Integrated Risk Assessment and Feedback Reporting for Clinical Decision Making in a Medicare Risk Plan

Schraeder, Cheryl; Britt, Teri; Shelton, Paul

doi:10.1097/00004479-200010000-00006

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…For example, studying the number of patient infections post-surgery can be an outcomes measure of how effectively a surgeon closed the wound or the effectiveness of nursing care if an infection was preventable. McAdams (2005) suggested that, "quality measurement and outcomes management is the sine qua non of excellence in patient care" (McAdams, 2005;Schraeder et al, 2000). Further, McAdams (2005) puts forward that until now, outcomes measurement was determined manually from medical records, discharge data, and administrative claims review.…”

Section: Benefits and Challenges Of Technology Use In Hospitalsmentioning

confidence: 99%

“…Use of data for decision-making can also be transformed into learning and teaching practices (Schraeder et al, 2000). Some ways this can be done are through activities like continuing medical education, evidence-based guidelines, social network learning and performance rewards (Schraeder et al, 2000: 41;Cooper & Zmud, 1990).…”

Section: Use Of Clinical Information Technologymentioning

confidence: 99%

“…Some ways this can be done are through activities like continuing medical education, evidence-based guidelines, social network learning and performance rewards (Schraeder et al, 2000: 41;Cooper & Zmud, 1990). Currently, systems of integrated reporting and feedback are used and there is the potential for information sharing, screening, and management, which can also lead to the production and dissemination of patient reports to aid clinicians in care planning (Schraeder et al, 2000). There is significant work to be done on transformation of data into clinical practice.…”

Section: Use Of Clinical Information Technologymentioning

confidence: 99%

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Factors associated with the extent of information technology use in Ontario hospitals

Chow

2013

International Journal of Healthcare Management

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I am deeply indebted to those who took me through this part of my journey.Jim Tiessen: my thesis supervisor who continues to be a pillar of strength and reason.Thank you for your direction, wisdom, patience, humour and kindness.Catherine Middleton: my thesis advisor and one of Canada's leading IT researchers.Thank you for your critical thinking and attention to detail and your time. Faculty, Administration and Staff at Ryerson: Thank you for recognizing my skills outside of the academic realm; I truly believe that diversity is a proven strength. Who would have ever known… thank you for the gift of curiosity. You have changed my life. Health care in Ontario: to the professionals, support staff, administration, academics and the realists/idealists, thank you for embracing my questions and my work. My hope is to turn my operational (and now strategic) health care experience into academic questions for discussion and discovery. May this be a lifelong learning experience. Faculty and Friends: thank you for the professional development and for piquing my curiosity in health care research/debate. The quest has already begun.To my Friends: to the readers, technical support, practical advisors and the listeners.Thank you for supporting me. Friends are like seasons, they come and go. I hope that you stay (even if it is only for a season) and grace me with your presence.To my Family: a million thanks for your support and encouragement. To my parents: I hope this may make you proud; to my brother: I hope you find what you seek; and to Bibi the dog: thank you for not tearing up my thesis or putting up too many physical obstacles.iii Table of Contents

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Section: Benefits and Challenges Of Technology Use In Hospitalsmentioning

confidence: 99%

Section: Use Of Clinical Information Technologymentioning

confidence: 99%

Section: Use Of Clinical Information Technologymentioning

confidence: 99%

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Factors associated with the extent of information technology use in Ontario hospitals

Chow

2013

International Journal of Healthcare Management

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“…The reports included individual patients and their characteristics (i.e. health status, medications, health conditions, utilisation) and overall characteristics of the patient panel of each PCP and clinical site (Schraeder et al. 2000).…”

Section: Interventionmentioning

confidence: 99%

Evaluation of a primary care nurse case management intervention for chronically ill community dwelling older people

