Aspect | Results | Changes made |
---|---|---|
PRECIS (pragmatic trial) review | Initial high-value elements were too focused and prescriptive | Broadened to allow flexibility and health professional judgment |
Alignment with health reform via multistakeholder panel (N = 12) | Incentives too complex; lack of alignment with other health reform efforts; team and clinic culture will drive results | Generated alignment document; revised intervention metrics and approach to better align with initiatives; extensive team and clinic assessment |
Chronic illness patient focus group (N = 9) | Access to the clinic and the specific services need to be improved; information gaps about what is newly available (like care coordination) was common | Look carefully for patient experience measures that examine access and information gathering; expect different experiences from patients than reported by clinics; improve education |
Insurer focus group (N = 22) | Each insurer had their own initiative or had a separate take on the current initiative set | Aligned principles were agreed to by payers; encourage payer alignment |
Pilot clinic interviews (N = 6) | Expectations of the clinic too vague and time-consuming | Generated a memorandum of understanding that clinics revised and implemented |