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Primary Care Transformation

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https://www.readbyqxmd.com/read/28339479/mouse-newborn-cells-allow-highly-productive-mouse-cytomegalovirus-replication-constituting-a-novel-convenient-primary-cell-culture-system
#1
Vu Thuy Khanh Le-Trilling, Mirko Trilling
Mammalian cell culture is indispensable for most aspects of current biomedical research. Immortalized cell lines are very convenient, but transforming principles (e.g. oncogenic viruses or their oncogenes) can heavily influence the experimental outcome. Primary cells do not share this apparent disadvantage but are more laborious to generate. Certain viruses (e.g. mouse cytomegalovirus) do not replicate efficiently in most transformed cell lines. In the past, such viruses have been routinely propagated on primary mouse embryonic fibroblasts (MEF) established around day 17 (d17) of gestation...
2017: PloS One
https://www.readbyqxmd.com/read/28314499/bringing-global-health-home-the-case-of-global-to-local-in-king-county-washington
#2
EDITORIAL
Adam Taylor, Fareeha Siddiqui
The article describes the experience of testing successful global health interventions in the cities of SeaTac and Tukwila, Washington-2 very diverse, underserved communities outside of Seattle that experience significant health disparities compared with surrounding areas in King County. Topics covered include an overview of the partnership that established Global to Local, the process of engaging Seattle-based global health institutions in identifying global health strategies to test, identifying communities experiencing health disparities that might benefit from global health-inspired interventions, engaging those local communities to understand the perceived drivers of poor health outcomes, tailoring global interventions to the local context, launching programs, and the successes and challenges that have emerged throughout this process...
November 2016: Annals of Global Health
https://www.readbyqxmd.com/read/28300989/analysis-of-the-performance-of-contractualization-primary-health-care-indicators-in-the-period-2009-2015-in-lisbon-and-tagus-valley
#3
Baltazar Ricardo Monteiro, Fátima Candoso, Magda Reis, Sónia Bastos
Reforms started in 1996 intended that Regional Health Administrations (ARS) should play a relevant role in the process of transforming an integrated model towards a contractual health care model. The essential tool of this transformation would be the Contractualization Agency, established in each ARS. Its role in the new contractualization culture was to negotiate prospective budgets with health care institutions, which included Primary Health Care (PHC). This paper is a longitudinal analysis of the development of a set of nine PHC contractualization indicators in three Health Center Clusters (ACeS) of the Regional Health Administration of Lisbon and Tagus Valley (ARSLVT)...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28289126/putting-the-four-pillars-for-primary-care-physician-workforce-into-practice-locally
#4
Philip M Diller, Amanda Weidner, Michelle Roett, Allan Wilke, Ardis Davis
No abstract text is available yet for this article.
March 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28284190/notifiable-condition-reporting-practices-implications-for-public-health-agency-participation-in-a-health-information-exchange
#5
Debra Revere, Rebecca H Hills, Brian E Dixon, P Joseph Gibson, Shaun J Grannis
BACKGROUND: The future of notifiable condition reporting in the United States is undergoing a transformation with the increasing development of Health Information Exchanges which support electronic data-sharing and -transfer networks and the wider adoption of electronic laboratory reporting. Communicable disease report forms originating in clinics are an important source of surveillance data for public health agencies. However, problems of poor data quality and delayed submission of reports to public health agencies are common...
March 11, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28272588/the-impact-of-bedside-interdisciplinary-rounds-on-length-of-stay-and-complications
#6
Andrew S Dunn, Maria Reyna, Brian Radbill, Michael Parides, Claudia Colgan, Tobi Osio, Ari Benson, Nicole Brown, Joy Cambe, Margo Zwerling, Natalia Egorova, Harold Kaplan
BACKGROUND: Communication among team members within hospitals is typically fragmented. Bedside interdisciplinary rounds (IDR) have the potential to improve communication and outcomes through enhanced structure and patient engagement. OBJECTIVE: To decrease length of stay (LOS) and complications through the transformation of daily IDR to a bedside model. DESIGN: Controlled trial. SETTING: 2 geographic areas of a medical unit using a clinical microsystem structure...
March 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28272112/starting-with-lucy-focusing-on-human-similarities-rather-than-differences-to-address-health-care-disparities
#7
Laura Clementz, Megan McNamara, Nicole M Burt, Matthew Sparks, Mamta K Singh
PROBLEM: Multicultural or cultural competence education to address health care disparities using the traditional categorical approach can lead to inadvertent adverse consequences. Nontraditional approaches that address these drawbacks while promoting humanistic care are needed. APPROACH: In September 2014, the Cleveland VA Medical Center's Center of Excellence in Primary Care Education Transforming Outpatient Care (CoEPCE-TOPC) collaborated with the Cleveland Museum of Natural History (CMNH) to develop the Original Identity program, which uses a biocultural anthropologic framework to help learners recognize and address unconscious bias and starts with a discussion of humans' shared origins...
