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Health care redesign

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https://www.readbyqxmd.com/read/28106518/a-case-report-cornerstone-health-care-reduced-the-total-cost-of-care-through-population-segmentation-and-care-model-redesign
#1
Dale E Green, Bruce H Hamory, Grace E Terrell, Jasmine O'Connell
Over the course of a single year, Cornerstone Health Care, a multispecialty group practice in North Carolina, redesigned the underlying care models for 5 of its highest-risk populations-late-stage congestive heart failure, oncology, Medicare-Medicaid dual eligibles, those with 5 or more chronic conditions, and the most complex patients with multiple late-stage chronic conditions. At the 1-year mark, the results of the program were analyzed. Overall costs for the patients studied were reduced by 12.7% compared to the year before enrollment...
January 20, 2017: Population Health Management
https://www.readbyqxmd.com/read/28093379/the-epital-care-model-a-new-person-centered-model-of-technology-enabled-integrated-care-for-people-with-long-term-conditions
#2
Klaus Phanareth, Søren Vingtoft, Anders Skovbo Christensen, Jakob Sylvest Nielsen, Jørgen Svenstrup, Gro Karine Rosvold Berntsen, Stanton Peter Newman, Lars Kayser
BACKGROUND: There is worldwide recognition that the future provision of health care requires a reorganization of provision of care, with increased empowerment and engagement of patients, along with skilled health professionals delivering services that are coordinated across sectors and organizations that provide health care. Technology may be a way to enable the creation of a coherent, cocreative, person-centered method to provide health care for individuals with one or more long-term conditions (LTCs)...
January 16, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28080947/hiv-testing-intervention-development-among-men-who-have-sex-with-men-in-the-developed-world
#3
Paul Flowers, Claudia Estcourt, Pam Sonnenberg, Fiona Burns
HIV testing is a 'gateway' technology, enabling access to treatment and HIV prevention. Biomedical approaches to prevention, such as pre-exposure prophylaxis and treatment as prevention, require accurate and regular HIV test results. HIV testing also represents a powerful 'teachable moment' for behavioural prevention. An increasing range of HIV tests and the emergence of self-managed diagnostic technologies (e.g. self-testing) means there is now considerable diversification of when, where and how results are available to those who test...
January 13, 2017: Sexual Health
https://www.readbyqxmd.com/read/28074569/screening-brief-intervention-and-referral-to-treatment-implications-of-samhsa-s-sbirt-initiative-for-substance-abuse-policy-and-practice
#4
Thomas F Babor, Frances Del Boca, Jeremy W Bray
AIMS: This paper describes the major findings and public health implications of a cross-site evaluation of a national Screening, Brief Intervention and Referral to Treatment (SBIRT) demonstration program funded by the US Substance Abuse and Mental Health Services Administration (SAMHSA). METHODS: Eleven multi-site programs in two cohorts of SAMHSA grant recipients were each funded for 5 years to promote the adoption and sustained implementation of SBIRT. The SBIRT cross-site evaluation used a multi-method evaluation design to provide comprehensive information on the processes, outcomes and costs of SBIRT as implemented in a variety of medical and community settings...
February 2017: Addiction
https://www.readbyqxmd.com/read/28074565/sustaining-screening-brief-intervention-and-referral-to-treatment-sbirt-services-in-health-care-settings
#5
Manu Singh, Amanda Gmyrek, Amy Hernandez, Donna Damon, Susan Hayashi
AIMS: To assess the sustainability of Screening, Brief Intervention and Referral to Treatment (SBIRT) services after cessation of initial start-up funding. DESIGN: Descriptive study with quantitative and qualitative data collected from 34 staff participants from six grantees (comprising 103 sites) funded previously through a large, federally supported SBIRT program. SETTING: Primary care out-patient clinics and hospitals in the United States...
