Abstract:
PURPOSE:Practice transformation in primary care is a movement toward data-driven redesign of care, patient-centered care delivery, and practitioner activation. A critical requirement for achieving practice transformation is availability of tools to engage practices. METHODS:A total of 48 practices with 109 practice sites participate in the Garden Practice Transformation Network in Maryland (GPTN-Maryland) to work together toward practice transformation and readiness for the Quality Payment Program implemented by the Centers for Medicare & Medicaid Services. Practice-specific data are collected in GPTN-Maryland by practices themselves and by practice transformation coaches, and are provided by the Centers for Medicare & Medicaid Services. These data are overwhelming to practices when presented piecemeal or together, a barrier to practices taking action to ensure progress on the transformation spectrum. The GPTN-Maryland team therefore created a practice transformation analytics dashboard as a tool to present data that are actionable in care redesign. RESULTS:When practices reviewed their data provided by the Centers for Medicare & Medicaid Services using the dashboard, they were often seeing, for the first time, cost data on their patients, trends in their key performance indicator data, and their practice transformation phase. Overall, 72% of practices found the dashboard engaging, and 48% found the data as presented to be actionable. CONCLUSIONS:The practice transformation analytics dashboard encourages practices to advance in practice transformation and improvement of patient care delivery. This tool engaged practices in discussions about data, care redesign, and costs of care, and about how to develop sustainable change within their practices. Research is needed to study the impact of the dashboard on costs and quality of care delivery.
journal_name
Ann Fam Medjournal_title
Annals of family medicineauthors
Khanna N,Gritzer L,Klyushnenkova E,Montgomery R,Dark M,Shah S,Shaya Fdoi
10.1370/afm.2382subject
Has Abstractpub_date
2019-08-12 00:00:00pages
S73-S76issue
Suppl 1eissn
1544-1709issn
1544-1717pii
17/Suppl_1/S73journal_volume
17pub_type
杂志文章abstract:PURPOSE:Few studies have attempted to link patients' beliefs about racism in the health care system with how they use and experience health care. METHODS:Using telephone survey data from a national sample of 1,479 whites, 1,189 African Americans, and 983 Latinos, we explored patients' beliefs about racism, their prefe...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.282
更新日期:2005-03-01 00:00:00
abstract:PURPOSE:We wanted to identify characteristics of adults who do not have a usual source of care and then stratify the analysis by those who prefer vs those who do not prefer to have a usual source of care. METHODS:We analyzed data from a nationally representative sample of 9,011 adults to identify characteristics of th...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.557
更新日期:2006-07-01 00:00:00
abstract:PURPOSE:We wanted to explore the context of help seeking for reproductive and nonreproductive health concerns by urban adolescent girls. METHODS:We undertook a qualitative study using in-depth interviews of African American and Latina girls (n = 22) aged 13 to 19 years attending public high schools in the Bronx, NY. ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.124
更新日期:2004-11-01 00:00:00
abstract:PURPOSE:Despite growing calls for team-based care, the current staff composition of primary care practices is unknown. We describe staffing patterns for primary care practices in the Centers for Medicare and Medicaid Services (CMS) Comprehensive Primary Care (CPC) initiative. METHODS:We undertook a descriptive analysi...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1626
更新日期:2014-03-01 00:00:00
abstract:PURPOSE:Whether patients with 1 or more chronic illnesses are more or less likely to receive recommended preventive services is unclear and an important public health and health care system issue. We addressed this issue in a large national practice-based research network (PBRN) that maintains a longitudinal database d...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1502
更新日期:2013-07-01 00:00:00
abstract:PURPOSE:Persons with multiple chronic diseases must integrate self-management tasks for potentially interacting conditions to attain desired clinical outcomes. Our goal was to identify barriers to self-management that were associated with lower perceived health status and, secondarily, with lower reported physical func...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.722
更新日期:2007-09-01 00:00:00
abstract:PURPOSE:Automated office blood pressure monitoring during 30 minutes (OBP30) may reduce overtreatment of patients with white-coat hypertension in primary health care. OBP30 results approximate those of ambulatory blood pressure monitoring, but OBP30 is much more convenient. In this study, we compared OBP30 with routine...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2041
更新日期:2017-03-01 00:00:00
abstract:PURPOSE:Multimorbidity is associated with adverse outcomes, yet research on the determinants of its incidence is lacking. We investigated which sociodemographic, health, and individual lifestyle (eg, physical activity, smoking behavior, body mass index) characteristics predict new cases of multimorbidity. METHODS:We u...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2271
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:The 5As (ask, advise, assess, assist, arrange) are recommended as a strategy for brief physical activity counseling in primary care. There is no reference standard for measurement, however, and patient participation is not well understood. This study's objectives were to (1) develop a coding scheme to measur...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1299
更新日期:2011-09-01 00:00:00
abstract:PURPOSE:We aimed to identify the strategies used to support patient behavior change by clinicians whose patients had an increase in patient activation. METHODS:This mixed methods study was conducted in collaboration with Fairview Health Services, a Pioneer Accountable Care Organization. We aggregated data on the chang...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1904
更新日期:2016-03-01 00:00:00
abstract:PURPOSE:Adolescent mothers are at risk for rapidly becoming pregnant again and for depression, school dropout, and poor parenting. We evaluated the impact of a community-based home-visiting program on these outcomes and on linking the adolescents with primary care. METHODS:Pregnant adolescents aged 12 to 18 years, pre...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.629
更新日期:2007-05-01 00:00:00
abstract:PURPOSE:The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. METHODS:We used a pragmatic cluster-randomized controlled design in 18 US family medicine and p...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.2179
更新日期:2018-03-01 00:00:00
abstract:PURPOSE:We wanted to estimate excess risk of in-hospital mortality associated with medical injuries identified using an injury surveillance system, after controlling for risk of death resulting from comorbidities. METHODS:The Wisconsin Medical Injuries Prevention Program (WMIPP) screening criteria were used to identif...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.553
