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Open Access Research

Use of RE-AIM to develop a multi-media facilitation tool for the patient-centered medical home

Russell E Glasgow1*, Perry Dickinson2, Lawrence Fisher3, Steve Christiansen4, Deborah J Toobert5, Bruce G Bender6, L Miriam Dickinson2, Bonnie Jortberg2 and Paul A Estabrooks7

Author Affiliations

1 Division of Cancer Control and Population Sciences, National Cancer Institute, 6130 Executive Blvd., Room 6144, Rockville, MD 20852, USA

2 University of Colorado School of Medicine, 12631 East 17th Avenue, Aurora, CO 80045, USA

3 Department of Family and Community Medicine, Diabetes Center, University of California, San Francisco, Parnassus Heights, Box 0900, 500 Parnassus Avenue, MU3E, San Francisco, CA 94143-0900, USA

4 Intervision Media, 261 E.12th Avenue, Eugene, OR 97401,USA

5 Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97403, USA

6 Division of Pediatric Behavioral Health, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA

7 Virginia Tech, Department of Human Nutrition, Foods and Exercise, VT Riverside, 1 Riverside Circle, SW Roanoke, VA 24016, USA

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Implementation Science 2011, 6:118  doi:10.1186/1748-5908-6-118

Published: 21 October 2011

Abstract

Background

Much has been written about how the medical home model can enhance patient-centeredness, care continuity, and follow-up, but few comprehensive aids or resources exist to help practices accomplish these aims. The complexity of primary care can overwhelm those concerned with quality improvement.

Methods

The RE-AIM planning and evaluation model was used to develop a multimedia, multiple-health behavior tool with psychosocial assessment and feedback features to facilitate and guide patient-centered communication, care, and follow-up related to prevention and self-management of the most common adult chronic illnesses seen in primary care.

Results

The Connection to Health Patient Self-Management System, a web-based patient assessment and support resource, was developed using the RE-AIM factors of reach (e.g., allowing input and output via choice of different modalities), effectiveness (e.g., using evidence-based intervention strategies), adoption (e.g., assistance in integrating the system into practice workflows and permitting customization of the website and feedback materials by practice teams), implementation (e.g., identifying and targeting actionable priority behavioral and psychosocial issues for patients and teams), and maintenance/sustainability (e.g., integration with current National Committee for Quality Assurance recommendations and clinical pathways of care). Connection to Health can work on a variety of input and output platforms, and assesses and provides feedback on multiple health behaviors and multiple chronic conditions frequently managed in adult primary care. As such, it should help to make patient-healthcare team encounters more informed and patient-centered. Formative research with clinicians indicated that the program addressed a number of practical concerns and they appreciated the flexibility and how the Connection to Health program could be customized to their office.

Conclusions

This primary care practice tool based on an implementation science model has the potential to guide patients to more healthful behaviors and improved self-management of chronic conditions, while fostering effective and efficient communication between patients and their healthcare team. RE-AIM and similar models can help clinicians and media developers create practical products more likely to be widely adopted, feasible in busy medical practices, and able to produce public health impact.