Primary Care Academics Transforming Healthcare (PATH)

Summary

The mission of the UW Health PATH collaborative is to bridge primary care clinical transformation and rigorous scientific study in order to improve our health system for the benefit of patients and communities. We will disseminate learnings locally and nationally, emphasizing scholarly contributions, in order to enable effective implementation.

We are a multidisciplinary coalition of physicians and change leaders. Primary care Academics Transforming Healthcare (PATH) members are experienced in clinical delivery and currently span two primary care departments (family medicine, internal medicine), Quality, Safety, and Innovations, Population Health, and the Center for Patient Partnerships.

We have been formally collaborating and meeting regularly since the beginning of 2013 to support publications and presentations about our primary care transformation journey. We have entered the national discourse on primary care redesign by highlighting some of UW Health’s important work to date.

Productivity

Since 2013, we’ve collectively disseminated on topics around patient engagement, innovation, quality, and theory through:

• 24 academic publications
• 1 editorial letter
• 2 manuscripts under review
• 9 manuscripts in progress
• 48 conference presentations and posters
• 7 national toolkits disseminated

High Visibility Achievements

PATH has had several national achievements:

• Raised national attention towards UW Health as topic of special editorials in the Journal of General Internal Medicine and the Joint Commission’s Journal on Quality and Patient Safety
• Invited to speak at the Association of American Medical Colleges’ Integrating Quality Meeting to share innovative collaborative approach
• Dissemination efforts have reached decision makers across 90+ health systems

Collaborative Members

Director

Members

Support Staff

Practice Redesign Papers

Patient Engagement

• Caplan W, Davis S, Kraft S, Berkson S, Gaines ME, Schwab W, Pandhi N. Engaging Patients at the Front Lines of Primary Care Redesign: Operational Lessons for an Effective Program. Jt Comm J Qual Patient Saf. 2014;40(12):533-540.
• Davis S, Berkson S, Gaines ME, Prajapati P, Schwab W, Pandhi N, Edgman-Levitan S. Implementation Science Workshop: Engaging Patients in Team-Based Practice Redesign – Critical Reflections on Program Design. J Gen Intern Med. 2016;31(6):688-695.
• Pandhi N, Jacobson N, Crowder M, Quanbeck A, Hass M, Davis S. Engaging Patients in Primary Care Quality Improvement Initiatives: Facilitators and Barriers. Am J Med Qual. 2020;35(1):52-62.
• Davis S, Pandhi N, Warren B, Grevious N, Crowder M, Ingersoll H, Perry E, Sussman A, Grob R. Developing catalyst films of health experiences: an analysis of a robust multi-stakeholder involvement journey. Res Involv Engagem. 2022;8(1):34.

