MedicalResearch.com Interview with: Stephen M. Shortell, PhD, MPH, MBA Blue Cross of California Distinguished Professor of Health Policy and Management and Director, Center for Healthcare Organizational and Innovation Research (CHOIR) School of Public Health UC-Berkeley Medical Research: What is the background for this study? What are the main findings? Dr. Shortell: To meet quality and expenditure targets, Accountable Care Organization (ACOs) need to change how care is delivered to patients to reduce preventable hospitalizations, readmissions, emergency department visits, and unnecessary tests. To do this they need to increase their engagement with patients and patient families. With support from the Gordon and Betty Moore Foundation, we undertook the study to assess the extent to which ACOs are engaging their patients and patient families and to identify some of the barriers and facilitators of such engagement. We did a survey of 101 ACOs, in-depth phone interviews with eleven ACOs and two on site visits. Among our key findings are: 1) There are some "early adopters" of patient engagement activities with, for example, respondents reporting an average of 62 percent of primary care physicians working with patients/families to set treatment goals and 61 percent of high risk chronic illness patients participating in formal care transition programs; but 2) Only 18 percent of ACO high risk chronic illness patients participate in peer support groups or group visits, and only 24 percent of patients have access to both medical records and clinical notes in the record; 3) ACO leaders strongly believe patient activation and engagement is critical to ACO success and those who have such beliefs do have greater patient engagement at the actual point of care; 4) Engaging patients is very difficult challenging work as it often involves a total re-organization of workflow within physician practices including the re-allocation of tasks to other healthcare professionals, reorganization of time commitments, adjustment to use of electronic health records and training in communication methods. (more…)