Partnerships between healthcare providers and patients develop over time. They are created to support patients in having a greater voice in their care and to empower them in self-management. A descriptive model of partnership is proposed to support researchers in generating or applying existing theory to the development of research designs and tools that could test how this process actually works.

The systems required to provide coordinated health care to the chronically ill within a managed care contract are complex. As an integrated health care delivery system assuming shared financial risk of enrollees in a Medicare + Choice contract, many care processes need to be created to meet the needs of the clients and administrators. Nursing case management and physician partnering are integral to the creation of the care model. The fiscal data demonstrated, for clients in this model, that there was an overall decrease in the inpatient length of stay, hospital days per thousand, and 30-day readmission rates.

There are tangible benefits to the use of models to inform dissemination and implementation research. However dissemination and implementation scientists may find it difficult to select, adapt, and apply a model to their work. Guidance is provided on how to select a model, as answering several questions (e.g., the research question, scope of the study) can aid a research team in selecting a model. Given the large number of models available and the amount of work required to develop a new model, a dissemination and implementation researcher likely does not need to create a new model. There is a need to look outside the field of health research to identify other models that might inform dissemination and implementation research, as reviews have identified gaps in availability models for certain types of dissemination and implementation research (e.g., policy research).

The resulting pain IM is a consensus model based on actual EHR documentation in the participating health systems. The IM captures the most important concepts related to pain.

We demonstrated the feasibility of using documentation artifacts in a bottom-up approach to develop common models and sets of terms that are complete from the perspective of clinical implementation. Importantly, we demonstrated a process by which a community of practice can contribute to closing gaps in existing standards using SDO processes.