“The Patient as a Catalyst for Change”: A Pilot

Consumers are beginning to find a voice. Our program builds upon the theme “The Patient as a Catalyst for Change,” (IOM News, April 16, 2007). LANET is actively engaged in programs and projects that seek to give patients a greater voice in the primary care setting. We are planning to collect patient rating and satisfaction data via a straightforward and inexpensive web-based tool. Patients who visit selected primary care sites will be asked to volunteer quality- and satisfaction-related information. This information can be used to modify and improve our services and can be an important source of feedback to providers. This is the innovative component of the on-going traditional data-collection processes that we have used in the past.

About You

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Location

Project Street Address

Project City

Project Province/State

Project Postal/Zip Code

Project Country

n/a

Your idea

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Focus of activity

Service/process

Year the initiative began (yyyy)

2007

Positioning of your initiative on the mosaic diagram

Which of these barriers is the primary focus of your work?

Patients not empowered

Which of the principles is the primary focus of your work?

Center consumers in business model

If you believe some other barrier or principle should be included in the mosaic, please describe it and how it would affect the positioning of your initiative in the mosaic:

This field has not been completed

Name Your Project

“The Patient as a Catalyst for Change”: A Pilot

Describe Your Idea

Consumers are beginning to find a voice. Our program builds upon the theme “The Patient as a Catalyst for Change,” (IOM News, April 16, 2007). LANET is actively engaged in programs and projects that seek to give patients a greater voice in the primary care setting. We are planning to collect patient rating and satisfaction data via a straightforward and inexpensive web-based tool. Patients who visit selected primary care sites will be asked to volunteer quality- and satisfaction-related information. This information can be used to modify and improve our services and can be an important source of feedback to providers. This is the innovative component of the on-going traditional data-collection processes that we have used in the past.

Innovation

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Define the innovation

Consumers are beginning to find a voice. Our program builds upon the theme “The Patient as a Catalyst for Change,” (IOM News, April 16, 2007). LANET is actively engaged in programs and projects that seek to give patients a greater voice in the primary care setting. We are planning to collect patient rating and satisfaction data via a straightforward and inexpensive web-based tool. Patients who visit selected primary care sites will be asked to volunteer quality- and satisfaction-related information. This information can be used to modify and improve our services and can be an important source of feedback to providers. This is the innovative component of the on-going traditional data-collection processes that we have used in the past.

Context for Disruption:

LANET is a community-based 501c(3) AHRQ-designated Primary Care Practice Based Research Network and a member of an ePBRN collaborative. Participation in the ePBRN has increased our access to tech resources and has heightened our awareness of the emerging role of technology in healthcare. We have recently proposed to AHRQ a very thorough review of the barriers to quality improvement in the primary care setting and plan to emphasize new approaches to old problems. The patient is a relatively untapped resource. Note the recent national coverage of “The Growing Clout of Online Patient Groups,” (The Wall Street Journal, June 13, 2007).

Delivery Model

LANET collaborators/members are primary care providers that serve primarily a disadvantaged and minority population in the greater Los Angeles metro area. All of our programs operate efficiently and on a very tight budget. Technology has reached the point that we can use online survey tools that are very low cost, and we can provide access points within the clinics, also at very little cost. Preliminary data from one of our member clinics (Venice Community Clinic) indicates that a majority of our patient population now has access to the computer and to the web. We therefore are fully prepared to implement this innovation with established partners in the very near future.

Key Operational Partnerships

LA Net has collaborated with AHRQ on several studies, including the National Children’s Study Pilot. Currently LA Net is a member of the Electronic Primary Care Research Network (ePCRN), a Master Contractor consortium of practice based researched networks headed by the Minnesota Academy of Family Physicians Research Network (MAFPRN) and comprised of nine practice based research networks located across the country. Locally, LA Net partners with over 25 community clinics including, The Family Practice Center at USC University Hospital, California Hospital Medical Center, Clinicas Msr. Oscar Romero, South Central Family Health Center, Mercy Family Health Center, East Valley Community Health Center, Cleaver Family Wellness Clinic, St. John's Well Child & Family Center, QueensCare Clinics, The Los Angeles Free Clinics, Crenshaw Community Health Center, Watts Health Corporation, Pasadena Family Practice Center, Eisner Pediatric and Family Medical Center, Women's Health Center, White Memorial, The Children’s Clinics, Comprehensive Community Health Centers, and Family Health Care Centers of Greater Los Angeles. Over 250 individual health care providers are members of LA Net. LA Net also has relationships with LA Care, AltaMed, The Community Clinic Association of Los Angeles County, the University of Southern California, The University of California, Los Angeles, and Latino Health Access. Currently LA Net is a member of Community Partners, a non-profit incubator service located at the California Endowment in Los Angeles.

