Accelerating the Use of Findings from Patient-Centered Outcomes Research in Clinical Practice to Improve Health and Health Care Proceedings of a Workshop Series (2022) / Chapter Skim
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5 Workshop 1, Session 3: Sustainable Strategies and Digital Tools to Expand Implementation of PCOR Findings
5 Workshop 1, Session 3: Sustainable Strategies and Digital Tools to Expand Implementation of PCOR Findings
Pages 29-40
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USING THE LEARNING COLLABORATIVE APPROACH FOR IMPLEMENTING AND SCALING INNOVATION James Schuster, chief medical officer for the University of Pittsburgh Medical Center's (UPMC) insurance services division and a member of the 1 A Learning Collaborative is a systematic approach to process improvement based on the Institute for Healthcare Improvement Breakthrough Series Collaborative model.
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. The Behavioral Health Home Plus model focuses on enhancing behavioral health providers' capacity to serve as health homes; to provide comprehensive care management, care coordination and health promotion; and to link service users to community resources.
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Quantitative results showed that the learning collaborative approach increased staff confidence, documented reciprocal communication between behavioral and physical health providers, boosted the number of individuals with a wellness plan, and led to individuals feeling engaged in their own care. In closing, Schuster said that UPMC's Community Care Behavioral Health Organization is now using the learning collaborative model to address additional practice challenges in other care settings.
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Current health care delivery models can perpetuate poor reproductive health outcomes when they fail to identify people's reproductive risks, their needs, and their preferences. She said current health care delivery models frequently do not adequately support people's autonomy regarding their health care decision-making and inadequately address preventable adverse outcomes in a patient-centered manner.
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"This tool let us identify folks at risk from a distance, but it also allowed us to update how they are cared for in person," she said. Krishnamurti said that when building the MyHealthyPregnancy platform, the FemTech team developed effective predictive machine learning models that allowed the team to pose indirect questions to app users to assess their risk for intimate partner violence throughout pregnancy (Krishnamurti et al., 2021a)
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ENGAGING PEOPLE IN INNOVATIVE DIGITAL INTERVENTIONS Andrea Graham, clinical psychologist and assistant professor at the Center for Behavioral Intervention Technologies at Northwestern University's Feinberg School of Medicine, discussed engaging people with digital tools. She began by noting that digital health tools have been considered an opportunity to extend provision of health care treatment beyond in-person interactions.
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that applies the experimental therapeutics approach, or the science of behavior change, to consider how a digital tool (in this case a theoretical digital mental health tool) can improve the user experience, and thus improve clinical outcomes for users (Graham et al., 2019)
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Presented by Andrea Graham on June 9, 2022, at Accelerating the Use of Findings from Patient-Centered Outcomes Research in Clinical Practice to Improve Health and Health Care: A Workshop Series.
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DISCUSSION Considerations for Assessing Digital Tools Session moderator Cara Nikolajski, director of research design and implementation at the UPMC Center for High-Value Health Care, asked the panelists to discuss whether designers should assess apps in terms of evidence-based workflow integration, attention to equity, and other factors so that clinicians know which tools to prescribe over others. Krishnamurti replied that the Food and Drug Administration (FDA)
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Opportunities to Combine Digital Tools and Community Health Workers Another question from the audience asked the panelists to comment on possible opportunities for AHRQ to support combining digital tools with community health workers to provide care. Krishnamurti answered that digital tools represent an amazing opportunity to support community health workers and bridge gaps in health care.
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Schuster agreed and noted the need to ensure developers engage with communities that have health equity challenges and often access services less frequently than others. From an implementation science2 perspective, said Graham, it is important to consider equity when creating and testing a tool that may not be equally available to all who might benefit from that tool.
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40 ACCELERATING THE USE OF FINDINGS FROM PCOR • short funding cycles and funding sustainability; • navigating complex adaptive systems that evolve during the course of research that can impact findings; • developing effective approaches for disseminating research findings; • increasing the use of effective digital tools that are designed for context, integrated smartly into workflows, and are engaging and valuable; and • examining the design of studies to consider including mixed method approaches and more community-based participatory research. She said another theme touched on by several speakers was the importance of continuing to challenge assumptions and consider new perspectives about engaging in patient-centered outcomes research (PCOR)
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