The Experts below are selected from a list of 213 Experts worldwide ranked by ideXlab platform
Steven M Asch - One of the best experts on this subject based on the ideXlab platform.
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effect of a lay health worker intervention on goals of Care Documentation and on health Care use costs and satisfaction among patients with cancer a randomized clinical trial
JAMA Oncology, 2018Co-Authors: Manali I Patel, Vandana Sundaram, Manisha Desai, Vyjeyanthi S Periyakoil, James G Kahn, Jay Bhattacharya, Steven M AschAbstract:Importance Although lay health workers (LHWs) improve cancer screening and treatment adherence, evidence on whether they can enhance other aspects of Care is limited. Objective To determine whether an LHW program can increase Documentation of patients’ Care preferences after cancer diagnosis. Design, Setting, and Participants Randomized clinical trial conducted from August 13, 2013, through February 2, 2015, among 213 patients with stage 3 or 4 or recurrent cancer at the Veterans Affairs Palo Alto Health Care System. Data analysis was by intention to treat and performed from January 15 to August 18, 2017. Interventions Six-month program with an LHW trained to assist patients with establishing end-of-life Care preferences vs usual Care. Main Outcomes and Measures The primary outcome was Documentation of goals of Care. Secondary outcomes were patient satisfaction on the Consumer Assessment of Health Care Providers and Systems “satisfaction with provider” item (on a scale of 0 [worst] to 10 [best possible]), health Care use, and costs. Results Among the 213 participants randomized and included in the intention-to-treat analysis, the mean (SD) age was 69.3 (9.1) years, 211 (99.1%) were male, and 165 (77.5%) were of non-Hispanic white race/ethnicity. Within 6 months of enrollment, patients randomized to the intervention had greater Documentation of goals of Care than the control group (97 [92.4%] vs 19 [17.5%.];P Conclusions and Relevance Incorporating an LHW into cancer Care increases goals-of-Care Documentation and patient satisfaction and reduces health Care use and costs at the end of life. Trial Registration ClinicalTrials.gov Identifier:NCT02966509
Sara L Nottingham - One of the best experts on this subject based on the ideXlab platform.
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future strategies to enhance patient Care Documentation among athletic trainers a report from the athletic training practice based research network
Journal of Athletic Training, 2018Co-Authors: Cailee Welch E Bacon, Tricia M Kasamatsu, Sara L NottinghamAbstract:Context: High-quality patient Care Documentation is an essential component of any health Care professional's daily practice. Whereas athletic trainers (ATs) recognize the importance of patient car...
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athletic trainers perceptions of and barriers to patient Care Documentation a report from the athletic training practice based research network
Journal of Athletic Training, 2017Co-Authors: Cailee Welch E Bacon, Tricia M Kasamatsu, Bradly L Eppelheimer, Sara L NottinghamAbstract:Context: For the practice characteristics of the services athletic trainers (ATs) provide to be identified, all ATs must complete high-quality patient Care Documentation. However, little is known ...
Allison Kempe - One of the best experts on this subject based on the ideXlab platform.
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randomized controlled trial of centralized vaccine reminder recall to improve adult vaccination rates in an accountable Care organization setting
Preventive medicine reports, 2019Co-Authors: Laura P Hurley, Brenda L Beaty, Steven Lockhart, Dennis Gurfinkel, Miriam L Dickinson, Heather Roth, Allison KempeAbstract:Our objectives were to assess 1) effectiveness of using Colorado's Immunization Information System (CIIS) to send out vaccine reminder/recalls (R/Rs) centrally vs. usual Care for adult vaccine delivery within an accountable Care organization (ACO) and 2) practice staff's perception of centralized R/R. From 9/2016 to 4/2017, we conducted a randomized controlled trial among adults enrolled in a Medicaid ACO at six healthCare entities. Adults were divided into two strata: 15,153 age 19-64 and 616 age 65+. Adults age 19-64 who needed influenza and/or Tdap vaccine, and adults age 65+ who needed influenza, and/or Tdap, and/or a pneumococcal vaccine were randomized to receive up to 3 R/Rs by autodialed telephone and mail or usual Care. Documentation of receipt of any needed vaccines in CIIS within six months was the primary outcome. We assessed intervention effectiveness using mixed effect logistic regression. Thirteen semi-structured exit interviews were conducted with staff from each healthCare entity. The intervention was not associated with the primary outcome for the age 19-64 population [OR 1.06 (95% CI 0.98-1.15)] or age 65+ population [(OR 0.96 (0.69-1.32)]. Practice staff perceived the intervention to be beneficial and not burdensome. Perceived barriers included lack of availability of appointments and adults receiving only influenza vaccine when other vaccines were needed. In conclusion, centralized R/R was not effective at improving adult vaccination rates in a Medicaid ACO. Future studies should consider better harmonizing vaccine centralized R/Rs with vaccine delivery efforts within the practice setting. Clinical Trials Registration Number: NCT02133391.
