Science Highlights
April 2012
- Installing gun cabinets in homes improves firearm storage safety. In study with rural Alaska Native people, gun cabinets reduce unlocked guns in homes
- How Lean helped spread Group Health’s medical home redesign
- Seniors have better experience and care in medical home—without more cost
- Integrative care found feasible for low-back pain
- Body mass index data from electronic records can help assess heart risk
- Depressed people with unmet deductibles are less likely to seek help
- Group Health psychiatrist urges better care for epilepsy and mental health in California
How Lean helped spread Group Health’s medical home redesign
Clarissa Hsu, PhD, described how Group Health used Lean Management principles to spread the patient-centered medical home model to all its diverse medical centers in 14 months, including standardized structural and practice-level changes. Her paper in the April Journal of Ambulatory Care Management provides insights to improve the design and implementation of future medical homes. Her co-authors were Katie Coleman, MSPH; Tyler Ross, MA; Eric Johnson, MS; Paul Fishman, PhD; Eric B. Larson, MD, MPH; David Liss, MA; Claire Trescott, MD; and Robert Reid, MD, PhD. See abstract.
Seniors have better experience and care in medical home—without more cost
The patient-centered medical home was originally devised for children with special needs. But Paul Fishman, PhD, found that Group Health patients aged 65 and older had better experiences and quality of care at the Factoria Medical Center’s medical home pilot—without increasing overall cost after one or two years. With Eric Johnson, MS; Katie Coleman, MSPH; Eric B. Larson, MD, MPH; Clarissa Hsu, PhD; Tyler Ross, MA; David Liss, MA; Robert Reid, MD, PhD; and a University of Washington (UW) colleague, he e‑published in The Gerontologist on March 15. See abstract.
Integrative care found feasible for low-back pain
Daniel Cherkin, PhD, co-authored a report of a pilot randomized trial of 12 weeks of individualized, integrative care for outpatients with subacute (short-term) low-back pain at Harvard’s Beth Israel Hospital, in Boston. A coordinated, multidisciplinary team provided an integrated program of conventional and complementary and alternative medicine therapies. Multiple measures showed a trend toward improvement in patients with low-back pain. The Journal of Alternative and Complementary Medicine e‑published the trial by Dr. Cherkin and his Harvard Medical School, Brown University, and Samueli Institute colleagues on March 28. See abstract.
Body mass index data from electronic records can help assess heart risk
Information from 122,000 Group Health patients helped Beverly Green, MD, MPH, conclude that body mass index (BMI) data from electronic medical records can be used to identify cardiovascular disease risk for most 30 to 74 year olds. This may help reduce unneeded lab testing, while identifying populations likely to benefit from risk-lowering treatments. With Melissa Anderson, MS; Andrea Cook, PhD; Sheryl Catz, PhD; Paul Fishman, PhD; Jennifer McClure, PhD; and Robert Reid, MD, PhD, Dr. Green published in the April American Journal of Preventive Medicine. See abstract.
Depressed people with unmet deductibles are less likely to seek help
Group Health patients were less likely to start psychotherapy for depression if they had to pay out‑of‑pocket costs because of unmet coverage deductibles of $100 to $500, compared to individuals who had met their deductibles. This was the finding of a retrospective observational study that controlled for economic and sociodemographic factors and prior use of behavioral health services. Paul Fishman, PhD; Victoria Ding; Rebecca Hubbard, PhD; Evette Ludman, PhD; Leo Morales, MD, PhD, MPH; Greg Simon, MD, MPH; Chester Pabiniak, MS; and Christine Stewart e-published the report in Health Services Research on February 29. See abstract.
Group Health psychiatrist urges better care for epilepsy and mental health in California
Alexander Thompson, MD, MBA, MPH, a Group Health psychiatrist, analyzed data from the 2005 California Health Interview Survey of 43,000 people. E‑publishing February 23 in Preventing Chronic Disease, he concluded that California adults with epilepsy have substantial unmet needs for care of both epilepsy and mental health. He conducted this research while at the UW and Texas A&M College of Medicine. His co-authors are at the Centers for Disease Control and Prevention and the University of California Los Angeles School of Public Health. See abstract.