The American journal of managed care
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With the introduction of more effective anticancer agents that prolong survival, there is a need for new methods to define the clinical value of treatments. The objective of this preliminary qualitative and quantitative analysis was to assess the utility of an expanded portfolio of survival metrics to differentiate the value of anticancer agents. ⋯ This analysis suggests that any 1 metric may not completely characterize the expected survival benefit of all patients. The cost-value analysis tool may be applied to trial data and may be useful in helping to make treatment decisions, regardless of the agent's effectiveness. A combined metric will be needed, as well as further research that includes more mature data, other tumor types, and emerging treatments.
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Comparative Study
Electronic health records and the frequency of diagnostic test orders.
To determine whether electronic health record (EHR) access influences the number of laboratory and imaging tests ordered, which is a frequently cited mechanism for EHR-enabled cost savings. ⋯ Using the most recent available nationally representative data, excluding federal and Veterans Affairs' hospitals, we found that physicians with EHR access ordered more tests than their non-EHR counterparts, thus contradicting a common rationale for EHR implementation. We argue that EHR use may actually increase healthcare expenditures by facilitating the ease of ordering tests. Whether these extra tests carry clinical utility requires further analysis.
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To assess the role of value-based payment (VBP) in improving fidelity and patient outcomes in community implementation of an evidence-based mental health intervention, the Collaborative Care Model (CCM). ⋯ VBP improved fidelity to key elements of the CCM, both directly incentivized and not explicitly incentivized by the VBP, and improved patient depression outcomes.
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Randomized Controlled Trial Multicenter Study Comparative Study
The effect of EHR-integrated patient-reported outcomes on satisfaction with chronic pain care.
Given its complexity, chronic noncancer pain presents an opportunity to use health information technology (IT) to improve care experiences. The objective of this study was to assess whether integrating patient-reported outcomes (PROs) data in an electronic health record (EHR) affects provider and patient satisfaction with chronic noncancer pain care. ⋯ Delivering EHR-integrated PROs did not consistently improve patient or provider satisfaction. Positively, we found no evidence that the PRO tools negatively affected satisfaction. Future studies and technological innovations are needed to translate point-of-care health IT tools into improvements in patient and provider experiences.
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The aim of this study was to evaluate health information technology (IT) adoption in hospitals participating in accountable care organizations (ACOs) and compare this adoption to non-ACO hospitals. ⋯ ACO-participating hospitals appear to be focused more on adopting health IT that aligns with broader strategic goals rather than those that achieve MU. Aligning adoption with quality and payment reform may be a productive path forward to encourage hospital health IT adoption behavior.