Table 1.

Innovations Identified from 2013 Group Health Publications and Reviewed by 26 WWAMI Region Practice and Research Network Clinicians Using the Decision-to-Implement Worksheet

InnovationDescriptionDiscussion Comments
Ask-Advise-Connect (AAC)21Active quitline referral: licensed vocational nurses assess and record the smoking status of all patients in the electronic health record. The names and phone numbers of smokers who agreed to be connected were sent electronically to the Texas quitline daily. Patients were proactively called by the quitline within 48 hours.“Easier than stocking brochures; don't have to worry about follow-up.”
“How would you assess return on investment/what is cost to clinic?”
“Helps prompt universal screening for tobacco use.”
Electronic Communications and Home Blood Pressure Monitoring to Improve Blood Pressure Control (e-BP)22Patients with uncontrolled BP were registered to use an existing shared patient electronic health record and secure E-mail and randomly assigned to (1) usual care; (2) home BP monitoring and website training; or (3) this plus pharmacist-led team care delivered via the Web.“Outcomes for hypertension were improved but not necessarily in [a] cost-effective manner.”
“Patient portal [is] helpful but not all patients have access to patient portal or Internet.”
“Would think about implementing but barriers include reimbursement model, reduced office visits, available staff; might be adaptable with cheaper personnel.”
Guide to Decide (GtD)20Website that walked women at high risk of breast cancer through 2 medical options to prevent breast cancer: tamoxifen and raloxifene. Information was tailored to each woman's age and race.“We have so many other battles to fight, more prevalent battles, this is more like Mercedes intervention compared to our population which merely needs bus ticket.”
“Important, but low on priority list compared to revenue-generating activities.”
TEAMcare23A collaborative approach to care for patients with depression and physical diseases in which nurse care managers monitor disease control and depression; work with patients and their primary care providers to set clinical and self-management goals and adjust medications; consult weekly with psychiatrists.“Patient literacy could be a problem.”
“How would reimbursement work?”
“Staff could be trained to do this.”
“Would federally qualified health center leadership buy in?”
  • BP, blood pressure.