更新日期:2006-09-01 00:00:00
abstract:PURPOSE:This report describes outcomes of an ongoing quality-improvement project (VitalSign6) in a large US metropolitan area to improve recognition, treatment, and outcomes of depressed patients in 16 primary care clinics (6 charity clinics, 6 federally qualified health care centers, 2 private clinics serving low-inco...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.2418
更新日期:2019-07-01 00:00:00
abstract::Large panel sizes are often held responsible for worse access to appointments in primary care. We evaluated the relationship between appointment backlog, panel size, and primary care clinician time in clinic, using Spearman correlation and multiple regression in a retrospective analysis. We found no independent associ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2313
更新日期:2018-11-01 00:00:00
abstract::In the United States, stable health insurance coverage is associated with improved health outcomes. A lack of insurance is associated with premature death from preventable causes. Although primary care clinicians are often in a position to see firsthand the impact that being uninsured has on patients, most ambulatory ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1541
更新日期:2013-09-01 00:00:00
abstract:PURPOSE:Little is known regarding the effects of psychological factors on data collection in research studies. We examined whether Five Factor Model (FFM) personality factors-Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness-predicted missing data in a randomized controlled trial (RCT). METHODS...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.920
更新日期:2009-03-01 00:00:00
abstract:PURPOSE:Describe the duration of symptoms, proportion of parents seeking primary care consultations, and costs for respiratory tract infections (RTIs) of children in the community. METHODS:Community-based, online, prospective inception cohort study. General practitioners from socioeconomically diverse practices posted...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2327
更新日期:2019-01-01 00:00:00
abstract::I had intended to spend our spring break week in Montana with my kids and my dad, going to parks and museums together. Instead, I spent the week in the hospital, helping my dad make end-of-life choices and learning more about the importance of communication in health care settings and the preciousness of close relatio...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1908
更新日期:2016-05-01 00:00:00
abstract::Patient-choice cesarean delivery is increasing in the United States. The American College of Obstetricians and Gynecologists supports this option, citing ethical premises of autonomy and informed consent, despite a lack of evidence for its safety. This increase in patient-choice cesarean delivery occurs during a time ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.537
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Clinicians are faced with a plethora of guidelines. To rate guidelines, they can select from a number of evaluation tools, most of which are long and difficult to apply. The goal of this project was to develop a simple, easy-to-use checklist for clinicians to use to identify trustworthy, relevant, and useful...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2119
更新日期:2017-09-01 00:00:00
abstract:PURPOSE:In 30 small, independent primary care practices, we examined the association between clinician-reported use of elements of the Chronic Care Model (CCM) and diabetic patients' hemoglobin A(1c) (HbA(1c)) and lipid levels and self-reported receipt of care. METHODS:Ninety clinicians (60 physicians, 17 nurse-practi...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.610
更新日期:2007-01-01 00:00:00
abstract:PURPOSE:Hot tea and coffee have been found to have antimicrobial properties. The purpose of this study was to determine whether the consumption of tea, coffee, or both is associated with less frequent nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA). METHODS:We performed a secondary analysis of dat...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1262
更新日期:2011-07-01 00:00:00
abstract:PURPOSE:Hearing loss, the second most common disability in the United States, is under-diagnosed and under-treated. Identifying it in early stages could prevent its known substantial adverse outcomes. METHODS:A multiple baseline design was implemented to assess a screening paradigm for identifying and referring patien...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2590
更新日期:2020-11-01 00:00:00
abstract:PURPOSE:Peer health coaches offer a potential model for extending the capacity of primary care practices to provide self-management support for patients with diabetes. We conducted a randomized controlled trial to test whether clinic-based peer health coaching, compared with usual care, improves glycemic control for lo...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.1443
更新日期:2013-03-01 00:00:00
abstract:PURPOSE:In screening for type 2 diabetes, guidelines recommend targeting high-risk individuals. Our objectives were to assess the yield of opportunistic targeted screening for type 2 diabetes in primary care and to assess the diagnostic value of various risk factors. METHODS:In 11 family practices (total practice popu...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.997
更新日期:2009-09-01 00:00:00
abstract:PURPOSE:The distinction between physiologic (innocent) and pathologic (organic) heart murmurs is not always easy in routine practice, leading too often to unnecessary cardiology referrals and expensive investigations. We aimed to test the hypothesis that the complete disappearance of murmur on standing can exclude card...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.2105
更新日期:2017-11-01 00:00:00
abstract:PURPOSE:The Seventh Report of the Joint National Commission (JNC 7) on High Blood Pressure established prehypertension (120 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic) as a new risk category. We aim to determine the risk of major cardiovascular events associated with blood pressure in the prehypertensive range i...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.312
更新日期:2005-07-01 00:00:00
abstract:PURPOSE:Qualitative research projects often involve the collaborative efforts of a research team. Challenges inherent in teamwork include changes in membership and differences in analytical style, philosophy, training, experience, and skill. This article discusses teamwork issues and tools and techniques used to improv...
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pub_type: 杂志文章
doi:10.1370/afm.290
更新日期:2005-07-01 00:00:00
abstract:PURPOSE:Recent national guidelines encourage a trial of labor after cesarean (TOLAC) as a means of increasing vaginal births after cesarean (VBACs) and decreasing the high US cesarean birth rate and its consequences (2010 National Institute of Health Consensus Statement and American College of Obstetricians and Gynecol...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1403
更新日期:2012-11-01 00:00:00