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Primary Care Access. Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care. IU Medical Group-Primary Care. >20 clinical venues in Indianapolis area Around 400,000 patient visits per year Around 120 Physicians
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Primary Care Access Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care
IU Medical Group-Primary Care • >20 clinical venues in Indianapolis area • Around 400,000 patient visits per year • Around 120 Physicians • Affiliated with 2 hospital systems: Wishard, Clarian • Host continuity clinics of over 100 resident physicians • Since 2000 have hosted over 60 research studies recruiting over 15,000 patients
The chronic illness • Symptoms: • Phones not being answered in timely manner • High utilization of urgent care venues • Patient complaints of “unable to get appointment” • Diagnosis: • Mismatch of supply and demand
Treatment Options • Leave unmet demand • Increase capacity • Previously accomplished through adding providers • Workforce shortage of primary care physicians across country is worsening • Clinic size constraints • Limited offsetting revenues because of payor mix • Desire to achieve system optimization
Desired Therapeutic Benefits • Minimize “symptoms” • Avoid side effects • Maintain “continuity” • Patient centered Medical Home • Improve outcomes • Increase the reliability of care delivery • Chronic illness care
Assessing Therapeutic Intervention • What has been your experience in working with engineering/statistics research teams and implementing research findings? • Systematic evaluation and data driven solutions • Evaluating multiple aspects of complex environment • Clear identification of solution(s) that are based on data
Assessing Therapeutic Intervention • What has been your experience in working with engineering/statistics research teams and implementing research findings? • Minimizing perception that some problems don’t have solutions • Identifying solutions to complex and complicated problems has been liberating
Assessing Therapeutic Intervention • What has been your experience in working with engineering/statistics research teams and implementing research findings? • Rapidity of changing environment • Problems today are addressed, ignored, or replaced tomorrow—adapting to avoid obsolescence • Premises that are central to a research study change
Assessing Therapeutic Intervention • What has been your experience in working with engineering/statistics research teams and implementing research findings? • Suboptimal Organizational Behaviors are Amplified • Decision making with incomplete or lack of data • Changing for the sake of change • Inadequate implementation planning • Inadequate prioritization of competing demands
Assessing Therapeutic Intervention • What has been your experience in working with engineering/statistics research teams and implementing research findings? • Buy-in challenges • Front line managers don’t understand/believe the results • Resource allocation to implementation is suboptimal • Used to have research in sites, but not used to having to implement/adapt to results
Assessing Therapeutic Intervention • What can researchers and practitioners learn from your experiences? Success factors • Strong communication between research team and site personnel • Learning how to adapt • Minimize data collection for office staff
Assessing Therapeutic Intervention • What can researchers do to better support practitioners in their quest to improve healthcare? • Implementation is difficult in a constantly changing environment with limited resources—helping sites develop clear, action oriented implementation plans and timelines