Organization of Healthcare Delivery

Streamlining how health care is delivered in the U.S.’s fragmented system.

43 Ways to Leave Your Technology

Feb. 14, 2017

We recently convened an expert roundtable to tackle how health systems, payers, and providers can spur the ‘de-adoption’ of medical practices and technologies no longer considered valuable. This got us thinking - while the process by which ineffective practices or technologies are abandoned is neither simple nor automatic, even the language used to describe it is not clear. And language matters. It often reflects an unstated focus on one mechanism or one level of decision-making. Here we review, and potentially clarify, the terminology.

Diagnosis and Medication Treatment of Pediatric Hypertension: A Retrospective Cohort Study

Jan. 2, 2017

David C. Kaelber, Weiwei Liu, Michelle Ross, A. Russell Localio, Janeen B. Leon, Wilson D. Pace, Richard C. Wasserman, Alexander G. Fiks

In Pediatrics, David Kaelber and colleagues, including LDI Senior Fellow Alexander Fiks, evaluate the diagnosis and initial medication management of pediatric hypertension and prehypertension in primary care. Pediatric hypertension predisposes children to adult hypertension and early markers of cardiovascular disease. Hypertension and pre-hypertension are well-defined, prevalent and generally asymptomatic conditions in children and adolescents that often go undiagnosed and untreated with...

When Compared to Each Other, Doctors Pay Attention

Nov. 11, 2016

In two recent JAMA Viewpoints, Amol Navathe and colleagues point to the potential of social comparisons to motivate physicians to improve the care they provide. Fulfilling this potential, however, will take careful attention to how these comparisons are designed and delivered.

Penn Center for Community Health Workers: Step-by-Step Approach to Sustain an Evidence-Based Community Health Worker Intervention at an Academic Medical Center

Sep. 19, 2016

Anna U. Morgan, David T. Grande, Tamala Carter, Judith A. Long, Shreya Kangovi

In the American Journal of Public Health, Anna Morgan and colleagues, including Dave Grande, Judith Long, and Shreya Kangovi, describe the process by which Penn’s Center for Community Health Workers grew from a small grant-funded research project into a robust program serving 2,000 patients annually and funded through the health system’s operational budget. The authors describe an 8-step framework to engage both low-income patients and funders, determine outcomes, and calculate return on investment. The case illustrates a path toward sustainability for other community-based...

Acute Health Care Utilization among Food-Insecure Children in Primary Care Practices

Sep. 13, 2016

Deepak Palakshappa, Saba Khan, Chris Feudtner, and Alexander G. Fiks

In the Journal of Health Care for the Poor and Underserved, Deepak Palakshappa and colleagues, including Chris Feudtner and Alexander Fiks, investigate the relationship between food insecurity and child health care utilization. They test whether differences in child health care utilization can predict household food insecurity and whether food insecurity is associated with subsequent acute health care use. This prospective cohort study involved 3,335 children screened for food insecurity at three-year well-child visits in three urban practices. The authors evaluated acute care use...

Adoption of a portal for the primary care management of pediatric asthma: a mixed method implementation study

Aug. 19, 2016

Alexander G. Fiks ; Nathalie Du Rivage ; Stephanie L. Mayne ; Stacia Finch ; Michelle E. Ross ; Kelli Giacomini ; Andrew Suh ; Banita McCarn ; Elias Brandt ; Dean Karavite ; Elizabeth W. Staton ; Laura P. Shone ; Valerie McGoldrick ; Kathleen Noonan ; Dorothy...

In the Journal of Medical Internet Research, LDI Senior Fellows Alexander Fiks and Kathleen Noonan and colleagues evaluate the feasibility of using a patient portal for pediatric asthma in primary care, its impact on management and the barriers and facilitators of implementation success. Patient portals improve communication between families of children with asthma and their primary care providers as well as outcomes. This mixed-methods multi-site (11 states) study used 10 clinician focus groups, 22 semi-structured parent interviews and surveys that were sent to the parents...

Pages