Research

Optimizing quality and service delivery one practice and provider at a time

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I3PI investigators are on the cutting edge of research to measure and improve quality, particularly with the application of simulated visits and contextual care.

Drs. Weiner and Schwartz completed a large federally funded study of over 100 physicians in practices in two large metropolitan areas using simulated patients to collect data on variations in approaches to management and quality of care. Actors are trained to reproduce the same scenarios, behaviors and dress, enabling the research team to examine the influence of length of visit, physician experience, and many characteristics of the practice environment that could influence quality of care. The study has been published in Annals of Internal Medicine. A video demonstration of the unannounced standardized method use in that study is available here.

A follow-up study by the team demonstrating an educational approaches to reducing errors in doctors-in-training appeared in JAMA, and a demonstration of the added value of simulated patients in the real practice environment vs. “known” simulated patients appeared in the Joint Commission Journal on Quality and Patient Safety in 2013.

Staff have also developed and validated a methodology for measuring how effectively care is individualized in the primary care setting. This coding method was used to show that individualizing care is associated with improved patient outcomes in a 2013 study in Annals of Internal Medicine.

I3PI Founder Dr. Saul Weiner was interviewed about research in individualizing care in The Hospitalist journal, in the July 20, 2010 issue of the Chicago Tribune, and on Chicago Public Radio’s Eight Forty-Eight show. I3PI Founder Dr. Alan Schwartz has spoken about individualizing care on NPR’s Talk of the Nation Science Friday and been quoted in several television and newspaper stories on the topic.

In 2017-2019, with support of the Robert Wood Johnson Foundation, I3PI has been working with Horizon Blue Cross Blue Shield of New Jersey and the American College of Physicians to document care quality and costs in New Jersey practices. View a project summary presented at the October 2018 Horizon Summit on Value-Based Care. A paper showing that providers improved in screening of depression appeared in the journal DIAGNOSIS – read coverage of it here. A comprehensive paper demonstrating improvement and cost savings in several clinical areas has been published in the Journal of General Internal Medicine.

In 2023, I3PI received funding from the National Institutes of Health to develop an automated version of its Foresee® coding system.

Much of their research appears in their award-winning book Listening for What Matters: Avoiding Contextual Errors in Health Care, and on the web site contextualizingcare.org.