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Supplemental Digital Content is Available in the Text. Background: The necessary suspension of nonacute services by healthcare systems early in the COVID-19 pandemic was predicted to cause delays in routine care in the United States, with potentially serious consequences for chronic disease management. However, limited work has examined provider or patient perspectives about care delays and their implications for care quality in future healthcare emergencies. Objective: This study explores primary care provider (PCP) and patient experiences with healthcare delays during the COVID-19 pandemic. Methods: PCPs and patients were recruited from four large healthcare systems in three states. Participants underwent semistructured interviews asking about their experiences with primary care and telemedicine. Data were analyzed using interpretive description. Results: Twenty-one PCPs and 65 patients participated in interviews. Four main topics were identified: (1) types of care delayed, (2) causes for delays, (3) miscommunication contributing to delays, and (4) patient solutions to unmet care needs. Conclusions: Both patients and providers reported delays in preventive and routine care early in the pandemic, driven by healthcare system changes and patient concerns about infection risk. Primary care practices should develop plans for care continuity and consider new strategies for assessing care quality for effective chronic disease management in future healthcare system disruptions. [ABSTRACT FROM AUTHOR]

Objective: We implemented routine daily electronic monitoring of patient-reported outcomes (PROs) for 10 days after discharge after ambulatory cancer surgery, with alerts to clinical staff for worrying symptoms. We sought to determine whether enhancing this monitoring by adding immediate automated normative feedback to patients regarding expected symptoms would further improve the patient experience. Summary of Background Data: PRO monitoring reduces symptom severity in cancer patients. In ambulatory cancer surgery, it reduces potentially avoidable urgent care center (UCC) visits, defined as those UCC visits without readmission. Methods: Patients undergoing ambulatory cancer surgery (n = 2624) were randomized to receive standard PRO monitoring or enhanced feedback. The primary study outcome was UCC visits without readmission within 30 days; secondary outcomes included patient anxiety and nursing utilization. Results: There was no significant difference in the risk of a potentially avoidable UCC visit [1.0% higher in enhanced feedback, 95% confidence interval (CI) -0.2–3.1%; P = 0.12]. There were similarly no significant differences in UCC visits with readmission or readmission overall (P = 0.4 for both). Patients randomized to enhanced feedback demonstrated a quicker reduction in anxiety (P < 0.001) and required 14% (95% CI 8–19%; P < 0.001) and 10% (95% CI 5–16%, P < 0.001) fewer nursing calls over 10 and 30 days postoperatively. Conclusions: Providing patients with feedback about symptom severity during recovery from ambulatory cancer surgery reduces anxiety and nursing workload without affecting UCC visits or readmissions. These results support wider incorporation of normative feedback in systems for routine PRO monitoring. [ABSTRACT FROM AUTHOR]

The patient-centered medical home (PCMH) is a strategy to transform primary care delivery organizations. However, PCMHs take on many forms and can "look different." To better understand the activities of organizations undertaking this strategy, we sought to identify discernible PCMH types using cluster analyses. From a sample of level 3 National Committee for Quality Assurance PCMHs, We extracted 3 types of PCMHs: information-focused, efficiency-focused, and high-scoring. Our findings confirm that the PCMH is not a uniform intervention. Characterizing PCMHs with particular areas of focus has implications for understanding the transformation process, identifying areas for continued practice development, and advancing evaluation of this organizational model. [ABSTRACT FROM AUTHOR]