February 2017: Addiction
https://www.readbyqxmd.com/read/28069047/task-shifting-or-shifting-care-practices-the-impact-of-task-shifting-on-patients-experiences-and-health-care-arrangements-in-swaziland
#6
Thandeka Dlamini-Simelane, Eileen Moyer
BACKGROUND: In the quest to achieve early HIV treatment goals, national HIV treatment programmes dependent on international funding have been dramatically redesigned over the last 5 years. Bottlenecks in treatment provision are conceived of as health system problems to be addressed via structural and logistical fixes (routine HIV testing, point-of-care equipment, nurse-led antiretroviral treatment initiation, and patient tracking). Patient perspectives are rarely taken into account when such fixes are being considered...
January 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28068138/payment-reform-in-the-patient-centered-medical-home-enabling-and-sustaining-integrated-behavioral-health-care
#7
Benjamin F Miller, Kaile M Ross, Melinda M Davis, Stephen P Melek, Roger Kathol, Patrick Gordon
The patient-centered medical home (PCMH) is a promising framework for the redesign of primary care and more recently specialty care. As defined by the Agency for Healthcare Research and Quality, the PCMH framework has 5 attributes: comprehensive care, patient-centered care, coordinated care, accessible services, and quality and safety. Evidence increasingly demonstrates that for the PCMH to best achieve the Triple Aim (improved outcomes, decreased cost, and enhanced patient experience), treatment for behavioral health (including mental health, substance use, and life stressors) must be integrated as a central tenet...
January 2017: American Psychologist
https://www.readbyqxmd.com/read/28067805/content-validation-and-semantic-evaluation-of-a-check-list-elaborated-for-the-prevention-of-gluten-cross-contamination-in-food-services
#8
Priscila Farage, Renata Puppin Zandonadi, Verônica Cortez Ginani, Lenora Gandolfi, Riccardo Pratesi, Yanna Karla de Medeiros Nóbrega
Conditions associated to the consumption of gluten have emerged as a major health care concern and the treatment consists on a lifelong gluten-free diet. Providing safe food for these individuals includes adapting to safety procedures within the food chain and preventing gluten cross-contamination in gluten-free food. However, a gluten cross-contamination prevention protocol or check-list has not yet been validated. Therefore, the aim of this study was to perform the content validation and semantic evaluation of a check-list elaborated for the prevention of gluten cross-contamination in food services...
January 6, 2017: Nutrients
https://www.readbyqxmd.com/read/28066918/implementation-of-the-redesigned-community-health-fund-in-the-dodoma-region-of-tanzania-a-qualitative-study-of-views-from-rural-communities
#9
Albino Kalolo, Lara Gautier, Ralf Radermacher, Manfred Stoermer, Albrecht Jahn, Menoris Meshack, Manuela De Allegri
The need to understand how an intervention is received by the beneficiary community is well recognised and particularly neglected in the micro-health insurance (MHI) domain. This study explored the views and reactions of the beneficiary community of the redesigned Community Health Fund (CHF) implemented in the Dodoma region of Tanzania. We collected data from focus group discussions with 24 groups of villagers (CHF members and nonmembers) and in-depth interviews with 12 key informants (enrolment officers and health care workers)...
January 8, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28062813/the-transition-of-primary-care-group-practices-to-next-generation-models-satisfaction-of-staff-clinicians-and-patients
#10
Therese Zink, John Kralewski, Bryan Dowd
INTRODUCTION: Restructuring primary care is essential to achieve the triple aim. This case study examines the human factors of extensive redesign on 2 midsized primary care clinics (clinics A and B) in the Midwest United States that are owned by a large health care system. The transition occurred when while the principles for patient-centered medical home were being rolled out nationally, and before the Affordable Care Act. METHODS: After the transition, interviews and discussions were conducted with 5 stakeholder groups: health system leaders, clinic managers, clinicians, nurses, and reception staff...
