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Sutter Health Research Projects on Patient-Centered Care Receive National Awards

 Palo Alto, Calif., (Feb. 13, 2017) – The Patient-Centered Outcomes Research Institute (PCORI) based in Washington, D.C., recently awarded funding to a study at Palo Alto Medical Foundation Research Institute (PAMFRI) on improving communication between patients and primary care doctors, and to a PAMF project aimed at improving preventive care for seniors.

A study led by Ming Tai-Seale, Ph.D., MPH, associate director of PAMFRI, received $5.8 million to assess the effectiveness of three different approaches to enhancing patient-doctor communication in a primary care setting.

“We want to enable patients to have a voice in their care from the beginning,” said Dr. Tai-Seale. “This project encourages patients to be better prepared and to engage in shared decision making so that they will get more out of their visit. And it will help doctors and patients choose the best treatment plan for the patient.’’

Dr. Ming Tai-Seale at a conference held by Health Affairs, a leading policy journal.

Dr. Ming Tai-Seale at a conference held by Health Affairs, a leading policy journal.

An award for $50,000 went to the Guzik Family Center for Geriatrics and Palliative Care at PAMF to advance the Fostering Successful Aging project. Established in 2014, Fostering Successful Aging has received funding from PCORI for three consecutive years. The project’s goal is to engage older people, the medical community, researchers and other stakeholders in studying effective strategies to help seniors maintain their health and independence for as long as possible.

“This work focuses attention on value-based preventive care for seniors by discovering how patients can help contribute meaningfully to improving care for seniors both now and in the future,” said Peter H. Cheng, M.D., founder of the project and leader of geriatric medicine at PAMF’s Guzik Center.

Targeting Senior Care

Dr. Cheng co-leads this project together with Cheryl D. Stults, Ph.D., a research sociologist at PAMFRI, and Jane David, a PAMF patient and former caregiver of a senior PAMF patient.

The PCORI funding will be used to develop a design that compares two approaches to care for seniors as well as to support documenting the work of patient ambassadors. The patient ambassadors are a group of volunteers, ages 66 to 88, who participate in the project by sharing experiences about needing and receiving preventive care as well as insights on successful aging. The patient ambassadors are also working with researchers, educators, and health care professionals to develop tools and processes to improve delivery of preventive care.

The project focuses on practices and outcomes in the Medicare Annual Wellness Visit and a series of group appointments known as Mind, Body, Soul Shared Medical Appointments (SMA).

“This project is all about the power of collaboration and giving patients a special opportunity to be valued stakeholders and partners,” David said.

PAMF patient Jane David connects with fellow Successful Aging Ambassadors.

PAMF patient Jane David connects with fellow Successful Aging Ambassadors.

Evaluating Doctor-Patient Communication

Dr. Tai-Seale’s study assesses the effectiveness of three different tools for supporting communications between a patient and a doctor in a primary care setting. Some of the tools were developed during an earlier PCORI-funded pilot study known as the Open Communication study. The communication tools that the current study assesses include:

  • A booklet that patients use to write down priorities for their office visits and reminders about recommended treatments and behaviors. A trained patient-physician communication coach also helps prepare the doctor for questions patients may have.
  • A questionnaire that patients receive through My Health Online, a digital portal that lets Sutter Health patients manage their health online. Patients list priorities for the appointment via My Health Online; doctors then review the list to be better prepared for the visit.
  • A poster that reminds the patients and doctors to discuss three questions about options, benefits and risks of options, and the likelihood that they would occur.

The four-year study will involve over 2,600 patients at PAMF and Sutter East Bay Medical Foundation clinics. Patients and doctors with Reliant Medical Group in Massachusetts also will be part of the study as well as researchers from the University of Massachusetts Medical School at Amherst.

Each approach to communication will be assessed by multiple outcome measures. Patients will fill out surveys on how well doctors engaged with them; investigators will review a patient’s action plan and gauge the patient’s intention to adhere to recommendations and treatments; and investigators also will look at clinical indicators and the patient’s quality of life immediately after a primary care session, and again three-months and 12- months later.

In addition to helping the patient get more out of an appointment, effective communication between a patient and a doctor may make health care systems more effective, Tai-Seale said.

“If a patient has their most important issue addressed clearly, they may be less likely to call or email with questions after the visit and be more satisfied with their care,’’ she said.