Schraeder¹,

Fraser²,

Clark³

et al. 2008

Journal of Clinical Nursing

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Evaluation of a primary care nurse case management intervention for chronically ill community dwelling older people Aim. The purpose of this study was to test the effectiveness of a collaborative primary care nurse case management intervention emphasising collaboration between physicians, nurses and patients, risk identification, comprehensive assessment, collaborative planning, health monitoring, patient education and transitional care on healthcare utilisation and cost for community dwelling chronically ill older persons. Background. Primary care teams comprised of nurses and primary care physicians have been suggested as a model for providing quality care to the chronically ill, but this type of intervention has not been systematically evaluated. Design. A non-randomised, 36 month comparison of two geographically distinct primary care populations was conducted. Methods. Six hundred and seventy-seven persons aged 65 and older were determined to be at high-risk for mortality, functional decline, or increased health service use. The treatment group (n = 400) received the intervention and the comparison group (n = 277) received usual care. Health plan claims files provided data on number of hospitalisations and bed days, emergency department (ED) visits, physician visits and total cost of care.Results. After adjustment for baseline variables, there were no significant differences between the treatment and comparison group in the percentage of patients hospitalised or ED visits. However, among those hospitalised in the treatment group, the likelihood of being re-hospitalised was significantly reduced by 34% (p = 0AE032). After adjusting for the cost of the intervention, although not statistically significant, the reduced hospital use resulted in cost savings of $106 per patient per month in the treatment group.Conclusions. The results indicate that a collaborative primary care nurse case management intervention has the potential to be an effective alternative to current primary care delivery system practice.Relevance to clinical practice. The study suggests that a chronic care intervention emphasising collaboration between physicians, nurses and patients, may be more effective when implemented in integrated provider networks.

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“…Risk stratification can help care teams better understand their populations' needs and reduce costs by targeting and tailoring care to high-needs patients with complex medical conditions and social issues [1][2][3][4] who constitute a large proportion of overall health care costs and utilization. 5,6 Patients are not uniform in their needs, and developing interventions to manage complex patients requires parsing those needs to match the approach.…”

mentioning

confidence: 99%

Implementing Risk Stratification in Primary Care: Challenges and Strategies

et al. 2019

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Introduction: Primary care risk stratification (RS) has been shown to help practices better understand their patient populations' needs and may improve health outcomes and reduce expenditures by targeting and tailoring care to high-need patients. This study aims to understand key considerations practices faced and practice experiences as they began to implement RS models. Methods: We conducted semistructured interviews about experiences in RS with 34 stakeholders from 15 primary care practices in Oregon and Colorado and qualitatively analyzed the data. Results: Three decisions were important in shaping practices' experiences with RS: choosing established versus self-created algorithms or heuristics, clinical intuition, or a combination; selecting mechanisms for assigning risk scores; determining how to integrate RS approaches into care delivery. Practices using clinical intuition found stratification time-consuming and difficult to incorporate into existing workflows, but trusted risk scores more than those using algorithms. Trust in risk scores was influenced by data extraction capabilities; practices often lacked sufficient data to calculate their perceived optimal risk score. Displaying the scores to the care team was a major issue. Finally, obtaining buy-in from care team members was challenging, requiring repeated cycles of improvement and workflow integration. Discussion: Practices used iterative approaches to RS implementation. As a result, procedural and algorithmic changes were introduced and were influenced by practices' health IT, staffing, and resource capacities. Practices were most successful when able to make iterative changes to their approaches, incorporated both automation and human process in RS, educated staff on the importance of RS, and had readily accessible risk scores.

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Integrated Risk Assessment and Feedback Reporting for Clinical Decision Making in a Medicare Risk Plan

Cited by 4 publications

References 10 publications

Factors associated with the extent of information technology use in Ontario hospitals

Factors associated with the extent of information technology use in Ontario hospitals

Evaluation of a primary care nurse case management intervention for chronically ill community dwelling older people

Implementing Risk Stratification in Primary Care: Challenges and Strategies

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