Methods, Comparative Effectiveness, Quality Improvement, 2014 EDM Forum Symposium, Learning Health Systems
Purpose: To develop and apply an outcomes assessment framework (OAF) for care management programs in health care delivery settings.
Background: Care management (CM) refers to a regimen of organized activities that are designed to promote health in a population with particular chronic conditions or risk profiles, with focus on the triple aim for populations: improving the quality of care, advancing health outcomes, and lowering health care costs. CM has become an integral part of a care continuum for population-based health care management. To sustain a CM program, it is essential to assure and improve CM effectiveness through rigorous outcomes assessment. To this end, we constructed the OAF as the foundation of a systematic approach to CM outcomes assessment.
Innovations: To construct the OAF, we first systematically analyzed the operation process of a CM program; then, based on the operation analysis, we identified causal relationships between interventions and outcomes at various implementation stages of the program. This set of causal relationships established a roadmap for the rest of the outcomes assessment. Built upon knowledge from multiple disciplines, we (1) formalized a systematic approach to CM outcomes assessment, and (2) integrated proven analytics methodologies and industrial best practices into operation-oriented CM outcomes assessment.
Conclusion: This systematic approach to OAF for assessing the outcomes of CM programs offers an opportunity to advance evidence-based care management. In addition, formalized CM outcomes assessment methodologies will enable us to compare CM effectiveness across health delivery settings.
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Wang, Lin; Kuntz-Melcavage, Kara; Forrest, Christopher; Lu, Yanyan; Piet, Leslie; Evans, Kathy; Uriyo, Maria Uriyo; Sherry, Melissa; Richardson, Regina; Hawkins, Michelle; and Neale, Donna
"Development and Applications of an Outcomes Assessment Framework for Care Management Programs in Learning Health Systems,"
eGEMs (Generating Evidence & Methods to improve patient outcomes):
1, Article 9.
Available at: http://repository.edm-forum.org/egems/vol3/iss1/9