2018
DOI: 10.1097/jac.0000000000000219
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Patient, Primary Care Provider, and Specialist Perspectives on Specialty Care Coordination in an Integrated Health Care System

Abstract: Successful coordination of specialty care requires understanding the perspectives of patients, primary care providers, and specialists-that is, the specialty care "triad." This study used qualitative methods to compare these perspectives in an integrated health care system, using diabetes specialty care as an exemplar. Primary care providers and endocrinologists relied on interclinician relationships to coordinate care. Clinicians rarely included patients or other staff in their conceptualization of specialty … Show more

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Cited by 38 publications
(43 citation statements)
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“…The current study found that providers valued CCM as a key component of care that supports patient self-management of their chronic conditions. Sharing of electronic health data as a necessary facilitator of CCM was a consistent finding for this study and in the wider literature [ 17 , 18 , 23 , 24 ] on CCM. In contrast to this study which focused on NFF encounters in primary care, another qualitative study on care management focused the importance and the limitations of EHR in the coordination of care across practices [ 24 ].…”
Section: Discussionsupporting
confidence: 89%
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“…The current study found that providers valued CCM as a key component of care that supports patient self-management of their chronic conditions. Sharing of electronic health data as a necessary facilitator of CCM was a consistent finding for this study and in the wider literature [ 17 , 18 , 23 , 24 ] on CCM. In contrast to this study which focused on NFF encounters in primary care, another qualitative study on care management focused the importance and the limitations of EHR in the coordination of care across practices [ 24 ].…”
Section: Discussionsupporting
confidence: 89%
“…Additionally, the current study indicates a movement towards finding solutions for challenges encountered in the implementation or planning of NFF CCM programs for elderly patients with diabetes, where health systems find the programs appealing but difficult to manage. Other recent studies of care systems for patients with diabetes and its complications have focused on: (1) improving patient engagement; (2) communication and information sharing between patient, provider, and care team; and (3) coordination of care across settings including community partners [ 6 , 20 , 24 ]. The present study identified some of these as being important, while highlighting other factors as well, such as value for patients and needs that extend beyond CCM.…”
Section: Discussionmentioning
confidence: 99%
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“…To then identify the key features of coordination from the medical specialist perspective, we used the AHRQ definition of coordination, literature review, and findings from our previous qualitative study that included interviews with specialists as members of the specialty care triad . This extensive preliminary work resulted in the identification of four constructs that provided the conceptual framework for further survey development (Table ).…”
Section: Methodsmentioning
confidence: 99%
“… 50 A study conducted by Vimalananda et al found that the most helpful contacts for patients were usually non-physician staff such as nurses. 51 This is due to them being easier to contact and them being typically the first ones to notice any problems in treatment; however, their roles need to be centralized to ensure adequate patient care. 37 Inpatient PC units are designed to support patients when they can no longer be cared for at home or within their community.…”
Section: Discussionmentioning
confidence: 99%