Innovation

• Trowbridge E, Bartels CM, Koslov S, Kamnetz S, Pandhi N. Development and Impact of a Novel Academic Primary Care Compensation Model. J Gen Intern Med. 2015;30(12):1865-1870.
• Kamnetz S, Marquez B, Aeschlimann R, Pandhi N. Are waiting rooms Passé? A pilot study of patient self-rooming. J Ambul Care Manage. 2015;38(1):25-28.
• Kraft S, Strutz E, Kay L, Welnick R, Pandhi N. Strange Bedfellows: A Local Insurer/Physician Practice Partnership to Fund Innovation. J Healthc Qual. 2015;37(5):298-310.
• Koslov S, Trowbridge E, Kamnetz S, Kraft S, Grossman J, Pandhi N. Across the divide: “Primary care departments working together to redesign care to achieve the Triple Aim”. Healthc (Amst). 2016;4(3):200-206.
• Lochner J, Trowbridge E, Kamnetz S, Pandhi N. Family Physician Clinical Compensation in an Academic Environment: Moving Away From the Relative Value Unit. Fam Med. 2016;48(6):459-466.
• Kraft S, Caplan W, Trowbridge E, Davis S, Berkson S, Kamnetz S, Pandhi N. Building the learning health system: Describing an organizational infrastructure to support continuous learning. Learn Health Syst. 2017;1(4):e10034.
• Karp Z, Kamnetz S, Wietfeldt N, Molfenter T, Pandhi N. “Exploratory study of the relationship between the clinic environment and staff communication.” Health Environments Research & Design 2017.
• Pandhi N, Kraft S, Berkson S, Davis S, Kamnetz S, Koslov S, Trowbridge E, Caplan W. Developing primary care teams prepared to improve quality: a mixed-methods evaluation and lessons learned from implementing a microsystems approach. BMC Health Serv Res. 2018;18(1):847.
• Micek M, Arndt B, Tuan W-J, Trowbridge E, Dean SM, Lochner J, Sampene E, Pandhi N. Physician Burnout and Timing of Electronic Health Record Use. ACI Open. 2020;4(1):e1-e8.
• Hartkopf KJ, Heimerl KM, McGowan KM, Arndt BG. Expansion and Evaluation of Pharmacist Services in Primary Care. Pharmacy (Basel). 2020;8(3):124.
• Flood G, Meier A, Anderson M, Ehlenbach W, Bidar-Sielaff S, Thao S, Smith M. A prioritization algorithm for healthcare personnel for the CDC’s COVID-19 Phase 1a vaccine distribution plan.
• Ann Fam Med. COVID pre-print.
• Swedlund M, Kamnetz S, Birstler J, Trowbridge E, Arndt B, Micek M, Lochner J, Pandhi N. Reduction in Medication Refill Encounters Through Primary Care Redesign Workflow Changes. J Ambul Care Manage. 2022;45(1):36-41.
• Perry E, Pandhi N, Caplan W, Huang H, Davis S, Arndt B, Micek M, Lochner J, Smith MA. Collaborative care implementation: lessons learned. Am J Manag Care. 2022;28(8):e308-e311.
• Lochner J, Birstler J, Smith MA, Rathouz P, Arndt B, Micek M, Trowbridge E, Trowbridge E, Kamnetz S, Pandhi N. Does a Change in Physician Compensation Lead to Changes in Care Delivery in Family Medicine Clinics?. WMJ. 2022;121(4):280-284.
• Ramly E, Kamnetz SA, Perry CE, Micek MA, Arndt BG, Lochner JE, Davis S, Trowbridge ER, Smith MA. Primary Care Patients’ and Staff’s Perceptions of Self-Rooming as Alternative to Waiting Rooms. Ann Fam Med. 2023;21(1):46-53.

Theory

• Kraft S, Carayon P, Weiss J, Pandhi N. A simple framework for complex system improvement. Am J Med Qual. 2015;30(3):223-231.
• Pandhi N, Yang WL, Karp Z, Young A, Beasley JW, Kraft S, Carayon P. Approaches and challenges to optimising primary care teams’ electronic health record usage. Inform Prim Care. 2014;21(3):142-151.
• Kamnetz S, Trowbridge E, Lochner J, Koslov S, Pandhi N. A Simple Framework for Weighting Panels Across Primary Care Disciplines: Findings From a Large US Multidisciplinary Group Practice. Qual Manag Health Care. 2018;27(4):185-190.
• Berkson S, Davis S, Karp Z, Jaffery J, Flood G, Pandhi N. Medicare shared savings programs: Higher cost accountable care organizations are more likely to achieve savings. Int J Healthc Manag. 2018;13:sup1:248-255.

Other Scholarly Work

• Trowbridge E, Berkson S, Koslov S, Kraft S, Jaffery J, Davis S, Kamnetz S, Lochner J, Pandhi N. Response to Greene et al. [eletter]. Ann Fam Med. 2015; June 4.

