AHRQ’s New Evidence-Based Guide Helps Implement Health Assessments in Primary Care Settings

AHRQ has announced an evidence-based guide designed to help primary care doctors, nurses and other staff select, adopt and implement health assessments. The Affordable Care Act authorized annual wellness visits for Medicare beneficiaries and specifies that a health risk assessment be included as part of those visits. The Health Assessments in Primary Care: A How-to Guide for Clinicians and Staff combines the best evidence for successful implementation of the assessments in the primary care setting, with tools to help clinicians decide which health assessments to use, integrate them into their daily workflow and maintain the process. The Guide can be used by practices that maintain electronic health records and those that continue to use paper charts.

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Health Assessments in Primary Care

A How-to Guide for Clinicians and Staff

Prepared for:
Agency for Healthcare Research and Quality
U.S. Department of Health and Human Services
Prepared by:
University of Colorado School of Medicine, Department of Family Medicine, the Colorado Health Outcomes Program, and the Shared Networks of Collaborative Practices and Partners (SNOCAP)
Contract No. HHSA29020071008
Authors:
Douglas H. Fernald, M.A.
Adam G. Tsai, M.D., M.S.C.E.
Betsy Vance, M.P.H.
Katherine A. James, Ph.D., M.S.C.E., M.S.P.H.
Juliana Barnard, M.A.
Elizabeth W. Staton, M.S.T.C.
Wilson D. Pace, M.D.
David R. West, Ph.D.

Introduction
Section 1. How Ready is Your Practice to Implement a New Health Assessment?
Section 2. How Does Your Practice Choose an Assessment?
Section 3. How Do You Work Health Assessments into Your Office Workflow?
Section 4. How Do You Use the Health Assessment Information You Collect?
Section 5. How Do You Activate and Engage Patients in Using Their Health Assessment Information?
Section 6. How Does Your Practice Sustain Health Assessments?
Appendixes
Appendix 1: Background on Health Assessments in Primary Care
Appendix 2: Health Assessment Case Study
Appendix 3: Health Assessments for Adults
Appendix 4: Adult Health Assessment Sample Questions
Appendix 5: Assessments for Children
Appendix 6: Assessments for Adolescents
Appendix 7: Health Assessments for Seniors
Appendix 8: Crosswalk of Health Assessments Related to Incentive and Quality Programs
Appendix 9: Tools for Making Changes in Your Practice
Appendix 10: Health Assessment Information for Patients
Appendix 11: Patient Feedback Survey Example
References
Disclaimer
This toolkit is based on research conducted by SNOCAP-USA under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA29020071008). The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment.
Public Domain Notice
This document is in the public domain and may be used and reprinted without permission.
Acknowledgements
SNOCAP-USA is grateful to the primary care practices that participated in the pilot project and freely shared their experiences so that future practices could learn. We wish to extend our thanks to each practice for their hard work and effort, as well as their willingness to participate in the evaluation:

Belmar Family Medicine.
Emory Family Medicine.
Exempla Capitol Hill Internal Medicine.
Exempla Green Mountain Family Medicine.
Exempla Oasis Family Medicine.
Family Care Medical Center.
Foothills Family Medicine.
Rocky Ford Family Health, LLC.
Sheridan Health Services.
University of Colorado Family Medicine, Park Meadows.
Walsh Medical Clinic.

We also thank the practice-based research networks—and their clinicians and staff—including Building InvestiGative practices for better Health Outcomes Research Network (BIGHORN), the Colorado Research Network (CaReNet), the High Plains Research Network (HPRN), and the American Academy of Family Physicians National Research Network (AAFP NRN). We extend special thanks to Richard Ricciardi, Ph.D., N.P., who provided outstanding support, direction, and feedback throughout this guide's development and production.

Current as of September 2013

Internet Citation: Health Assessments in Primary Care: A How-to Guide for Clinicians and Staff. September 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/prevention-chronic-care/improve/system/health-assessments/index.html

Health Assessments How-To Guide

New Evidence-based Guide Helps Implement Health Assessments in Primary Care Settings

Press Release Date: November 21, 2013

An evidence-based guide designed to help primary care doctors, nurses and other staff successfully select, adopt and implement health assessments was released today by the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ).
Health assessments are used to collect information to help primary care providers evaluate a patient’s health status and risks. The information is used to identify potentially problematic but treatable health behaviors and factors such as anxiety, alcohol use, depression, unhealthy eating, and sedentary lifestyle that patients often don’t bring up during a medical visit. However, research shows that many patients do not receive an assessment of health risks or a plan to address those risks. The Affordable Care Act authorizes Medicare coverage of annual wellness visits and specifies that a health risk assessment be included as part of those visits.
"The guide provides practical and evidence-based methods to implement health risk assessments and ultimately to engage patients in making lifestyle changes to improve their health," said AHRQ Director Richard Kronick, Ph.D.
Health Assessments in Primary Care: A How-to Guide for Clinicians and Staff employs the best current evidence for successful implementation of health assessments in the primary care setting. It includes tools to help clinicians decide which health assessments to use, how to integrate them into their daily workflow and how to maintain the process. The guide is designed for practices that use electronic health records as well as those that use paper charts.
The guide gives clinicians sample health assessment questions for seniors, adults, adolescents and children. It also provides a crosswalk of health assessments related to incentive and quality programs. Sample health assessment information for patients and a patient feedback survey are included. These tools represent findings from observations and interviews with primary care providers, staff and administrators.
The health assessment guide was developed by a team of researchers led by Douglas Fernald, M.A., and David West, Ph.D., in the Department of Family Medicine at the University of Colorado School of Medicine, the Colorado Health Outcomes Program, and the Shared Networks of Collaborative Practices and Partners. The guide was pilot-tested by primary care practices in Colorado, New Jersey, Georgia and Louisiana.
Use Twitter to get AHRQ news updates: http://www.twitter.com/ahrqnews/
For more information, please contact AHRQ Public Affairs: (301) 427-1244.

Current as of November 2013

Internet Citation: Health Assessments How-To Guide: New Evidence-based Guide Helps Implement Health Assessments in Primary Care Settings. November 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsroom/press-releases/2013/hapcpr.html