March 7, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28264948/early-impact-of-carefirst-s-patient-centered-medical-home-with-strong-financial-incentives
#8
Christopher C Afendulis, Laura A Hatfield, Bruce E Landon, Jonathan Gruber, Mary Beth Landrum, Robert E Mechanic, Darren E Zinner, Michael E Chernew
In 2011 CareFirst BlueCross BlueShield, a large mid-Atlantic health insurance plan, implemented a payment and delivery system reform program. The model, called the Total Care and Cost Improvement Program, includes enhanced payments for primary care, significant financial incentives for primary care physicians to control spending, and care coordination tools to support progress toward the goal of higher-quality and lower-cost patient care. We conducted a mixed-methods evaluation of the initiative's first three years...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264946/oregon-s-medicaid-reform-and-transition-to-global-budgets-were-associated-with-reductions-in-expenditures
#9
K John McConnell, Stephanie Renfro, Richard C Lindrooth, Deborah J Cohen, Neal T Wallace, Michael E Chernew
In 2012 Oregon initiated an ambitious delivery system reform, moving the majority of its Medicaid enrollees into sixteen coordinated care organizations, a type of Medicaid accountable care organization. Using claims data, we assessed measures of access, appropriateness of care, utilization, and expenditures for five service areas (evaluation and management, imaging, procedures, tests, and inpatient facility care), comparing Oregon to the neighboring state of Washington. Overall, the transformation into coordinated care organizations was associated with a 7 percent relative reduction in expenditures across the sum of these services, attributable primarily to reductions in inpatient utilization...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28255992/the-reduction-in-ed-and-hospital-admissions-in-medical-home-practices-is-specific-to-primary-care-sensitive-chronic-conditions
#10
Lee A Green, Hsiu-Ching Chang, Amanda R Markovitz, Michael L Paustian
OBJECTIVE: To determine whether the Patient-Centered Medical Home (PCMH) transformation reduces hospital and ED utilization, and whether the effect is specific to chronic conditions targeted for management by the PCMH in our setting. DATA SOURCES AND STUDY SETTING: All patients aged 18 years and older in 2,218 primary care practices participating in a statewide PCMH incentive program sponsored by Blue Cross Blue Shield of Michigan (BCBSM) in 2009-2012. STUDY DESIGN: Quantitative observational study, jointly modeling PCMH-targeted versus other hospital admissions and ED visits on PCMH score, patient, and practice characteristics in a hierarchical multivariate model using the generalized gamma distribution...
March 2, 2017: Health Services Research
https://www.readbyqxmd.com/read/28243874/primary-care-practice-transformation-and-the-rise-of-consumerism
#11
William H Shrank
Americans are increasingly demanding the same level of service in healthcare that they receive in other services and products that they buy. This rise in consumerism poses challenges for primary care physicians as they attempt to transform their practices to succeed in a value-based reimbursement landscape, where they are rewarded for managing costs and improving the health of populations. In this paper, three examples of consumer-riven trends are described: retail healthcare, direct and concierge care, and home-based diagnostics and care...
February 27, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28238522/endovascular-thrombectomy-and-medical-therapy-versus-medical-therapy-alone-in-acute-stroke-a-randomized-care-trial
#12
Naim N Khoury, Tim E Darsaut, Jimmy Ghostine, Yan Deschaintre, Nicole Daneault, André Durocher, Sylvain Lanthier, Alexandre Y Pope, Céline Odier, Louise-Hélène Lebrun, François Guilbert, Jean-Christophe Gentric, André Batista, Alain Weill, Daniel Roy, Serge Bracard, Jean Raymond
BACKGROUND: Until recently, the benefits of endovascular treatment in stroke were not proven. Care trials have been designed to simultaneously offer yet-to-be validated interventions and verify treatment outcomes. Our aim was to implement a care trial for patients with acute ischemic stroke. METHODS: The study was offered to all patients considered for endovascular management of acute ischemic stroke in one Canadian hospital. Inclusion criteria were broad: onset of symptoms≤5h or at any time in the presence of clinical-imaging mismatch and suspected or demonstrated proximal large vessel occlusion...
February 23, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28237210/the-value-of-addressing-patient-preferences
#13
Jeff D Allen, Mark D Stewart, Samantha A Roberts, Ellen V Sigal
Recent scientific progress is, in some cases, leading to transformative new medicines for diseases that previously had marginal or even no treatment options. This offers great promise for people affected by these diseases, but it has also placed stress on the health care system in terms of the growing cost associated with some new interventions. Effort has been taken to create tools to help patients and health care providers assess the value of new medical innovations. These tools may also provide the basis for assessing the price associated with new medical products...
