What Works?

Everyday we get a new understanding of what interventions work that impact patient health. With most healthcare research, sites and journals primarily dedicated to which ABCD Interventions work, this page will now duplicate it. This page will begin to catalog the E Interventions and PC Interventions that work. While these are typically not peer reviewed articles, links are provided for people or organizations interested in further evaluating their efficacy and context to managing health.

E Interventions

Patient Dialog - 9 in 10 Brazilian doctors use WhatsApp to talk to patients

Nutrition Support - Steward Health Care delivers three low-sodium meals and two snacks to selected heart failure patient's home each day hoping healthy food will reduce trips to the hospital.

Patient Education - Choosing Wisely provides decision making education for physicians and patients on over 135 tests and treatments that they say are overused or inappropriate.

Palliative Care - A study by University of Rochester Medical Centers in 2007 found the palliative care intervention saved about 1,400 ICU patient days, at an average of about $450 a day.

Recommend Apps - A study from Digitas Health found that 90 percent of chronic patients in the US would accept a mobile app prescription as opposed to only 66 percent willing to accept a prescription of medication.

Recommended Referral - Online Patient Communities can provide many potential benefits, such as improving coping skills, reducing anxiety, depression, isolation, ignorance about the condition and finding others that are experience common conditions.

Transitional Care - A study found that personal contact with patients before and after their hospital discharge resulted in Brooklyn significantly lower readmission rates over 60 days from 26.3% to 17.6%.

Transitional Care - A collaborative initiative involving 83 hospitals and 93 community partners in Minnesota saw 4,570 fewer avoidable hospital readmissions over 24 months, saving more than $40 million by using comprehensive discharge planning, medication management, patient engagement, transition care support, and transition communications.

Transitional Care - A study demonstrated high risk patients being discharged from the hospital that receive social work interventions reduce readmission rates to 7% as compared to the 15 percent readmission rate for the control group--patients discharged

Patient Stories

Comprehensive Patient Programs- Rebecca Bryson has 10 different medical conditions and depends on 13 health care providers. Her life improved when a program funded a Clinical Care Specialist and the creation of a Shared Care Plan.

Home Care - A patient suffering from an infected artificial shoulder couldn't afford intravenous antibiotics three times a day for six weeks in home. Medicare spent an unnecessary $30,000 on hospitalization and care rather than reimbursing for home care.

Palliative Care - A patient dying of cancer was denied home treatment that would have improved her quality of life over her last few days and saved tens of thousands of dollars.

Super-Utilizers - Forty-year-old Jeremie Seals was assigned a care manager and a regular physician that helped reduced his 15 ER visits and 11 hospitals stays to 4 ER visits and 4 hospitals stays the following year.

Super-Utilizers - Virginia Hunt's story illustrates the effectiveness and ineffectiveness of our healthcare system that addresses conditions and often lacks capability to treat the overall patient.

Unnecessary End-of-Life Intervention - A frail, 94-year old women with with advanced Alzheimer’s has hip fracture surgery during her dying days due to poor communications

Determinants

Health

Mental Health Conditions - Dementia - Dementia has a disproportionate impact on family and unpaid caregiving to older adults

Functional Conditions - Homebound - Approximately four million adults in the United States are homebound, and many of them cannot access office-based primary care.

Functional Conditions - Daily Activities Help - Nearly Half of All Seniors Need Help With Daily Activities, Far More Than We Thought

Behavior

Patient Activation - Medication Management - A study found that only 6.5% of patients (only 46 in study) adhered completely to the discharge medication list after average hospital stay of 4.3 days. The average patient age was 76, prescription medications was 10 and number of chronic diseases was 7.

Patient Activation - Education - A survey of patients with terminal lung cancer found nearly two-thirds did not understand that radiation treatments intended only to ease their symptoms would not cure their disease.

Environmental

Home - Many seniors living at home feel imprisoned by their independence

Care Management

Patient Dialog & Monitoring - Electronic Communication - 71% of vulnerable patient populations want to use electronic communication with health care providers.

Care Coordination & Protocols - Four in Ten Older Adults Burdened by Demands of Health Care System

Patients

Complex patients - 53% of California's healthcare expenditures are spent by just 5% of the population