Early Evidence on the Patient-Centered Medical Home | PCMH Resource Center
This study systematically reviews the early evidence on effectiveness of the PCMH. … While much can be learned from rapid-cycle evaluations of small pilots and from evaluations of specific … In many cases, because of the limits of what study authors can include in a journal article, we sought … The evaluation of IMPACT reported the strongest evidence of these effects, and the evaluation of GRACE … None of the studies reported effects on out-of-pocket patient costs or practice revenues.
Engaging Patients and Families in the Medical Home - Appendix | PCMH Resource Center
Bodenheimer et al. reviewed the literature in 2002 and reported that 32 of 39 studies testing the chronic … Point of care changes including promotion of e-mail and phone visits, previsit chart review and visit … A review of 33 articles on 30 distinct studies examined the impact of the medical home. … marketing, rapid change cycles, and measurement for improvement. … Members of G-I-N PUBLIC recently reported on how different organizations involved patients and the public
Formative Evaluation: Fostering Real-Time Adaptions and Refinements to Improve the Effectiveness of Patient-Centered Medical Home Interventions | PCMH Resource Center
with stakeholders, structured surveys, focus groups, direct observations through site visits, document reviews … resource- intensive because they require frequent data collection, analysis, and reporting, as well as rapid … This rapid refinement process also poses several methodological challenges when trying to evaluate the … impact of the intervention. … time to ensure a balance between rapid interim feedback and rigorous conclusions.
Early Evidence on the Patient-Centered Medical Home - Table 1 | PCMH Resource Center
Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Overview of the 12 interventions reviewed. … Community Care of North Carolina Community-based care management provided through networks of primary … outreach, health IT, and management; reducing caseloads; increasing visit times; using team huddles; and rapid … Department of Veterans Affairs, 2007; Hughes et al., 2000.
Efficient Orthogonal Designs: Testing the Comparative Effectiveness of Alternative Ways of Implementing Patient-Centered Medical Home Components | PCMH Resource Center
Efficient Orthogonal Designs
A recent review by AHRQ (Peikes, Dale, Lundquist et al., 2012) shows that … The review argues that future evaluations of medical homes should not only address the effectiveness … They combine the rigor of experimental design with the ability to produce rapid results on the effectiveness … of primary care practices in the case of the PCMH. … Facilitates rapid learning.
Anthropological Approaches: Uncovering Unexpected Insights About the Implementation and Outcomes of Patient-Centered Medical Home Models | PCMH Resource Center
The following factors are critical to the success of focus groups:
Thoughtful creation of a list of … Each focus group is considered a unit of analysis (N=1), irrespective of the number of participants. … exist, researchers can conduct a systematic review of textual materials produced by the practice for … For large projects with teams of researchers, individual review of the data is followed by repeated group … Qualitative Methods in Health Research: Opportunities and Considerations in Application and Review.
Contextual Factors: The Importance of Considering and Reporting on Context in Research on the Patient-Centered Medical Home | PCMH Resource Center
implementation, learning, and rapid refinement will dramatically and quickly advance learning from the … A recent review of quantitative measures of the PCMH and its appendix provide a starting point, 1 and … reported perspective of participants in the middle of the process. … Review of external validity reporting in childhood obesity prevention research. … Tensions and paradoxes in electronic patient record research: a systematic literature review using the
Citations Database Definitions | PCMH Resource Center
they are a Case Study, Commentary Opinion Piece, Historical Publication, Key/Foundational Article, Literature … Review, or Position Statement. … the large majority of each patient’s physical and mental health care needs, including what types of providers … These articles are highly cited in discussions and literature on the medical home. … Literature review. Reviews and synthesizes literature on the medical home.
Building the Evidence Base for the Medical Home: What Sample and Sample Size Do Studies Need? Appendix | PCMH Resource Center
Review We conducted a targeted literature review, examining selected health care interventions that … Examples of selected effects found in a targeted literature review Study (Author) Population Gross Savings … This infrequent reporting of ICCs is consistent with reviews of the health care literature that found … 50 percent (and therefore a CV of 1), we did not systematically review the literature for the means … Coefficients of variation (CVs) reported in the literature Outcome Measure by Population Studied CV Studies
PCMH Evaluation Guide | PCMH Resource Center
In such cases, you could review larger, published studies to learn about the impact of the intervention … Such reviews can illustrate whether and how well certain aspects of the primary care intervention have … You could select cases to review randomly or focus on patients with specific characteristics, such as … ▲ Medical record reviews of a larger sample of patients can provide a more comprehensive assessment … In most cases, evaluations of primary care interventions require surprisingly large numbers of practices
Evidence and Evaluation | PCMH Resource Center
of a PCMH, as well as how the effects of individual components interact with one another. … of change, or theory of action – is a graphic illustration of how a program of intervention is expected … This study systematically reviews the early evidence on effectiveness of the PCMH. … : A Review of the Current State of the Evidence on the Effects of the Patient Centered Medical Home Model … of why and how to commission effective evaluations of medical home demonstrations.