Brenda L Beaty - One of the best experts on this subject based on the ideXlab platform.
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randomized controlled trial of centralized vaccine reminder recall to improve adult vaccination rates in an accountable Care organization setting
Preventive medicine reports, 2019Co-Authors: Laura P Hurley, Brenda L Beaty, Steven Lockhart, Dennis Gurfinkel, Miriam L Dickinson, Heather Roth, Allison KempeAbstract:Our objectives were to assess 1) effectiveness of using Colorado's Immunization Information System (CIIS) to send out vaccine reminder/recalls (R/Rs) centrally vs. usual Care for adult vaccine delivery within an accountable Care organization (ACO) and 2) practice staff's perception of centralized R/R. From 9/2016 to 4/2017, we conducted a randomized controlled trial among adults enrolled in a Medicaid ACO at six healthCare entities. Adults were divided into two strata: 15,153 age 19-64 and 616 age 65+. Adults age 19-64 who needed influenza and/or Tdap vaccine, and adults age 65+ who needed influenza, and/or Tdap, and/or a pneumococcal vaccine were randomized to receive up to 3 R/Rs by autodialed telephone and mail or usual Care. Documentation of receipt of any needed vaccines in CIIS within six months was the primary outcome. We assessed intervention effectiveness using mixed effect logistic regression. Thirteen semi-structured exit interviews were conducted with staff from each healthCare entity. The intervention was not associated with the primary outcome for the age 19-64 population [OR 1.06 (95% CI 0.98-1.15)] or age 65+ population [(OR 0.96 (0.69-1.32)]. Practice staff perceived the intervention to be beneficial and not burdensome. Perceived barriers included lack of availability of appointments and adults receiving only influenza vaccine when other vaccines were needed. In conclusion, centralized R/R was not effective at improving adult vaccination rates in a Medicaid ACO. Future studies should consider better harmonizing vaccine centralized R/Rs with vaccine delivery efforts within the practice setting. Clinical Trials Registration Number: NCT02133391.
Sandra K Burge - One of the best experts on this subject based on the ideXlab platform.
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family physicians opinions on the primary Care Documentation coding and billing system a qualitative study from the residency research network of texas
Family Medicine, 2014Co-Authors: Richard A Young, Bryan Bayles, Jason H Hill, Kaparaboyna Ashok Kumar, Sandra K BurgeAbstract:BACKGROUND AND OBJECTIVES: The study's aim was to deepen our understanding of family physicians' perceptions of the strengths and weaknesses of the widely used US Documentation, coding, and billing rules for primary Care evaluation and management (E/M) services. METHODS: This study used in-depth, qualitative interviews of 32 family physicians in urban and rural, academic, and private practices. Interviews were initiated with a series of grand tour questions asking participants to give examples and personal narratives demonstrating cost efficiencies and cost inefficiencies relating to the E/M rules in their own practices. Investigators independently used an immersion-crystallization approach to analyze transcripts to search for unifying themes and subthemes until consensus among investigators was achieved. RESULTS: The majority of participants reported that the Documentation rules, coding rules, and common fees for procedures and preventive services were reasonable. The E/M Documentation rules for all other visit types, however, were perceived by the participants as unnecessarily complicated and unclear. The existing codes did not describe the actual work for common clinic visits, which led to documenting and coding by heuristics and patterns. Participants reported inadequate payment for complex patients, multiple patient concerns in a single office visit, services requiring extra time beyond a standard office visit, non-face-to-face time, and others. The E/M rules created unintended negative consequences such as family physicians not accepting MediCare or Medicaid patients, inaccurate Documentation, poor-quality Care, and system inefficiencies such as unnecessary tests and referrals. CONCLUSIONS: Family physicians expressed many problems and frustrations with the existing E/M Documentation, coding, and billing rules and felt the system undervalued and unappreciated them for the complex and comprehensive Care they provide. Findings of this study could inform improved guidelines for primary Care Documentation, coding, and billing.