Computerized alerts did not influence physician ordering habits or improve clinical outcomes for elderly, hospitalized patients with cognitive impairment.
Large health care systems in Detroit came together to develop an organizational structure and common goals and policies designed to strengthen the safety net for uninsured residents, leading to increased enrollment in public insurance, enhanced access to primary and specialty care, and lower uncompensated care costs.
Verizon adopted a policy related to selecting vendors that emphasizes the ability to identify and address health disparities, leading to enhanced access to information and screening services for racial and ethnic minority employees, dependents, and retirees.
A statewide, multipayer pilot program provides technical and financial support to physician practices interested in becoming patient-centered medical homes, leading to all participating practices being recognized as medical homes and to anecdotal reports of better access and higher quality.
Specially trained and certified lay workers known as “Grand-Aides” use illness-specific protocols to ensure that patients receive appropriate treatment in primary care settings and to ease the transition from hospital to home after discharge. The primary care-based program has reduced unnecessary visits and demonstrated the potential to reduce costs. Early data from one hospital program show significant reductions in readmissions.
As required by law, hospitals in New York track and report information on select hospital-acquired infections to the State Department of Health, which publicly releases hospital-specific performance data and supports hospitals with quality improvement initiatives; the program has reduced infection rates and generated substantial cost savings.
As part of a statewide public-private initiative, the diverse Burlington (Vermont) health service area supports 18 patient-centered medical home practices via a multidisciplinary team, real-time electronic information, and financial incentives, leading to more appropriate care, better health outcomes and patient experiences, and lower utilization and costs.
An outpatient clinic pilot tested use of widely available, inexpensive, easily implemented consumer videoconferencing technology to provide Spanish-speaking patients with an offsite interpreter during appointments, generating high levels of satisfaction among both patients and clinicians.
A collaborative program leverages information technology to connect ED patients to a medical home and patients receiving care at FQHCs and county health clinics to specialists, leading to enhanced access to care, fewer ED visits, and significant cost savings.
Emergency department–based case managers at nine Milwaukee hospitals use electronic technologies to schedule and track attendance at follow-up clinic appointments for low-income, uninsured patients who come to the emergency department with nonurgent needs, allowing many such patients to establish a medical home.