The Roles of Patient-Centered Medical Homes And Accountable Care Organizations in Coordinating Patient Care | PCMH Resource Center
Coordination of care is one of the core functions of primary care. … Summary of Evidence from Care Coordination Activities
A review of existing evidence on care coordination … refills, and 45 reviews of laboratory, imaging, or consultation reports per day. … of ACOs. … Technical Review 9 (Prepared by Stanford-UCSF Evidence-Based Practice Center under contract No. 290-
Coordinating Care for Adults With Complex Care Needs in the Patient-Centered Medical Home: Challenges and Solutions | PCMH Resource Center
low prevalence of such cases can create serious challenges. … Figure 2
Through searches of published and “grey” literature, recommendations from a technical expert … The other programs reported that their providers and care coordinators used separate electronic systems … Academic health centers could have their own special role to play, providing regional resources to support … Systematic Review: The relationship between clinical experience and quality of health care.
Coordinating Care in the Medical Neighborhood: Critical Components and Available Mechanisms | PCMH Resource Center
A related body of literature on the concept of accountable care organizations (ACOs) is also highly relevant … First, we conducted a review and synthesis of existing literature, recognizing that many of the potential … review of the literature. … Develop a mechanism for regular review of the agreements’ effectiveness. … Value-based purchasing: a review of the Literature. New York: The Commonwealth Fund, 2003.
Engaging Primary Care Practices in Quality Improvement: Strategies for Practice Facilitators | PCMH Resource Center
We first conducted a targeted environmental scan of the published and unpublished literature on engaging … Health, and an academic institution; each of these experts has years of experience in refining their … In some cases, payers have worked together as part of a multipayer demonstration project or regional … Cochrane Database of Systematic Reviews. 2006(2):CD000259. … Systematic review and meta-analysis of practice facilitation within primary care settings.
Ensuring That Patient-Centered Medical Homes Effectively Serve Patients With Complex Health Needs | PCMH Resource Center
Their heavy use of health services puts them at greater risk of receiving fragmented or poor-quality … Allowing flexibility in matching staff to the needs of each practice. … versus rural settings and rely on different types of support organizations. … American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians … Joint principles of a patient-centered medical home.
Building the Evidence Base for the Medical Home: What Sample and Sample Size Do Studies Need? | PCMH Resource Center
Average coefficient of variation (CV) for continuous variables from studies in our literature review … Average ICC reported in studies in our literature review
Table 3. … Average ICC reported in studies in our literature review
This table shows the average ICC reported in … Again, even a study with a CV of 1.0 (lower than the smallest CV reported in the literature for costs … Appendix Table E.1 provides details on the coefficients of variation reported in the literature.
Necessary But Not Sufficient: The HITECH Act and Health Information Technology’s Potential to Build Medical Homes | PCMH Resource Center
In addition, the use of technology is rewarded, and in some cases required, for primary care practices … care by primary care practices as revealed in the literature. … , financial payments, and, in some cases, payment for improvements in process-of-care or clinical outcomes … Systematic review: impact of health information technology on quality, efficiency, and costs of medical … The use of electronic health records in the exam room and patient satisfaction: a systematic review.
Building the Evidence Base for the Medical Home: What Sample and Sample Size Do Studies Need? Table 2 | PCMH Resource Center
Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Average ICC reported in studies in our literature review Costs Hospitalizations Emergency Room Visits … Note: n denotes the number of studies that were included in the average for each cell. 0.026 (n=2) 0.023
PCMH Citations Collection | PCMH Resource Center
Case Study Commentary Opinion Piece Historical Publication Key/Foundational Article Literature … Review
Access to Care Care Coordination Comprehensive Care Cost and Reimbursement Defining