Author Interviews, Health Care Systems, Kidney Disease, NEJM, NIH, UT Southwestern / 04.04.2024
NEJM: UTSW Study Evaluates Whether Practice Facilitators Reduce Hospitalizations in CKD Patients
MedicalResearch.com Interview with:
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Dr. Vazquez[/caption]
Miguel A. Vazquez, MD
Professor of Internal Medicine
University of Texas Southwestern Medical Center
MedicalResearch.com: What is the background for this study?
Response: The main reason to conduct our trial was to improve the care of patients with coexistent chronic kidney disease CKD), type 2 diabetes and hypertension. Patients with this triad are at high risk for multiple complications, end stage kidney disease and premature death. There are effective interventions for these conditions. Unfortunately, detection and awareness of CKD is low and many patients do not receive interventions that could be beneficial
In our study in patients with the coexistent triad of chronic kidney disease, type 2 diabetes, and hypertension the use of an electronic algorithm to identify patients from the electronic health record and practice facilitators embedded in four large health systems to assist primary practitioners deliver evidence-based care did not lower hospitalizations when compared to usual care.
Dr. Vazquez[/caption]
Miguel A. Vazquez, MD
Professor of Internal Medicine
University of Texas Southwestern Medical Center
MedicalResearch.com: What is the background for this study?
Response: The main reason to conduct our trial was to improve the care of patients with coexistent chronic kidney disease CKD), type 2 diabetes and hypertension. Patients with this triad are at high risk for multiple complications, end stage kidney disease and premature death. There are effective interventions for these conditions. Unfortunately, detection and awareness of CKD is low and many patients do not receive interventions that could be beneficial
In our study in patients with the coexistent triad of chronic kidney disease, type 2 diabetes, and hypertension the use of an electronic algorithm to identify patients from the electronic health record and practice facilitators embedded in four large health systems to assist primary practitioners deliver evidence-based care did not lower hospitalizations when compared to usual care.
Dr. Khullar[/caption]
Dhruv Khullar, M.D., M.P.P.
Director of Policy Dissemination
Physicians Foundation Center for Physician Practice and Leadership
Assistant Professor of Health Policy and Economics
Weill Cornell Medicine, NYC
MedicalResearch.com: What is the background for this study?
Response: From prior research, we know that there are racial/ethnic differences in the acute impact of COVID-19, including higher rates of hospitalization and death among Black and Hispanic individuals compared to white individuals. Less is known about whether there are differences in the rates or types of long COVID by race and ethnicity.
Dr. Caraballo-Cordovez[/caption]
César Caraballo-Cordovez, MD
Joanna Jiang, PhD
Agency for Healthcare Research and Quality
Rockville, Maryland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Over the last decade we have seen two trends occurring to rural hospitals – closures and mergers. A hospital in financial distress could likely face closure. But if the hospital affiliates with a multihospital system, it may have access to resources from the system that help shelter the hospital from closure.
That is exactly what we found in this study. System affiliation was associated with a lower risk of closure for financially distressed hospitals. However, among hospitals that were financially stable, system affiliation was associated with a higher risk of closure. This is somewhat puzzling and needs further study to better understand the reason for closure.
Dr. McPeek Hinz[/caption]
Eugenia McPeek Hinz MD MS FAMIA
Associate CMIO - DHTS
Duke University Health System
MedicalResearch.com: What is the background for this study?
Response: Clinician burnout rates have hovered around 50% for much of the past decade. Burnout is a significant concern in healthcare for its effects on care givers and associated downstream adverse implications on patient care for quality and safety. The ubiquitous presence of Electronic Health Records (EHR) along with the increased clerical components and after hours use has been a significant concern for contributing to provider burnout.
Mr. Olin[/caption]
Steve Olin
Chief Product Officer
Rally Health, Inc., part of the Optum business of UnitedHealth Grou
MedicalResearch.com: Can you please elaborate on Rally Health’s mission?
Mr. Olin: Our founding mission 10 years ago and still to this day is to put health in the hands of the individual. As a digital health company, we live this mission through our focus in three key areas:
1) Providing digital-first access to care by giving individuals easy-to-use digital tools and support to navigate their health care and take full advantage of their health benefits;
2) Engaging people in their daily health by creating experiences that people enjoy and that inspire them to perform healthy actions, and by giving them access to resources that help them achieve their health goals;
3) Saving people time and money by providing digital tools that help them understand health care costs and guide them to lower-cost, high-quality care options.