Organizing for Higher Performance: Case Studies of Organized Delivery Systems

Offers lessons learned from healthcare delivery systems promoting the attributes of an ideal model as defined by the Fund: information continuity, care coordination and transitions, system accountability, teamwork, continuous innovation, and easy access

Organizing the U.S. Health Care Delivery System for High Performance

Analyzes the fragmentation of the healthcare delivery system and makes policy recommendations -- including payment reform, regulatory changes, and infrastructure -- for creating mechanisms to coordinate care across providers and settings

State Strategies to Improve Quality and Efficiency: Making the Most of Opportunities in National Health Reform

Examines ten states' initiatives to address key components of quality and efficiency improvement, including data collection, aggregation, and standardization; public reporting; payment reform; consumer engagement; and provider engagement

Health Information Technology in the United States: Driving Toward Delivery System Change, 2012

Examines progress on electronic health record adoption, health information exchange under the HITECH Act, and models for meaningful delivery system reform through health information technology. Includes interview with former national HIT coordinator

Reforming Primary Care in the United States: Analysis of Deficiencies and Potential Solutions Based on Existing Models

Primary care medicine is an essential component of the U.S. health care system, yet there is no other part of the health care system that is in greater trouble right now. Primary care is undergoing profound change in the United States, as evidenced by an increasingly sick population along with the concurrent decrease in the supply of doctors to care for that population. The passage and the Supreme Court’s upholding of the constitutionality of the Affordable Care Act (ACA) is but another confirmation of the need to improve upon primary care in the U.S. In this paper, the major deficiencies in the primary care infrastructure in the U.S. are outlined. In addition, analysis of health care systems of countries that have substantial primary care systems, namely the United Kingdom, Spain and Italy, was performed to identify solutions to mitigate U.S. deficiencies. Innovative U.S. models and initiatives spurred by the ACA were also assessed. The results of this analysis indicate that to make substantive change to the U.S. health care system requires community directed initiatives based on the medical home model and centered on the primary care physician

Consumer Access to Immunization Information Systems: Evaluation of a 5-State Pilot Project

Background: Maintaining documentation of a family member’s vaccination history is one way to ensure that individuals are accurately informed of their vaccination status. To help increase patients’ access to health information in order to enable action, a 5-state pilot project was implemented to allow consumers access to their immunization information stored in their state Immunization Information System (IIS) via a consumer access portal. Purpose: To evaluate the implementation of the consumer access pilot project and identify the key factors for successful implementation. Methods: A mixed methods study design, incorporating both quantitative and qualitative methods, was used for this project. The study collected information from the three stakeholders engaged in the implementation of the consumer access portal: the state immunization program (via key informant interviews), the healthcare provider (via key informant interviews and an online survey), and the consumer (via an online survey). Results: Although stakeholders reported the consumer portal was easy to learn and use, completion of consumer registration was low. Organizational factors contributing to the low uptake was the lack of dedicated staff among the immunization programs to recruit and train providers as well as provide adequate follow-up. Human factors that contributed to low use included many providers forgetting to promote the portal to their patients along with many consumers forgetting to complete the final steps to activate their account. While the state immunization programs and providers saw the potential for the portal to empower consumers to make decisions about their health, many felt it was too early in the project to see real benefits. However, among consumers who learned that a vaccine was needed, half took action by calling their healthcare provider to learn more or schedule a visit. Conclusion: A consumer access portal linking consumers to their immunization information stored in their state IIS was moderately successful. As the project continues for another year, adjusting the registration process to allow the consumer to complete all the steps online in one session has the potential to increase the number of users, reduce the burden on the state immunization program and providers and allow for statewide promotion of the portal.Doctor of Public Healt

A Roadmap for Patient + Family Engagement In Healthcare Practice and Research

This report is a call to action for anyone interested in advancing work related to patient and family engagement. It includes:A vision for patient and family engagement in healthcare.8 change strategies to drive action towards increased patient and family engagement.5 simple actions that different stakeholder groups can begin today.This report unifies actions for patient and family engagement in healthcare, building on decades of evidence, knowledge, and experience. It highlights opportunities to improve our healthcare system by creating meaningful partnerships with patients and families. It is a catalyst, intended to spark ideas and action from individuals and organizations interested in advancing the work of patient and family engagement