January 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28055062/cost-of-joint-replacement-using-bundled-payment-models
#11
Amol S Navathe, Andrea B Troxel, Joshua M Liao, Nan Nan, Jingsan Zhu, Wenjun Zhong, Ezekiel J Emanuel
Importance: Medicare launched the mandatory Comprehensive Care for Joint Replacement bundled payment model in 67 urban areas for approximately 800 hospitals following its experience in the voluntary Acute Care Episodes (ACE) and Bundled Payments for Care Improvement (BPCI) demonstration projects. Little information from ACE and BPCI exists to guide hospitals in redesigning care for mandatory joint replacement bundles. Objective: To analyze changes in quality, internal hospital costs, and postacute care (PAC) spending for lower extremity joint replacement bundled payment episodes encompassing hospitalization and 30 days of PAC...
January 3, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27983894/health-system-advance-care-planning-culture-change-for-high-risk-patients-the-promise-and-challenges-of-engaging-providers-patients-and-families-in-systematic-advance-care-planning
#12
Jennifer Reidy, Jennifer Halvorson, Suzana Makowski, Delila Katz, Barbara Weinstein, Christine McCluskey, Alex Doering, Kathryn DeCarli, Jennifer Tjia
BACKGROUND: The success of a facilitator-based model for advance care planning (ACP) in LaCrosse, Wisconsin, has inspired health systems to aim for widespread documentation of advance directives, but limited resources impair efforts to replicate this model. One promising strategy is the development of interactive, Internet-based tools that might increase access to individualized ACP at minimal cost. However, widespread adoption and implementation of Internet-based ACP efforts has yet to be described...
December 16, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27933151/improving-asthma-care-in-a-pediatric-resident-clinic
#13
Julia Lee, Albina Gogo, Daniel Tancredi, Erik Fernandez Y Garcia, Ulfat Shaikh
There is variation in pediatric asthma management in the outpatient setting. Adherence to national asthma guidelines provides a systematic standardized approach to asthma management. There is a gap between usual and guideline-consistent asthma care in resident clinics. Practice improvement modules aimed at improving resident physician adherence to asthma care guidelines have not been consistently utilized and have not yet been studied. Our aim was to increase guideline consistent care in our pediatric resident clinic in a twelve-month period via increasing performance on the following measures to 75%: spirometry testing; influenza immunization recommendation; level of control assessed through the use of a standardized questionnaire; appropriate medications per national guideline; and use of written asthma action plans...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27932315/design-and-testing-of-the-safety-agenda-mobile-app-for-managing-health-care-managers-patient-safety-responsibilities
#14
José Joaquín Mira, Irene Carrillo, Cesar Fernandez, Maria Asuncion Vicente, Mercedes Guilabert
BACKGROUND: Adverse events are a reality in clinical practice. Reducing the prevalence of preventable adverse events by stemming their causes requires health managers' engagement. OBJECTIVE: The objective of our study was to develop an app for mobile phones and tablets that would provide managers with an overview of their responsibilities in matters of patient safety and would help them manage interventions that are expected to be carried out throughout the year...
December 8, 2016: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/27925075/leadership-and-cooperation-25-years-of-mission-as-a-who-collaborating-center
#15
Isabel Amélia Costa Mendes, Carla Aparecida Arena Ventura, Maria Auxiliadora Trevizan, Leila Maria Marchi-Alves, Simone de Godoy, Juliana Gazzotti
Objective: analyse the evolution in the mission and vision of a World Health Organization Collaborating Centre in Nursing in Brazil in the context of the implementation of its terms of reference. Method: Historical-social documentary research with a qualitative approach. Results: During the 25 years of its activities as a Collaborating Centre, its mission to "promote and stimulate the development of nursing research in the region, with a focus on Latin America" triggered activities in the context of its terms of reference in four areas: Human Resource Formation for Research, Knowledge Production, Knowledge Dissemination, Encouragement of Exchange and Stimulus of Partnerships...