Practice Redesign Presentations

Patient Engagement

• National: Pandhi N, Jacobson N, Quanbeck A, Davis S. “Measuring the outcomes of patient engagement in primary care quality improvement: a modified Delphi study.” Presented to the North American Primary care research group, 2018.
• National: Davis S. “Patients at the Table.” Presented to the Healthcare Value Hub, 2018.
• Local: Davis S. “Supporting ALL Partners – Families, Youth, and Staff – on the Health Care QI team.” Presented to the WI Department of Health Services, Madison, WI, 2018.
• Local: Davis S, Pandhi N. “Developing Productive Research Collaborations with Health Care Organizations.” Presented at the Engaging Key Partners to Design & Conduct High Quality Research Short-Course. Institute for Clinical and Translational Research, UW-Madison, 2018.
• Local: Davis S. “The Insider Panel: Healthcare System Stakeholders’ Perspective on Research Collaboration.” Presented at the Engaging Key Partners to Design & Conduct High Quality Research Short-Course. Institute for Clinical and Translational Research, UW-Madison, 2018.
• Local: Karp Z, Crowder M, Davis S, Jacobson N, Quanbeck A, Hass, Pandhi N. “Identifying effective strategies for scaling an intervention to engage patients in care redesign.” Presented at the University of Wisconsin Institute for Clinical and Translational Research Dissemination & Implementation Short Course, 2018.
• National: Pandhi N, Davis S. “Patient engagement in care redesign: Identifying effective strategies for measuring and scaling the intervention.” Presented at the Association of American Medical Colleges’ (AAMC) Integrating Quality Meeting, 2017.
• Local: Davis S, Pandhi N. “Harnessing High Touch and High Tech: Combining Traditional Engagement and Social Media to Maximize Dissemination.” Presented at the Stakeholder Engagement Short-Course. Institute for Clinical and Translational Research, UW-Madison, 2017.
• Local: Davis S. “Patient Engagement in Quality Improvement Toolkit Introduction.” Presented at the Tribal Medical Home Project Learning Community Webinar, Children’s Hospital Alliance of Wisconsin, 2017.
• Local: Davis S. “The Power of Partnering with Families to Transform Health.” Presentation at Advancing Family Engagement in Health Care Quality Improvement, Oshkosh, WI, 2017.
• National: Pandhi N, Grob R. “Research Collaborations.” Workshop at the National Collaborative for Improving Primary Care Through Industrial and Systems Engineering (I-PrACTISE) Conference, 2016, Madison, WI.
• National: Pandhi N, Davis S. “Patient Engagement with Primary Care Teams for Quality Improvement.” Keynote Speaker at the National Collaborative for Improving Primary Care Through Industrial and Systems Engineering (I-PrACTISE) Conference, 2015, Madison, WI
• National: Davis S, Pandhi N. “Engaging patients, staff, and community in quality improvement.” Presentation at the Health Innovation Program – Association of American Medical Colleges “Building an Academic Learning Health System” conference, 2015, Madison, WI
• Regional: Pandhi N, Davis S, Berkson S, Spranger J. “Engaging Patients in Primary Care Team Continuous Improvement.” Workshop at the Wisconsin Health Improvement and Research Partnerships Forum, 2014, Madison, WI

Quality

• Local: Hauschild L, Trowbridge E, Welnick R, Kamnetz S. “Variations in Primary Care.” Presentation at UW Health Quality and Safety Week, 2014, Madison, WI

