Patient, Physician, Medical Assistant, and Office Visit Factors Associated With Medication List Agreement

Reedy, Alexis Benavides; Yeh, Jun Yun; Nowacki, Amy S.; Hickner, John

doi:10.1097/pts.0000000000000100

Cited by 6 publications

(6 citation statements)

References 12 publications

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“…The majority of transplant programs in our survey utilize unreliable screening methods, such as self- report and medical records reviews. 31,32 There also is a large reliance on toxicology screens, which have limitations based on the timing between exposure and test and cross- reactivity of the ingested opioid’s metabolites and the target of the urinary drug test. 33 Substantially fewer programs rely on state prescription drug monitoring programs, which may be the most accurate method of screening for prescriptions, and are operational in 49 of 50 states.…”

Section: Discussionmentioning

confidence: 99%

Opioid and opioid substitution therapy in liver transplant candidates: A survey of center policies and practices

Fleming

Lai

et al. 2017

Clinical Transplantation

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This national survey sought to determine the practices and policies pertaining to opioid and opioid substitution therapy (OST) use in the selection of liver transplant (LT) candidates. Of 114 centers, 61 (53.5%) responded to the survey, representing 49.2% of the LT volume in 2016. Only two programs considered chronic opioid (1 [1.6%]) or OST use (1 [1.6%]) absolute contraindications to transplant, while 63.9% and 37.7% considered either one a relative contraindication, respectively. The majority of programs did not have a written policy regarding chronic opioid use (73.8%) or OST use (78.7%) in LT candidates. Nearly half (45.9%) of centers agreed that there should be a national consensus policy addressing opioid and OST use. The majority of responding LT centers did not consider opioid or OST use in LT candidates to be absolute contraindications to LT, but there was significant variability in center practices. These surveys also demonstrated a lack of written policies in the assessment of the candidacy of such patients. The results of our survey identify an opportunity to develop a national consensus statement regarding opioid and OST use in LT candidates to bring greater uniformity and equity into the selection of LT candidates.

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Section: Discussionmentioning

confidence: 99%

Opioid and opioid substitution therapy in liver transplant candidates: A survey of center policies and practices

Fleming

Lai

et al. 2017

Clinical Transplantation

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“…19 These innovative MA roles have been reported across diverse settings, including private practices 2,3,5,20 , community health centers 5,10,13,15,16,19 , academic primary-care practices 8,9,12,14 , rural practices 17 , and large health care systems. 4,5,7 Outcomes in studies that have focused on or included MA role expansion or innovation have varied. Some pilot programs have found improvements in cancer screenings 4,6 , cholesterol levels 21 , diabetes control 11,21 , medication adherence 19 , physical activity levels and body mass index.…”

mentioning

confidence: 99%

“…iors 2 , track lab reports 3 , identify preventive and chronic care gaps [3][4][5] , outreach to patients for cancer screenings 6 , call patients after emergency department visits or hospitalizations 3 , reconcile medications 7 , scribe clinical encounters in electronic medical records 1 , offer HIV screenings 8 , and administer vaccinations per protocol. 5 They also serve as health coaches to improve lifestyle behaviors 9 , chronic disease care processes 3,10 -18 , and medication adherence.…”

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confidence: 99%

Barriers and Facilitators to Expanding Roles of Medical Assistants in Patient-Centered Medical Homes (PCMHs)

et al. 2018

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Background: Many primary care practices participating in patient-centered medical home (PCMH) transformation initiatives are expanding the work roles of their medical assistants (MAs). Little is known about attitudes of MAs or barriers and facilitators to these role changes.Methods: Secondary data analysis of qualitative cross-case comparison study of 15 New Jersey primary care practices participating in a PCMH project during 2012 to 2013. Observation field notes and in-depth and key informant interviews (with physicians, office managers, staff and care coordinators) were iteratively analyzed using grounded theory.Results: MA roles and responsibilities changed from a mostly reactive role, completing tasks dependent on physician orders during the patient visit and facilitating patient flow through the office, to a more proactive one, conducting previsit planning, engaging in the overall care for patients, and assisting with population management. MAs differed in their attitudes about increased responsibilities, with some welcoming the opportunity to take on expanded roles, others resenting their increased responsibilities, and some expressing insufficient understanding regarding why new tasks and procedures were being implemented.

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“…; Reedy et al. ). There are few rigorous studies of cost effectiveness or evidence of return on investment of implementing new models (Anderson and Halley ; Reid et al.…”

Section: Who Are Medical Assistants?mentioning

confidence: 98%

“…The evidence for practice change innovations that include new roles for MAs on patient, staff, and provider satisfaction and clinical outcomes is building Magill et al 2009;Ruggiero et al 2010Ruggiero et al , 2014Day et al 2013;Ladden et al 2013;Sinsky et al 2013;Thom et al 2014Thom et al , 2015Dub e et al 2015;Lichtenstein et al 2015;Reedy et al 2016). There are few rigorous studies of cost effectiveness or evidence of return on investment of implementing new models (Anderson and Halley 2008;Reid et al 2010;Sinsky et al 2010;Day et al 2013).…”

Section: Previous Research On New Roles For Medical Assistantsmentioning

confidence: 99%

New Roles for Medical Assistants in Innovative Primary Care Practices

Chapman

Blash

2016

Health Services Research

103

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Objective. To identify and describe new roles for medical assistants (MAs) in innovative care models that improve care while providing training and career advancement opportunities for MAs. Data Sources/Study Setting. Primary data collected at 15 case study sites; 173 key informant interviews and de-identified secondary data on staffing, wages, patient satisfaction, and health outcomes. Study Design. Researchers used snowball sampling and screening calls to identify 15 organizations using MAs in new roles. Conducted site visits from 2010 to 2012 and updated information in 2014. Data Collection/Extraction Methods. Thematic analysis explored key topics: factors driving MA role innovation, role description, training required, and wage gains. Categorized outcome data in patient and staff satisfaction, quality of care, and efficiency. Principal Findings. New MA roles included health coach, medical scribe, dual role translator, health navigator, panel manager, cross-trained flexible role, and supervisor. Implementation of new roles required extensive training. MA incentives and enhanced compensation varied by role type. Conclusions. New MA roles are part of a larger attempt to reform workflow and relieve primary care providers. Despite some evidence of success, spread has been limited. Key challenges to adoption included leadership and provider resistance to change, cost of additional MA training, and lack of reimbursement for nonbillable services. Key Words. Health care workforce, medical assistants, primary care, new models of careThe need to reform primary care delivery models has been extensively discussed in the literature, in clinical forums, and in policy arenas (Bodenheimer 2007;Gawande 2011;Fernandopulle 2013;Porter, Pabo, and Lee 2013;Bodenheimer et al. 2014a). The challenges in primary care delivery have been attributed to workforce shortages of primary care providers, an aging population with an increase in chronic conditions, reimbursement models that do not

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Patient, Physician, Medical Assistant, and Office Visit Factors Associated With Medication List Agreement

Abstract: Having MAs begin their medication review with an open-ended question may be a simple, inexpensive, and easily implemented process to increase accuracy of medication lists for prescription and nonprescription medications.

Cited by 6 publications

References 12 publications

Opioid and opioid substitution therapy in liver transplant candidates: A survey of center policies and practices

Opioid and opioid substitution therapy in liver transplant candidates: A survey of center policies and practices

Barriers and Facilitators to Expanding Roles of Medical Assistants in Patient-Centered Medical Homes (PCMHs)

New Roles for Medical Assistants in Innovative Primary Care Practices

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