November 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27870546/integrated-care-organizations-medicare-financing-for-care-at-home
#16
Karen Davis, Amber Willink, Cathy Schoen
OBJECTIVES: As the boomer population ages, there is a growing need for integrated care organizations (ICOs) that can integrate both medical care and long-term services and supports in the home. This paper presents a policy proposal to support the creation of ICOs, redesign care, and provide financing for home- and community-based services (HCBS), with the goal of enhancing financial protection for beneficiaries, coordinating care, and preventing costly hospital and nursing home use. METHODS: This study used the 2012 Medicare Current Beneficiary Survey (MCBS) Cost and Use File, inflated to 2016 figures, to describe the characteristics of Medicare beneficiaries and their healthcare utilization and spending...
November 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27821596/do-online-communities-change-power-processes-in-healthcare-using-case-studies-to-examine-the-use-of-online-health-communities-by-patients-with-parkinson-s-disease
#17
Laura M Visser, Inge L Bleijenbergh, Yvonne W M Benschop, Allard C R Van Riel, Bastiaan R Bloem
OBJECTIVE: Communication technologies, such as personal online health communities, are increasingly considered as a tool to realise patient empowerment. However, little is known about the actual use of online health communities. Here, we investigated if and how patients' use of online communities supports patient empowerment. SETTING: A network of primary and secondary care providers around individual patients with Parkinson's disease. PARTICIPANTS: We conducted case studies to examine our research question...
November 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27802560/outcomes-oriented-medical-training-a-critical-curricular-design-consideration-in-developing-21st-century-health-care-professionals
#18
Darrin D'Agostino, Frank J Papa
The core competencies of medical schools and residencies have initiated a change in curricular design but have been limited in their execution of systems-based practice. The introduction of milestones and entrustable professional activities has emerged to enhance the current educational paradigm. Linking public health systemic approaches with evidence-based practices focused on population-level health care will affect patients more than current non-systems-based approaches. Curricular redesign, including population health-based strategies, public health competency, health care policy, and education linking the "determinants of health" to patient care, will better prepare future physicians to practice in the emerging paradigm of health care of the future...
November 1, 2016: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/27784648/protocol-for-a-randomized-controlled-trial-of-proactive-web-based-versus-telephone-based-information-and-support-can-electronic-platforms-deliver-effective-care-for-lung-cancer-patients
#19
Christine L Paul, Allison W Boyes, Lorna O'Brien, Amanda L Baker, Frans A Henskens, Ian Roos, Tara Clinton-McHarg, Douglas Bellamy, Glenda Colburn, Shiho Rose, Martine E Cox, Elizabeth A Fradgley, Hannah Baird, Daniel Barker
BACKGROUND: Community-based services such as telephone support lines can provide valuable informational, emotional, and practical support for cancer patients via telephone- or Web-based (live chat or email) platforms. However, very little rigorous research has examined the efficacy of such services in improving patient outcomes. OBJECTIVE: This study will determine whether: proactive telephone or Web-delivered support produces outcomes superior to printed information; and Web-delivered support produces outcomes comparable to telephone support...
October 26, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27756368/the-effect-of-ncms-on-catastrophic-health-expenditure-and-impoverishment-from-tuberculosis-care-in-china
#20
Chengchao Zhou, Qian Long, Jiaying Chen, Li Xiang, Qiang Li, Shenglan Tang, Fei Huang, Qiang Sun, Henry Lucas, Shitong Huan
BACKGROUND: Health expenditure for tuberculosis (TB) care often pushes households into catastrophe and poverty. New Cooperative Medical Scheme (NCMS) aims to protect households from catastrophic health expenditure (CHE) and impoverishment in rural China. This article assesses the effect of NCMS on relieving CHE and impoverishment from TB care in rural China. METHODS: Three hundred fourty-seven TB cases are included in the analysis. We analyze the incidence and intensity of CHE and poverty, and assess the protective effect of NCMS by comparing the CHE and impoverishment before and after reimbursement...
October 18, 2016: International Journal for Equity in Health
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