Impact

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Financial Model

We have already applied for funding for a pilot of innovations. In the absence of an award, we will seek funds from additional outside sources. The important point is that we project that the initial outlay for a pilot can be minimal. We can provide commercially available online survey software, initial recruitment of sites, and basic PR for an amount that we can fund one way or another. We are all about doing good works on a shoestring.

What is your annual operating budget?

100,000.00

What are your current sources of revenue? (please list any sources that are foundation grants)

Currently operating on a reduced budget pending outcome of funding proposals.

In the past, LANET has been funded by the following:
Agency for Health Care Research and Quality ($250,000)
Centers for Disease Control and Prevention ($50,000)
University of Southern California, Department of Family Medicine ($300,000)
American Academy of Family Physicians ($100,000

Effectiveness

We are about to pilot this process. We see the patient as a major untapped resource for innovation. Tech upgrades are opening up possibilities. Other programs with a similar focus are just beginning to demonstrate impact. “Researchers Ask Patients To Help Fill Gaps in Data On Side Effects of Statins,” (The Wall Street Journal, October 3, 2006) and
“MedPage Today Introduces ‘Add Your Knowledge’,” are two examples of this trend. HealthGrades, a commercial site, claims “more than 2 million patients a month visit HealthGrades looking for the right physicians.”

Which element of the program proved itself most effective?

tbd. LANET will focus on the response to quality- and satisfaction-related input from cosumers of primary care services.

Number of clients in the last year?

tbd. LANET has a strong network (see above) and has successfully recruited active participation of partners for prior projects.

What is the potential demand?

tbd. The possibilities remain to be explored. Note that HealthGrades, a very basic physician rating site, reports 2 million visitors per month, a tremendous increase over the past few years.

Scaling up Strategy

The priority is to expand the program incrementally, based on input from the pilot phase. We will expand the number of locations, refine the survey tool, improve the type and quality of feedback to providers and clinics. The overall goal is improved service that is client-focused and that results in better health outcomes.

Stage of the initiative:

0

Expansion plan:

The plan includes expansion to other primary care sites, further tailoring of the survey instrument, analysis of the data, as well as evaluation of the entire feedback process.

Origin of the Initiative

One member of the LANET group presented a poster at an USC-NIH Conference in May, "Consumer Input into Healthcare." The objective was to "present the status of consumer input via online sites"...and "to identify sites that have had a demonstrable impact on consumer behavior." Response was positive, and led to further thought about how to include the basic primary care consumer in this process.

Regina Herzlinger is quoted in the poster, and her remarks bear repeating:
"If I have breast cancer or you have prostate cancer, where do we find the data we need? Ironically, data about performance--not feelings--are readily available for cars, mutual funds, cereals, but not for the most important consumer purchase..."

This Entry is about (Issues)

Sustainability

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What are your two main challenges to finance the growth of your initiative

1. Administrative support. For outreach to our partners, PR, back-office support.
2. Technical support. For access points, data analysis, survey support.

How did you hear about this contest and what is your main incentive to participate?

Internet announcement
Incentive is to demonstrate the ability of the primary care patient and providers to make patient-oriented upgrades to healthcare. LANET benefits, of course, for taking a role in the process.

The Story

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Do you have an annual financial statement?

Yes

Do you currently have an annual financial statement that tracks profit/loss?

Yes

Please describe the amount (and/or type) of funding you need to implement your initiative, at year 1 and at year 5.

As above. Support could be in kind.