Primary Care Access Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care

>20 clinical venues in Indianapolis area Around 400,000 patient visits per year Around 120 Physicians Affiliated with 2 hospital systems: Wishard, Clarian Host continuity clinics of over 100 resident physicians Since 2000 have hosted over 60 research studies recruiting over 15,000 patients

The chronic illness Symptoms: Phones not being answered in timely manner High utilization of urgent care venues Patient complaints of “unable to get appointment” Diagnosis: Mismatch of supply and demand

Treatment Options Leave unmet demand Increase capacity Previously accomplished through adding providers Workforce shortage of primary care physicians across country is worsening Clinic size constraints Limited offsetting revenues because of payor mix Desire to achieve system optimization

Desired Therapeutic Benefits Minimize “symptoms” Avoid side effects Maintain “continuity” Patient centered Medical Home Improve outcomes Increase the reliability of care delivery Chronic illness care

Assessing Therapeutic Intervention What has been your experience in working with engineering/statistics research teams and implementing research findings? Systematic evaluation and data driven solutions Evaluating multiple aspects of complex environment Clear identification of solution(s) that are based on data

Assessing Therapeutic Intervention What has been your experience in working with engineering/statistics research teams and implementing research findings? Minimizing perception that some problems don’t have solutions Identifying solutions to complex and complicated problems has been liberating

Assessing Therapeutic Intervention What has been your experience in working with engineering/statistics research teams and implementing research findings? Rapidity of changing environment Problems today are addressed, ignored, or replaced tomorrow—adapting to avoid obsolescence Premises that are central to a research study change

Assessing Therapeutic Intervention What has been your experience in working with engineering/statistics research teams and implementing research findings? Suboptimal Organizational Behaviors are Amplified Decision making with incomplete or lack of data Changing for the sake of change Inadequate implementation planning Inadequate prioritization of competing demands

Assessing Therapeutic Intervention What has been your experience in working with engineering/statistics research teams and implementing research findings? Buy-in challenges Front line managers don’t understand/believe the results Resource allocation to implementation is suboptimal Used to have research in sites, but not used to having to implement/adapt to results

Assessing Therapeutic Intervention What can researchers and practitioners learn from your experiences? Success factors Strong communication between research team and site personnel Learning how to adapt Minimize data collection for office staff

Assessing Therapeutic Intervention What can researchers do to better support practitioners in their quest to improve healthcare? Implementation is difficult in a constantly changing environment with limited resources—helping sites develop clear, action oriented implementation plans and timelines