Innovation

• National: Swedlund M, Kamnetz S, Birstler J, Trowbridge B, Arndt B, Lochner J, Pandhi N. “Effect of Optimization of the Medical Assistant Role on Volume of Refill Requests.” Society of Teachers of Family Medicine Annual Spring Conference, Washington, DC, 2019.
• National: Lochner J, Arndt B, Kamnetz S. “A simple tool for Weighting Patient Panels Based on Primary Care Workload Estimates.” Presented at the Society of Teachers of Family Medicine Annual Spring Conference, Washington, DC, 2018.
• National: Lochner J, Arndt B, Micek M, Birstler J, Kamnetz S, Trowbridge B, Pandhi N. “Impact of physician compensation change on patient care delivery.” Presented to the North American Primary care research group, 2018.
• National: Lochner J, Kamnetz S. “Improving UW Health’s Panel Weighting System.” Presented at the Family Medicine Leaders in Large Multispecialty Groups, Baylor Scott & White Conference, Dallas, TX, 2017.
• National: Trowbridge B, Pandhi N. “WIPCOT (Wisconsin Primary Care Compensation Toolkit).” Presented at the ELAM (Executive Leadership in Academic Medicine) Leaders Forum, 2017.
• National: Lochner J, Ardnt B. “Maintaining comprehensive family medicine care in a world of shifting incentives.” Presented at the Society of Teachers of Family Medicine Annual Spring Conference, 2017.
• National: Karp Z, Kamnetz S, Pandhi N. “Primary care patient perceptions of clinic design across three practices.” Presented at the National Collaborative for Improving Primary Care Through Industrial and Systems Engineering (I-PrACTISE), 2017.
• National: Lochner J. “Care delivery changes with implementation of primary care redesign and physician compensation reform.” Presented at the Family Medicine Leaders in Large Multispecialty Groups Meeting sponsored by Baylor Scott & White, 2017.
• National: Trowbridge B. “Beyond RVUs: Changing your primary care compensation plan from volume to value.” Presented at the ACLGIM Leon Hess Institute Management Training and Leadership Institute, 2017.
• National: Lochner J, Potter, Arndt B. “Moving away from the RVU: Care delivery changes with implementation of physician compensation reform.” Presentation at the Society of Teachers of Family Medicine Annual Spring Conference, 2016.
• National: Pandhi N, Karp Z, Kamnetz S, Trowbridge E. “Developing an effective writing collaborative to rapidly disseminate lessons from system redesign.” Presentation at the Association of American Medical Colleges’ Integrating Quality Meeting, 2016, Chicago, IL.
• National: Pandhi N, Trowbridge E. “Developing an Effective Writing Collaboration to Share Learnings from Primary Care Design.” Presentation at the I-PrACTISE Conference, 2016, Madison, WI.
• National: Karp Z, Kamnetz S, Pandhi N. “Primary Care Team Perceptions of Team-Based Care and Clinic Design Types Across 3 Practices.” Presentation at the I-PrACTISE Conference, 2016, Madison, WI.
• National: Pandhi N, Trowbridge E. “Engaging Clinical Faculty in Research and Publishing.” Health Innovation Program-Association of American Medical Colleges Meeting, 2015, Madison, WI.
• National: Karp Z, Kamnetz S, DeCheck N, Pandhi N. “Influences of the Primary Care Clinic Environment on Patients and Staff: Observational and Preliminary Focus Group Findings.” Presentation at the I-PrACTISE Conference, 2015, Madison, WI.
• National: Trowbridge E, Bindl L. “Beyond RVU’S: Changing Your Primary Care Compensation Plan from Volume to Value.” Webinar through the Alliance for Academic Internal Medicine (AAIM), 2014.
• National: Trowbridge E, Feldstein D, Schmidt A, Thom M, Sosman J, Bindl L. “Beyond RVU’s: Changing Your Compensation Plan to Reflect Primary Care Providers’ Actual Work.” Presentation at the Society of General Internal Medicine Annual Meeting, 2014, Denver, CO.
• National: Trowbridge E, Bindl L. “Beyond RVU’S: Changing Your Primary Care Compensation Plan from Volume to Value.” Presentation at the AAIM Academic Internal Medicine Week, 2014, Washington, DC.
• National: Trowbridge E. “Successful Clinical Advocacy: The Story of the Ugly Duckling.” Presentation at the Association of Chiefs & Leaders of General Internal Medicine Winter Summit, 2014, Paradise Valley, AZ.
• National: Pandhi N, Berkson S, Caplan W, Davis S, Kamnetz S, Koslov S, Trowbridge E, Karp Z, Kraft S. “Finding a PATH to Support Scholarly Careers: Primary care Academics Transforming Healthcare.” Poster presented at the Association of American Medical Colleges’ Integrating Quality Meeting, 2014, Chicago, IL.
• National: Kraft S, Pandhi N. “Connecting Dots: Creating a learning system linking clinical quality improvement, maintenance of certification and research.” Presentation at the American Board of Medical Specialties Annual Conference Innovate.Activate.Advance, 2014, Chicago, IL.
• National: Karp Z, Kamnetz S, Pandhi N. “Influences of the Primary Care Clinic Environment on Patients and Staff: Study Design.” Poster presented at the I-PrACTISE Conference, 2014, Madison, WI.
• National: Trowbridge E, Bindl L. “Beyond RVU’S: Changing Your Compensation Plan to Reflect PCP’s Actual Work (The UW Health Primary Care Comp Plan).” Presentation at the Group Practice Improvement Network Meeting, 2013, San Antonio, TX.
• Regional: Trowbridge E. “Redesigning Primary Care: Partnering With Patients to Improve Health 2008-2013.” Hot Topics in Internal Medicine presentation at the UWSMPH Department of Medicine, 2014, Madison, WI.
• Regional: Trowbridge E. “Primary Care Redesign: The UW Health Story.” Presentation at the State Primary Care Conference, Office of CME, UW School of Medicine and Public Health (UWSMPH), 2013, Madison, WI.
• Local: Kamnetz S, Trowbridge E, Koslov S. “Primary Care Redesign: A 5 Year Retrospective.” Presentation to the UW Medical Foundation’s Board of Directors, 2013, Madison, WI.
• Local: Trowbridge E, Kraft S. “Redesigning Primary Care: A Brave New World.” Grand Rounds presentation at the UWSMPH Department of Medicine, 2014, Madison, WI.
• Local: Pandhi N, Schrager S. “Finding Collaborators and Colleagues to Be Successful in Your Academic Work: Writing Groups.” Panel discussion at UW Office of Faculty Development’s Career Paths 201 Spring Seminar: Taking Charge of Your Career, 2015, Madison, WI.

