Physicians, the Affordable Care Act, and Primary Care: Disruptive Change or Business as Usual?

Jacobson, Peter; Jazowski, Shelley A.

doi:10.1007/s11606-011-1695-8

Cited by 31 publications

(25 citation statements)

References 19 publications

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“…1 The second is a growing shortage of primary care clinicians available to provide primary and preventive care and management of chronic illness. 2 Last of these is the increasing prevalence of chronic diseases among a longer-lived patient population. 3 These trends are well documented and have been cited as the momentum builders behind the concept of a ''medical home,'' which is rooted in the concept of care being accessible, contiguous, comprehensive, and coordinated.…”

Section: Introductionmentioning

confidence: 99%

Asynchronous Virtual Visits for the Follow-Up of Chronic Conditions

Dixon

Rao

2014

Telemedicine and e-Health

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Clinicians and patients are interested in tools that improve patient health, are convenient, and save time for both parties. Targeting patients with chronic illness and leveraging available technology to deliver the care are very satisfactory to both clinicians and patients. Asynchronous virtual visits for patients with chronic medical conditions are an effective way to evaluate and manage patients, while providing physicians significant time savings. These visits have the potential to reduce in-office follow-up visits across primary care, potentially improving access and reducing costs.

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Section: Introductionmentioning

confidence: 99%

Asynchronous Virtual Visits for the Follow-Up of Chronic Conditions

Dixon

Rao

2014

Telemedicine and e-Health

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“…The medication-related activities that will be required of the ACOs will be well managed by clinical pharmacists in collaboration with other primary care providers [ 52 , 53 ]. And as noted by Jacobsen, physicians and medical professional organizations may be better served to abandon their long-standing opposition to non-physician practitioners and create high functioning healthcare teams that truly create patientcentered healthcare models [ 53 ].…”

Section: Role Of Interprofessional Patient Managementmentioning

confidence: 99%

Integration of a Team Approach to Hypertension Treatment

Sneed¹

2014

Hypertension in High Risk African Americans

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Hypertension is the most common chronic cardiovascular condition encountered in outpatient and ambulatory settings. According to the American Heart Association Heart Disease Statistics 2013 update, it is estimated that 33 % of US adults have hypertension [ 1 ]. This represents approximately 78 million American adults with hypertension [ 1 ]. Through signifi cant patient education and outreach, clinical management, and general greater self-awareness, the USA has seen a marked increase in the number of people that are aware of their condition. It is estimated that approximately 82 % of adult patients are aware of their hypertension condition, and approximately 75 % of adult patients are using antihypertensive medication [ 1 ]. Despite this enhanced awareness, only 53 % of patients diagnosed with hypertension are at or below their target blood pressure goals at current recommended levels. African American awareness of hypertension has signifi cantly improved, but the excess burden of elevated blood pressure and the subsequent consequences on health outcomes remain high [ 1 ]. Medication nonadherence is widely recognized as a major cause of patients not maintaining control of chronic cardiovascular conditions [ 2 -4 ]. Other causes for patients not attaining their blood pressure goals may include socioeconomic challenges, advanced atherosclerotic vascular changes from prolonged exposure to uncontrolled cardiovascular risks, and lack of positive response to medication therapy [ 5 ]. Despite the overall causes, the necessity to fi nd alternative and innovative methods to adequately control hypertension in Americans remains the goal of all healthcare clinicians.

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“…Although physicians are key office policy decision makers, much ambulatory care also is provided by nonphysicians (eg, nurse practitioners, physician assistants, nurses, medical assistants). 13 Hence, Clinicians are the target group. The champion or change agent leading the group must recognize that inducing change is effectively a social process.…”

Section: Components Of a Cee Sessionmentioning

confidence: 99%

The Clinician Engagement and Education Session

2013

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CommentaryIn industrial processes, Deming demonstrated that "quality" required the active application of a measured systems approach to production. 1 Eisenberg effectively began the wide dissemination of promoting the "quality" process in health care, with his disciples recognizing that research discovery does not automatically lead to practice. 2-4 It has been clearly shown that systems innovations in health care, including changing physician practice behavior, can improve quality and reduce cost. 5,6 Central to the implementation of quality in the health care system are the social and professional processes that influence clinician behavior. Traditionally, "academic detailing" has been used widely as a way to engage physicians to influence clinical practice. 7 Modeled from the approach taken by the pharmaceutical industry, academic detailing focuses on establishing credibility, assessing baseline knowledge, and identifying physician opinion leaders for follow-up interaction. Many others have studied and further developed this approach, with Grol providing a highly effective summary of available tools to initiate change in physician practice behavior (eg, rewards, penalties, audit, feedback, decision support) that can result in improvement of outcomes by between 4% and 22%. 8,9 It has been predicted that clinical outcomes could be improved by as much as 75% with a focus on changing clinician systems of care. 10

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Physicians, the Affordable Care Act, and Primary Care: Disruptive Change or Business as Usual?

Cited by 31 publications

References 19 publications

Asynchronous Virtual Visits for the Follow-Up of Chronic Conditions

Asynchronous Virtual Visits for the Follow-Up of Chronic Conditions

Integration of a Team Approach to Hypertension Treatment

The Clinician Engagement and Education Session

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