A "What Matters Index" (WMI) for Adolescents.

A "What Matters Index" (WMI) represents the distillation of many self-reported measures about what matters. The WMI for adults contains only 5 items that efficiently identify important needs, reliably identify people at risk for future problems, and provide guidance for improving health care and well-being. This report uses data from 10 000 respondents to illustrate the value of a 3-item WMI for adolescents built on the model of the Adult WMI.

A National Pre-Pandemic Survey of Patient-Reported Health Confidence and Implications for Post-Pandemic Practice.

Patient-reported health confidence is a valuable indicator of effective patient-clinician communication, which improves outcomes and reduces costly care use. This national survey examines health confidence attainment in the United States before the COVID pandemic strained health care resources. Health confidence was low for both the percentage of respondents who were financially secure (36%) and financially insecure (18%).

Standardized assessment, information, and networking technologies (SAINTs): lessons from three decades of development and testing.

Purpose: To rectify the significant mismatch observed between what matters to patients and what clinicians know, our research group developed a standardized assessment, information, and networking technology (SAINT).

Methods: Controlled trials and field tests involving more than 230,000 adults identified characteristics of a successful SAINT- www.HowsYourHealth.

Insights From Organized Crime for Disorganized Health Care.

During college and medical school, the author's summer employment acquainted him with members of organized crime families. After a full career as a primary care clinician and geriatrician with research on improving health care delivery, the author opines that several insights from organized crime should be of interest to health care professionals: (1) don't damage the host; (2) protect the brand; and (3) lead necessary adaption. From these insights, the author presents symptoms of failure evidenced by the US health care system, followed by several adaptations that would reduce the system's costs, improve its image, and address future challenges.

A Brief Review of Single-Item and Multi-Item Quality-of-Life Measures for Medicare Patients.

Using responses to HowsYourHealth.org from 9068 patients aged 65 years or older, I illustrate measurement compromises for quality-of-life assessment and management.

Validation of the What Matters Index: A brief, patient-reported index that guides care for chronic conditions and can substitute for computer-generated risk models.

Introduction: Current health care delivery relies on complex, computer-generated risk models constructed from insurance claims and medical record data. However, these models produce inaccurate predictions of risk levels for individual patients, do not explicitly guide care, and undermine health management investments in many patients at lesser risk. Therefore, this study prospectively validates a concise patient-reported risk assessment that addresses these inadequacies of computer-generated risk models.

Development of a care guidance index based on what matters to patients.

Introduction: Targeting resources for a designated higher-risk subgroup is a strategy for chronic care management. However, risk-designation has several limitations: it is inaccurate, seldom helpful for care guidance, and potentially misallocates care away from many patients.

Methods: To address limitations of risk designation, we tested a "what matters index" (WMI) in 19,593 adult patients with chronic conditions.

Regular exercise is strongly associated with anticipated success for reducing health risks.

Regular exercise is a healthy behavior associated with desirable benefits. Regular exercise also makes manifest 2 fundamental behaviors-a choice and the discipline to continuously act on that choice. This cross-sectional analysis of more than 10 000 adults examines the association of regular exercise with unhealthy behaviors.

Two useful tools: to improve patient engagement and transition from the hospital.

We use an Internet-based health assessment and feedback system to examine the range of needs and diverse experiences of 520 hospitalized adults in transition and the factors most strongly associated with their self-reported health confidence. Our results strongly suggest that patient engagement prior to admission and the quality of care coordination and communication during hospitalization can greatly enhance successful transition from the hospital back to the community. Hospitals are complex institutions.

A patient-reported spectrum of adverse health care experiences: harms, unnecessary care, medication illness, and low health confidence.

As part of a health "checkup," a large national sample of adults used an Internet technology that also asks about adverse experiences. About half of all respondents do not feel very confident they can manage and control most of their health problems, almost 30% consider that their hospital or emergency department use was unnecessary, 20% believe that their medications may be causing illness, and 1.5% report a medical-related harm.

The right tool for the right job: the value of alternative patient experience measures.

Patient-reported experience of care predicts health care outcomes. Fourteen US and Canadian practices intercalated a standard ambulatory care Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey within their usual Internet-based survey to compare results from the Internet survey, Internet CAHPS survey, and a mailed CAHPS survey. They found that practice performance rankings obtained via the multi-item CAHPS survey were equivalent to a single measure captured by the Internet survey.

Improvement of patients' health confidence: a comparison of 15 primary care practices and a national sample.

Patient health confidence is an easy-to-obtain proxy measure for patient engagement and patient activation. In evidence-based literature syntheses, longitudinal studies, and empiric analyses, this measure is related to desirable consequence of medical care. Adult patients from 15 primary care practices and a national sample report on changes in health confidence over time.

The medium is the (health) measure: patient engagement using personal technologies.

With the phrase "the medium is the message", Marshall McLuhan argued that technologies are the messages themselves and not just the medium. Almost 50 years later, we understand that modern information and communication technologies expand our ability to perceive our world to an extent that would be impossible without the medium. In this article, we contend that information and communication technologies are becoming the dominant medium for patient engagement.

Patients use the internet to enter the medical home.

There is a large gap between the promise of patient-centered medical home (PCMH) and our current capacity to define and measure it. The purpose of this article is to describe the findings of "real-time" patient-reported data about constructs of the PCMH and to demonstrate how an Internet-based method can be useful for obtaining patient report about the PCMH. We find that patients' Internet ratings seem stable and demonstrate relationships that fit constructs and models for the PCMH.

Practice redesign and the patient-centered medical home: history, promises, and challenges.

Medical practice redesign refers to the intentional efforts to improve practice processes and outcomes. Efforts to redesign office-based medical care go back some forty years. We divide the history of practice redesign into three overlapping phases: basic investigation, model development, and dissemination.

CARE Vital Signs supports patient-centered, collaborative care.

CARE Vital Signs refers to a standard form created by practices to Check what matters to patients, Act on that assessment, Reinforce the actions, and systematically Engineer or incorporate actions into staff roles and clinical processes. On its face, CARE Vital Signs is a deceptively simple tool that, when properly used, can help a practice attain levels of efficiency and quality. This article describes the rationale for CARE Vital Signs and the ways it can be used for the greatest benefit.