1. Development and Applications of an Outcomes Assessment Framework for Care Management Programs in Learning Health Systems
- Author
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Michelle Hawkins, Christopher B. Forrest, Maria Uriyo, Regina Richardson, Lin Wang, Leslie Piet, Yanyan Lu, Kathy Evans, Melissa Sherry, Donna M Neale, and Kara Kuntz-Melcavage
- Subjects
050402 sociology ,Quality management ,Process management ,Process (engineering) ,Best practice ,Population ,Psychological intervention ,Learning Health Systems ,lcsh:Computer applications to medicine. Medical informatics ,0504 sociology ,0502 economics and business ,Health care ,Methods ,Medicine ,education ,education.field_of_study ,business.industry ,Management science ,05 social sciences ,Comparative Effectiveness ,Articles ,Quality Improvement ,3. Good health ,Analytics ,2014 EDM Forum Symposium ,lcsh:R858-859.7 ,Construct (philosophy) ,business ,050203 business & management - Abstract
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.
- Published
- 2015