Journal of general internal medicine
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The Providence Diabetes Collective Impact Initiative (DCII) was designed to address the clinical challenges of type 2 diabetes and the social determinants of health (SDoH) challenges that exacerbate disease impact. ⋯ DCII participation was associated with improvements in diabetes education use, SDoH screening, and some measures of care utilization.
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Interest in complementary and integrative health (CIH) approaches, such as meditation, yoga, and acupuncture, continues to grow. The evidence of effectiveness for some CIH approaches has increased in the last decade, especially for pain, with many being recommended in varying degrees in national guidelines. To offer nonpharmacological health management options and meet patient demand, the nation's largest integrated healthcare system, the Veterans Health Administration (VA), greatly expanded their provision of CIH approaches recently. ⋯ Veterans' use of some approaches rapidly grew recently and was robust, especially among patients most in need. This information might help shape federal/state health policy on the provision of evidence-based CIH approaches and guide other healthcare institutions considering providing them.
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Health information exchanges (HIEs) have proliferated over the last decade, but a gap remains in our understanding of their benefits to patients and the healthcare system. In this systematic review, we provide an updated report on what is known regarding the impacts of HIE on clinical, health care utilization, and cost outcomes in the adult inpatient setting. ⋯ Evidence for the impacts of HIE remains largely observational with little direct measure of HIE use during clinical care, making causality difficult to assess. The highly variable outcomes examined by these studies limit meaningful synthesis. The strength of evidence is low that HIE reduces unplanned readmissions and mortality and there is insufficient evidence for the impact of HIE on cost or utilization. The increased number of studies specific to inpatient settings that examine objective outcomes with more rigorous statistical methods is a promising development since prior reviews.