Standardized assessment, information, and networking technologies (SAINTs): lessons from three decades of development and testing

Abstract

Purpose To rectify the significant mismatch observed between what matters to patients and what clinicians know, our research group developed a standardized assessment, information, and networking technology (SAINT). Methods Controlled trials and field tests involving more than 230,000 adults identified characteristics of a successful SAINT—www.HowsYourHealth.org—for primary care and community settings. Results Evidence supports SAINT effectiveness when the SAINT has a simple design that provides a service to patients and explicitly engages them in an information and communication network with their clinicians. This service orientation requires that an effective SAINT deliver easily interpretable patient reports that immediately guide provider actions. For example, our SAINT tracks patient-reported confidence that they can self-manage health problems, and providers can immediately act on patients’ verbatim descriptions of what they want or need to become more health confident. This information also supports current and future resource planning, and thereby fulfills another characteristic of a successful SAINT: contributing to health care reliability. Lastly, SAINTs must manage or evade the “C-monsters,” powerful obstacles to implementation that largely revolve around control and commercialism. Responses from more than 10,000 adult patients with diabetes illustrate how a successful SAINT offers a standard and expedient guide to managing each patient’s concerns and adjusting health services to better meet the needs of any large patient population. Conclusion Technologies that evolve to include the characteristics described here will deliver more effective tools for patients, providers, payers, and policymakers and give patients control over sharing their data with those who need it in real time.

A “What Matters Index” (WMI) for Adolescents

“…When automated, the Adolescent WMI provides the responder a summary and suggested resources tailored to responses. Examples include a problem-solving tool that promotes a personal, cognitive-behavior therapeutic approach and a more comprehensive assessment when the WMI score is greater than zero ( https://howsyourhealth.org/ ; Wasson, 2021 ).…”

“…observed between what matters to adult patients and what clinicians know (Wasson, 2021;. This brief and immediately interpretable WMI efficiently communicates important needs to health professionals and identifies strategies that can improve health care and overall health.…”

“…A “WHAT MATTERS INDEX” (WMI) represents a distillation of many self-reported measures into the few that matter. Over several decades, a primary care research group developed and tested a multipurpose, 5-item WMI to rectify the significant mismatch observed between what matters to adult patients and what clinicians know ( Wasson, 2021 ; Wasson, Soloway, et al, 2018 ). This brief and immediately interpretable WMI efficiently communicates important needs to health professionals and identifies strategies that can improve health care and overall health.…”

Patient-Centered Payment for Care of Chronic Conditions

“…In addition to delivering evidence-based services to the patient, a physician practice that is delivering condition management services should proactively monitor the patient's condition to identify any problems the patient is experiencing and to assess the outcomes of the services delivered. A Standardized Assessment, Information, and Networking Technology (SAINT) provides a systematic way for patients to provide the physician practice with actionable information about any physical and/or emotional problems they are having and whether the services the practice is providing to the patient are addressing the issues that are of most concern to that patient ( Wasson, 2020 ).…”

Using feedback tools to enhance the quality and experience of care

“…The paper presents a substantial amount of process learning and especially the discussion of technical and legal issues that the project faced are a unique contribution within this special issue, which highlights important operational aspects to consider when developing such systems. The fifth paper [22] illustrates the contribution of such systems from a different point of the life span of such research and practice programs. Using the concept of "Standardized assessment, information, and networking technologies" (SAINTs), the authors summarize findings from their practice-research network spanning nearly three decades of development.…”