1. Measuring What Matters in and from Primary Care
Rebecca S Etz,1,4 Kurt C Stange,1,2,5 Stephen J Zyzanski,1,5 Martha M Gonzalez,1,4 Jonathan P O’Neal,1,4 Sarah R Reves,1,4 and Robert L Phillips3,6
1 The Larry A. Green Center; 2 The Center for Community Health Integration; 3 The Center for Professionalism and Value in Health Care; 4 Virginia Commonwealth University; 5 Case Western Reserve University; 6 The American Board of Family Medicine
This work supported by ABFM Foundation, AHRQ, NAPCRG, FMAHealth and VCU.

2. The Research Question
To develop and test the psychometric properties of a potentially meaningful and parsimonious set of core primary care items, grounded in the experience of patients, primary care clinicians, and employers.

3. Research Design and Method
Stage 1 – Crowd-Sourcing Surveys
Fielded among patients (412), clinicians (525), employers (85)
Goal: Identify stakeholder definitions of quality
Stage 2 – Starfield Summit III
2½ day meeting of diverse primary care stakeholders
Goal: Revise & refine crowd-sourced quality indicator areas
Goal: Create set of items able to meaningfully assess primary care
Stage 3 – Assess properties of patient-report items
Field potential set of patient reported items asynchronously and at point of care
Test reliability and construct validity using factor, goodness of fit, & Rasch model analyses

4. What the Research Found
Stage 1 – Stakeholders had unique interests
Clinicians say: current measures miss 42% of what’s important & what they do that’s important is not recognized or supported
Patients agree: 72% overlap with clinicians & highlight importance of personalized attention
Stage 2 – 11 domains that integrate stakeholders and research
Identified a concise set of patient-reported measures: 11 items total
Measure integrates best stakeholder voices with best practice research
Stage 3 – Assess 11-item Person-Centered Primary Care Measure
All 11 items strongly assess a single factor with negligible redundancy
Works in pediatric and adult populations, asynchronously or at point of care

5. What this means for Clinical Practice
The 11-item Person-Centered Primary Care Measure*…
Is a person centered patient assessment of primary care quality
Provides empirical evidence that broad scope of primary care is conceptually coherent
Can be used effectively in a diversity of primary care settings
Allows for assessment of primary care while significantly reducing measure burden
Can be used to determine which primary care aspects most impact population health
Can be used to reduce physician burnout and support QI and high quality care
* Etz RS, Zyzanski SJ, Gonzalez MM, Reves SR, O'Neal JP, Stange KC. A new comprehensive measure of high-value aspects of primary care. Ann Fam Med 2019; (under review).