By Lisa Rotenstein MD MBA, Founder of CareZooming

As a resident physician in internal medicine who has my own primary care panel, and the Co-Founder of CareZooming, I loved the opportunity to learn at the Putting Care at the Center 2018 conference. CareZooming is a platform that crowdsources information about ambulatory care delivery. Our core mission is to reduce the extent to which people “reinvent the wheel.” So, we learn how people all around the US are improving ambulatory care delivery – whether having to do with behavioral health, chronic disease management, digital health, and more – and write it up into an easy to understand step-by-step format. In contrast to journal articles that focus on the statistical significance of an intervention, we focus on the why, and how, and what did you learn. We are particularly interested in how care is delivered to medically and socially complex populations, and how all members of the care team are involved in enhancing delivery. This made Putting Care at the Center the perfect conference for us. 

Implementation Focus

Given these goals, I particularly enjoyed the conference’s focus on standards of practice. As outlined in the National Center’s Blueprint for Complex Care, standards of practice can take many forms, including codifying practices, developing and disseminating models and solutions, training and professional development programs, and establishing processes that ensure fidelity in implementation. 

J-PAL focused on implementation challenges in its workshop Will it Work Here? A Generalizability Framework for Applying Evidence in New Contexts. In the session, we were taught to articulate a “theory of change” for an intervention that could explain why it worked in its setting of origin (i.e. how the components of the intervention mapped to the needs and population). The presenters then helped us analyze what the critical assumptions are that should be met for the program to be implemented with fidelity in another setting, and what the enabling and hindering factors for translation might be. This framework is key for those of us at CareZooming seeking to design our content to meet the implementation needs of diverse organizations with tailored evidence.

Technology Options

Technology is an increasingly critical part of any implementation effort (in fact, it’s a key question we ask when we put together CareZooming’s protocols), and it was a breath of fresh air to learn about technology options available for taking care of complex populations in the conference’s interactive Beehive. For example, Aunt Bertha helps people find and apply for government and charitable programs. Similarly, Health Leads has a platform that helps organizations make referrals for their patients to address their “essential needs” i.e. housing, food, heat, while also sponsoring learning collaboratives that help organizations share best practices around essential needs. NowPow connects patients to local resources but uniquely allows providers to write “prescriptions” to local resources using EHR integration. Each of these organizations is redefining what it means to use technology in the clinical setting. Rather than being just another app or gadget, these platforms are bringing communities closer to their resources and integrating them with the medical system. 

Multidisciplinary Collaboration
One of the things I loved the most about Putting Care at the Center was the conference’s multidisciplinary nature. At most conferences I attend, physicians are preponderant. At Putting Care at the Center, I got a chance to meet and learn from a diverse set of individuals, including social workers, community health workers, nurses, patient advocates, and more. The diversity made my conference experience particularly rich and provided me a unique perspective on the implementation questions I was hoping to learn about. 

Thanks to the Camden Coalition’s National Center team for such an enriching experience!

This blog post was developed by a scholarship recipient from the Camden Coalition’s National Center for Complex Health and Social Needs conference Putting Care at the Center 2018. Register for this year’s conference at www.centering.care.  

Biography:

Lisa Rotenstein is a physician at Brigham and Women’s Hospital/Harvard Medical School and the Co-Founder of CareZooming, a platform that helps clinicians and administrators avoid re-inventing the wheel in care delivery. She has authored work on care delivery innovation, physician wellness, and healthcare leadership in outlets such as JAMA, NEJM, Annals of Internal Medicine, and the Harvard Business Review. While CareZooming focuses on all aspects of ambulatory care delivery, Dr. Rotenstein’s particular expertise lies in enhancing systems of care to enhance the physician and patient experience, care for complex populations, and novel uses of technology in care delivery innovation.