What we are doing
The Patient Revolution team is currently leading or contributing to 2 types of projects; those designed to explore the possibilities of system and process reform within industrial healthcare and those that focus on new strategies for bringing information, tools, and support to people and communities.
We hope to make the learnings and tools from these projects available to communities and clinical practices in the near future (hopefully early 2019.) If you have any questions, or would like to find out more, reach out to our director, Maggie Breslin.
In partnership with 2 community clinics in SE Minnesota, we have been working to understand issues related to access. After extensive research with the community, we are embarking on 2 large-scale experiments during the fall/winter of 2018. Our goal is to understand how to embody the principles identified in Why We Revolt in the systems, policies, rules, and guidelines that support care in a rural community.
Primary Care Experiment
Clinicians and patients coming together to co-develop a model for caring for people that identifies and attempts to diminish blur and incidental cruelty.
It does this through strategies and systems that advocate for integrity (clinicians empowered and supported to work with patients to manage the situations they find themselves in as opposed to clinicians asked to administer care dictated by guidelines and rules), timelessness (a coming together of clinical team and patient which happens most deeply during face-to-face visits, but is present and accessible during asynchronous visits and phone calls) and elegance (imagined across the points of care, the least number of touchpoints in order to address the patient’s issue or situation.)
Community Health Worker Experiment
Fit CHWs into the community care ecosystem most especially for those patients experiencing significant burden of care (in which workload and capacity are misaligned) by focusing on solidarity (meeting patients where they are and helping to establish a bridge for them back to primary care in which the patient’s context can better inform care.)
what is best for me and my family?- a new model to support shared decision making
The idea behind a shared decision making (SDM) program is to combine light facilitated peer group events to the tools designed for use in the clinical encounter. (examples) The peer groups are an effort to create spaces where people can begin the process of thinking, feeling, and talking about what may be important to them before they have to make a decision.
We have focused our initial efforts on the topics of mammography screening and cardiovascular risk. We are working with Yale Health and researchers at Yale New Haven Hospital to implement and ultimately study this program at scale to see if creating these spaces allows people to have different types of conversations with their clinicians.
We believe this model will help address issues of burden (patients often take on additional work simply because it is suggested or they believe it is necessary with little real discussion about how it will fit into their life) and blur (clinicians can assume they know what is important to a patient without really having probed to understand their context.) Our model tries to address this by giving patients access to resources and support so that they feel more confident and prepared to participate in conversations with their clinicians; promoting carefulness (a balancing of the evidence along with patient context) and integrity (promoting clinician recommendations based on evidence.)