Research

The global demands on primary care and health care systems call for innovative approaches to teamwork, culture, financing, and technology such that care delivery can better cultivate patient and physician satisfaction. While primary care leaders and practices have been chronicled in many venues, readers are limited to learning what these leaders or practices are doing, not how they operate. The Harvard Medical School Center for Primary Care seeks to fill this critical knowledge gap by profiling exemplar practices, systems, and models in order to address how they operate and defy systemic challenges to deliver high performing primary care. (more…)

Education

Education: The Center is working to transform primary care education at Harvard and beyond. We are working closely with the HMS Program in Medical Education to develop a new foundational curriculum that for the first time will include a longitudinal primary care practicum for the development of clinical skills at Harvard Medical School, as well as developmental curriculum in primary care that will span all four years of medical school.

Digital Health and Chronic Disease Prevention

Center Research and Curriculum Director Erin Sullivan and
Case Writer Jessica Alpert co-author recent Harvard Business Review Article.

The Center’s research team studied Omada Health, a digital therapeutics firm focused on preventing obesity-related chronic conditions. This research is part of our Harvard Medical School initiative to identify and share knowledge about innovative approaches to major health challenges that primary care providers play the lead in treating.

Omada’s diabetes prevention program provides a model of how digital health interventions can be used to address other conditions in ways that reduce costs, improve patient involvement in their own care, and mitigate the overwhelming burden of chronic diseases in the United States.

Read the full article

A New Approach to Decreasing Physician Burnout

This article originally appeared in Harvard Business Review

As part of our work researching high-performing primary care systems, we discovered a system-wide approach launched by Southern California Permanente Medical Group (SCPMG) in 2004 that unburdens primary care physicians. We believe the program — Complete Care — may be a viable model for other institutions looking to decrease burnout or increase physician satisfaction.

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Integrating Oral Health into Primary Care Training

The Center for Integration of Primary Care in Oral Health (CIPCOH) is a national center established in 2016 through a cooperative agreement with the United States Department of Health and Human Services to serve as a national resource for systems-level oral health integration into primary care training. CIPCOH is a joint endeavor involving the Center for Primary Care and the following partners: (more…)

Primary Care Practice Policy Model

The Primary Care Practice Model is a stochastic simulation model that estimates how practice financial performance varies depending on six variable inputs:

• numbers of practice staff of various types (ex. clerical staff, physician assistants, community health workers etc.),
• salaries and benefits for all practice employees,
• overhead expenditures including physical infrastructure and service-related expenses such as EMR expenses,
• patient characteristics including age, sex, race/ethnicity, income, insurance type if any, and ICD diagnoses as available
• patient volume per physician day and/or number of appointment slots available per day,
• typical billing rates per physician
(more…)

A Visit to Gold Direct Care: Massachusetts’ First Direct Primary Care Practice

In the Center’s quest to learn more about the direct primary care (DPC) model and movement, four members from the Center’s team traveled to Marblehead, MA in early August to visit Gold Direct Care.  Gold Direct Care is located in the heart of downtown Marblehead, in a beautiful building with a quaint courtyard. The office was thoughtfully designed; the front room was saturated with natural light and the waiting area looked more like a modest living room instead of a doctor’s waiting room. Megan, the practice’s nurse, one of three employees, immediately greeted us as we entered, and led us back to Dr. Gold’s office. (more…)

Designing Primary Care in the Netherlands: Almere and Nieuwegein

In mid-late April, two main events take hold of the Netherlands—the tulip blooming season and King’s Day (formerly Queen’s Day). The Dutch are famous worldwide for their never-ending, colorful fields of tulips that paint the countryside, and the king’s birthday boasts the year’s biggest street party filled with live music, open markets, and crowds of orange. During this period, the Center’s Research Team joined the hordes of tourists visiting the Netherlands, but on a different mission: to conduct fieldwork for their third installment of the Primary Care Systems Case Collection. (more…)

Martin’s Point Health Care – Bangor

Last March, the Center’s research team traveled to Bangor, Maine—only a couple hours drive from the post-blizzard world of Boston. We were visiting the Bangor practice of Martin’s Point Health Care (MPHC), in preparation to write the next case study in our Primary Care Systems Case Collection series. MPHC-Bangor has been lauded for their innovative practice, high-performing workforce model, and high workforce satisfaction levels by the Institute of Medicine, the Robert Wood Johnson Foundation, and the ABIM Foundation, respectively. The buzz generated by this kind of recognition got us excited, and throughout our site visit, it was clear in the interactions that this practice valued both their staff and patients. (more…)

City Invincible: A Visit to the Camden Coalition of Healthcare Providers (CCHP)

In June, the Center’s Research Team visited CCHP, the subject of the fourth installment of the Primary Care Systems Case Collection (Center for Primary Care Case Studies). Since their inception in 2006, CCHP has been at the forefront of care management for complex patients. Over the years they have built a network of community partners, an innovative super-utilizer intervention, and a robust business model to deliver quality care at lower costs – all of which sparked the Center’s interest. At the end of our visit, we were able to attend the monthly staff meeting in the assembly room, which, that Friday morning, was overflowing. CCHP has been pressed for space; the rapid increase in staff over the past few years meant monthly meetings are more necessary- and more crowded (more…)

Patient Provider Relationships Lead to Better Health Outcomes

This article originally appeared in Harvard Business Review

Center Co-Director, Andy Ellner, and Director of Research and Curriculum, Erin Sullivan, recently co-authored an article that explores the effect patient-provider relationships on better health outcomes. The article highlights key findings from studies of exemplary primary care organizations, which are part of a cased-based series.

“The leaders of these practices all believe that by promoting relationship building on an individual patient level, favorable costs and outcomes will follow. Here’s a brief account of what we found…”

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