Toolkits Disseminated

1. Center for Patient Partnerships, UW Madison, University of New Mexico School of Medicine, Family & Community Medicine, UW Institute for Clinical and Translational Research, Health Experiences Research Network. “Catalyst Films about Health Experiences Guidebook.” Health Innovation Program HIPxChange Toolkit, 2021. https://www.hipxchange.org/CatalystFilms
2. UW Health, PATH. “Shared Values and Tools for Implementing Collaborative Care.” Health Innovation Program HIPxChange Toolkit, 2021. https://www.hipxchange.org/CollaborativeCare
3. UW Health, UW School of Medicine and Public Health. “COVID-19 Vaccine Prioritization Tool.” Health Innovation Program HIPxChange Toolkit, 2020. https://www.hipxchange.org/COVIDvaccine
4. UW Health, PATH. “Rapidly Integrating Telemedicine Visits into Primary Care Toolkit.” Health Innovation Program HIPxChange Toolkit, 2020. https://www.hipxchange.org/Telemedicine
5. Center for Patient Partnerships, UW Department of Family Medicine and Community Health, UW Institute for Clinical and Translational Research, PATH. “Engaging Research Participants in Disseminating Health Experiences Research.” Health Innovation Program HIPxChange Toolkit, 2018. https://www.hipxchange.org/HealthExperiencesResearch
6. Pandhi N, Kraft S, Caplan W, Kamnetz S, Davis S, Berkson S, Koslov S, Trowbridge E. “Partnering with Patients to Improve the Quality of Primary Care.” Association of American Medical Colleges, MedEdPORTAL iCollaborative, 2013 Clinical Care Innovation Challenge. https://www.mededportal.org/icollaborative/resource/983
7. Center for Patient Partnerships, UW Health, PATH. “Patient Engagement in Redesigning Care.” Health Innovation Program HIPxChange Toolkit, 2014. http://hipxchange.org/PatientEngagement
8. Davis S, Gaines S. “Patient Engagement in Redesigning Care.” Association of American Medical Colleges, MedEdPORTAL iCollaborative, 2015. https://www.mededportal.org/icollaborative/resource/3891

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