February 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28192568/early-performance-in-medicaid-accountable-care-organizations-a-comparison-of-oregon-and-colorado
#14
K John McConnell, Stephanie Renfro, Benjamin K S Chan, Thomas H A Meath, Aaron Mendelson, Deborah Cohen, Jeanette Waxmonsky, Dennis McCarty, Neal Wallace, Richard C Lindrooth
Importance: Several state Medicaid reforms are under way, but the relative performance of different approaches is unclear. Objective: To compare the performance of Oregon's and Colorado's Medicaid Accountable Care Organization (ACO) models. Design, Setting, and Participants: Oregon initiated its Medicaid transformation in 2012, supported by a $1.9 billion investment from the federal government, moving most Medicaid enrollees into 16 Coordinated Care Organizations, which managed care within a global budget...
February 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28187747/using-the-consolidated-framework-for-implementation-research-cfir-to-produce-actionable-findings-a-rapid-cycle-evaluation-approach-to-improving-implementation
#15
Rosalind E Keith, Jesse C Crosson, Ann S O'Malley, DeAnn Cromp, Erin Fries Taylor
BACKGROUND: Much research does not address the practical needs of stakeholders responsible for introducing health care delivery interventions into organizations working to achieve better outcomes. In this article, we present an approach to using the Consolidated Framework for Implementation Research (CFIR) to guide systematic research that supports rapid-cycle evaluation of the implementation of health care delivery interventions and produces actionable evaluation findings intended to improve implementation in a timely manner...
February 10, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28186016/collaborators-and-communication-channels-in-eight-patient-centered-medical-homes
#16
Dian A Chase, David A Dorr, Deborah J Cohen, Joan S Ash
BACKGROUND: The patient-centered medical home (PCMH) concept requires collaboration among clinicians both within the medical home clinic, and outside the clinic. As we redesign health information technology (HIT) to support transformation to the PCMH, we need to better understand these collaboration patterns. This study provides quantitative data describing these collaborations in order to facilitate the design of systems to allow for more efficient collaboration. APPROACH: Eighty-four clinicians in eight clinics identified their two most recent significant collaborators - one each within the clinic and in the medical neighborhood...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28186015/community-paramedicine-initiative-transforming-paramedicine-in-british-columbia
#17
Colton Calderone, Michelle Brittain, Daniel Sirivar, Nancy Kotani
British Columbia's health care system is facing challenges related to rural access to care and an ever increasing demand for services. These variables are compounded by the anticipated needs of an aging population that can expect to live several of their golden years with a chronic illness. The introduction of community paramedicine in BC allows for a care delivery model that expands the role of qualified paramedics to include the delivery of prevention, health promotion and primary care services in the community...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28169976/the-impact-of-alternative-payment-in-chronically-ill-and-older-patients-in-the-patient-centered-medical-home
#18
Claudia A Salzberg, Asaf Bitton, Stuart R Lipsitz, Cal Franz, Shimon Shaykevich, Lisa P Newmark, Japneet Kwatra, David W Bates
BACKGROUND: Patient-centered medical home (PCMH) has gained prominence as a promising model to encourage improved primary care delivery. There is a paucity of studies that evaluate the impact of payment models in the PCMH. OBJECTIVES: We sought to examine whether coupling coordinated, team-based care transformation plan with a novel reimbursement model affects outcomes related to expenditures and utilization. RESEARCH DESIGN: Interrupted time-series model with a difference-in-differences approach to assess differences between intervention and control groups, across time periods attributable to PCMH transformation and/or payment change...
February 6, 2017: Medical Care
https://www.readbyqxmd.com/read/28166113/using-a-mixed-methods-approach-to-examine-practice-characteristics-associated-with-implementation-of-an-adult-immunization-intervention-using-the-4-pillars-practice-transformation-program
#19
Mary Hawk, Mary Patricia Nowalk, Krissy K Moehling, Valory Pavlik, Jonathan M Raviotta, Anthony E Brown, Richard K Zimmerman, Edmund M Ricci
Adult immunization rates are consistently suboptimal, exacting significant human and financial burden of preventable disease. Practice-level interventions to improve immunization rates have produced mixed results. The context of change critically affects implementation of evidence-based interventions. We conducted a randomized controlled cluster trial of the 4 Pillars Practice Transformation Program to increase adult vaccination rates in primary care practices and used qualitative methods to test intervention effects and understand practice characteristics associated with implementation success...
January 11, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28160758/a-model-for-integrative-transformation-a-back-pain-group-appointment-program
#20
Keith S Rayburn
A back pain treatment program was developed for the outpatient, primary care clinic setting. In this pilot study, measured functional status scores improved in a cohort of patients enrolled in the program. The program consists of a series of 5 monthly group appointments and follows a sequential curriculum involving multiple therapeutic modalities. These modalities include exercise, social interaction, motivation/raison d'être, holistic coaching, music, and behavioral modelling. The program provides a forum for the discussion and implementation of complementary and alternative approaches, alongside mainstream approaches, and represents a model of integrative medical practice...
January 2017: Alternative Therapies in Health and Medicine
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