Read More »

Street Medicine—a home for high quality medical care for people experiencing homelessness

“One foot in the grave,” he said. “Is that how you feel?” I asked.  “No, it’s how I live.” Unsheltered for 38 years, he had lived primarily behind a dumpster floating in and out of the medical, social and judicial system. In the month before the new Keck School of Medicine of the University of… Read More »

Can teamwork make the dream work?

By | January 17, 2019

In 2019, mental health and opioid use disorders remain major public health issues. The most recent estimates suggest that 40 million adults experience mental illness in the U.S. and nearly 8 million adults experience both mental and substance use disorders at the same time. Individuals with mental illness also face higher risks of co-occurring chronic health conditions and… Read More »

Priority Topics for Obesity and Diabetes Research

By | December 10, 2018

Patients are increasingly involved in shaping research in health care, especially since the advent of the federal Patient-Centered Outcomes Research Institute (PCORI). PCORI actively promotes the engagement of patients and other stakeholders (clinicians, caregivers, purchasers, etc.) in the research process. As we discussed in an earlier entry on this blog, research terminology alone can be a… Read More »

Swiping left and the evolution of primary care

By | September 25, 2019

A few weeks ago, a headline in the Chicago Tribune grabbed my attention: “Millennials are trading primary care doctors for faster, cheaper alternatives.” This headline fits the rather unfortunate stereotype of millennials as impatient, job-hopping, financially-struggling, digital natives. But if this is true, then millennials are bound to “swipe left” to health care delivered in a… Read More »

Opportunistic Salpingectomy: How is this Not Totally a Thing?

By | September 18, 2019

The name doesn’t exactly help. But before we discuss rebranding, a brief introduction to the concept . . . Salpingectomy refers to surgical removal of one (unilateral) or both (bilateral) fallopian tubes. It is thus a surgical option for female sterilization—but also drastically reduces a woman’s risk of ovarian cancer. This is huge. Ovarian cancer… Read More »

Five principles for developing digital clinic-based, behavior-change health interventions

 In this post, we describe five principles that guided the development of Positive Health Check, a clinic-based digital health intervention for HIV-positive patients, aimed at making it acceptable and feasible in a clinic setting.

Survey says: Most women don’t know about breast cancer overdiagnosis and overtreatment

By | October 4, 2017

October is here, so along with the fall foliage, prepare yourself for a deluge of pink ribbons, umbrellas, bumper stickers, and billboards: it’s Breast Cancer Awareness Month. Started as a well-intentioned campaign to raise awareness about breast cancer and fundraise for breast cancer research, some have said that the movement commodifies a deadly disease at… Read More »

Healthcare engagement and follow-up after perceived discrimination in maternity care

By | September 15, 2017

As unconscious bias and discrimination comes to the forefront of national conversation, it is fitting to discuss bias in the healthcare system. Though we pledge to treat all patients fairly and to the best of our capacity, regardless of their background, increasing evidence suggests that healthcare providers, too, have bias and exhibit behaviors perceived by… Read More »

Reducing Ambulatory Malpractice and Safety Risk: Results of the Massachusetts PROMISES Project

By | August 16, 2017

Every physician fears being sued. Almost half of primary care doctors are subject to a malpractice lawsuit at some point in their careers. In some quarters, physicians are fatalistic about this fact. I have heard colleagues say: “It’s going to happen at some point, I know it.” But since the publication of the Institute of… Read More »

Trying to Reduce Unnecessary Emergency Visits? First, Strengthen Our Primary Care System

By | May 26, 2017

Emergency departments (EDs) nationwide are busy places. In some locales they are overcrowded. In places like Los Angeles and other dense, urban areas with high poverty, they are over-capacity to such an extent that they can grind to a halt for all but the highest priority cases. In years past, it was not unheard of for… Read More »

Measuring patient-centered communication in colorectal cancer care

Every year, 340,000 Americans are diagnosed with cancer, and fully 4 in 10 of these diagnoses will be colorectal cancer (CRC). CRC is the second leading cause of cancer death in the United States; however, 60% of CRC deaths could be prevented if everyone 50 years old and older were screened. By instituting patient-centered communication, we… Read More »

Data sharing between patient-centered medical homes and addiction treatment providers

By | November 14, 2016

In my medical practice, lacking the tools to communicate meaningfully with other providers who are caring for my patients is a daily frustration. This is only magnified when it comes to caring for my most vulnerable patients who have difficulty communicating for themselves, such as those suffering from substance use disorders (SUDs), so I was… Read More »

The Person-Centered Wellness Home: Reflections on a Conversation with Dr. Thelma Mielenz

By | October 31, 2016

With the mania of the presidential election in full tilt and the election just days away, it’s hard to have a rational public discussion about health care.  Supporters of the two presidential candidates have drawn a deep and divisive line (or rather a tectonic fissure) in the sand about health care reform.  This is due, in great part, to the bombastic, and ultimately… Read More »

Tools to improve coordination in primary care

By | July 28, 2016

Last month, I left readers with a bit of cliffhanger: How do we actually improve care coordination? Last time, I suggested there were some great ideas, and now it’s time to delve into three promising strategies: 1) individualize and personalize the electronic medical record (EMR); 2. fix the hospital discharge process; and 3) make it a part of normal practice to measure care coordination. Read on for more about each of these tools…

Is Care Coordination the Magic Bullet in Primary Care?

By | June 14, 2016

Decades of thoughtful research into how we design health care systems has shown that primary care is essential.  We know enough to confidently say that systems responsible for the overall health of patients (like health insurance plans or the Veterans Administration) that choose to skimp on primary care do so at their own peril.  But in a time… Read More »