BACKGROUND: To improve and learn from patient outcomes, particularly under new care models such as Accountable Care Organizations and Patient-Centered Medical Homes, requires establishing systems for follow-up and feedback. OBJECTIVE: To provide post-visit feedback to physicians on patient outcomes following acute care visits. DESIGN: A three-phase cross-sectional study [live follow-up call three weeks after acute care visits (baseline), one week post-visit live call, and one week post-visit interactive voice response system (IVRS) call] with three patient cohorts was conducted. A family medicine clinic and an HIV clinic participated in all three phases, and a cerebral palsy clinic participated in the first two phases. Patients answered questions about symptom improvement, medication problems, and interactions with the healthcare system. PATIENTS: A total of 616 patients were included: 142 from Phase 1, 352 from Phase 2 and 122 from Phase 3. MAIN MEASURES: Primary outcomes included: problem resolution, provider satisfaction with the system, and comparison of IVRS with live calls made by research staff. KEY RESULTS: During both live follow-up phases, at least 96% of patients who were reached completed the call compared to only 48% for the IVRS phase. At baseline, 98 of 113 (88%) patients reported improvement, as well as 167 of 196 (85%) in the live one-week follow-up. In the one-week IVRS phase, 25 of 39 (64%) reported improvement. In all phases, the majority of patients in both the improved and unimproved groups had not contacted their provider or another provider. While 63% of providers stated they wanted to receive patient feedback, they varied in the extent to which they used the feedback reports. CONCLUSIONS: Many patients who do not improve as expected do not take action to further address unresolved problems. Systematic follow-up/feedback mechanisms can potentially identify and connect such patients to needed care.
BACKGROUND: To improve and learn from patient outcomes, particularly under new care models such as Accountable Care Organizations and Patient-Centered Medical Homes, requires establishing systems for follow-up and feedback. OBJECTIVE: To provide post-visit feedback to physicians on patient outcomes following acute care visits. DESIGN: A three-phase cross-sectional study [live follow-up call three weeks after acute care visits (baseline), one week post-visit live call, and one week post-visit interactive voice response system (IVRS) call] with three patient cohorts was conducted. A family medicine clinic and an HIV clinic participated in all three phases, and a cerebral palsy clinic participated in the first two phases. Patients answered questions about symptom improvement, medication problems, and interactions with the healthcare system. PATIENTS: A total of 616 patients were included: 142 from Phase 1, 352 from Phase 2 and 122 from Phase 3. MAIN MEASURES: Primary outcomes included: problem resolution, provider satisfaction with the system, and comparison of IVRS with live calls made by research staff. KEY RESULTS: During both live follow-up phases, at least 96% of patients who were reached completed the call compared to only 48% for the IVRS phase. At baseline, 98 of 113 (88%) patients reported improvement, as well as 167 of 196 (85%) in the live one-week follow-up. In the one-week IVRS phase, 25 of 39 (64%) reported improvement. In all phases, the majority of patients in both the improved and unimproved groups had not contacted their provider or another provider. While 63% of providers stated they wanted to receive patient feedback, they varied in the extent to which they used the feedback reports. CONCLUSIONS: Many patients who do not improve as expected do not take action to further address unresolved problems. Systematic follow-up/feedback mechanisms can potentially identify and connect such patients to needed care.
Authors: Jennifer S Haas; Aarthi Iyer; E John Orav; Gordon D Schiff; David W Bates Journal: Pharmacoepidemiol Drug Saf Date: 2010-09 Impact factor: 2.890
Authors: Dean F Sittig; Adam Wright; Enrico Coiera; Farah Magrabi; Raj Ratwani; David W Bates; Hardeep Singh Journal: Health Informatics J Date: 2018-12-11 Impact factor: 2.681
Authors: Gordon D Schiff; Elissa Klinger; Alejandra Salazar; Jeffrey Medoff; Mary G Amato; E John Orav; Shimon Shaykevich; Enrique V Seoane; Lake Walsh; Theresa E Fuller; Patricia C Dykes; David W Bates; Jennifer S Haas Journal: J Gen Intern Med Date: 2018-10-05 Impact factor: 5.128
Authors: Ronen Rozenblum; Rosa Rodriguez-Monguio; Lynn A Volk; Katherine J Forsythe; Sara Myers; Maria McGurrin; Deborah H Williams; David W Bates; Gordon Schiff; Enrique Seoane-Vazquez Journal: Jt Comm J Qual Patient Saf Date: 2019-11-27
Authors: James C Benneyan; Tiantian White; Nicole Nehls; Tze Sheng Yap; Mark Aronson; Scot Sternberg; Tim Anderson; Kashika Goyal; Julia Lindenberg; Hans Kim; Marc Cohen; Russell S Phillips; Gordon D Schiff Journal: J Ambul Care Manage Date: 2021 Oct-Dec 01