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What Were the Top 5 AJAC® Articles in 2017?

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This year, papers published in The American Journal of Accountable Care® (AJAC®)explored novel notes systems, telemedicine, alternative payment models, specialist consult coordination, and health workforce use within accountable care organizations, in addition to many other topics. These 5 articles exploring the meaning of quality and how to achieve it were the most read from AJAC® in 2017.

The American Journal of Accountable Care® (AJAC®) publishes research and analysis that encourages the sharing of best practices to ensure the improvement of healthcare quality. This year, papers explored novel notes systems, telemedicine, alternative payment models, specialist consult coordination, and health workforce use within accountable care organizations, in addition to many other topics.

These 5 articles exploring the meaning of quality and how to achieve it were the most read from AJAC® in 2017.

5. Successful Implementation of APSO Notes Across a Major Health System

Researchers were able to show widespread adoption of APSO (Assessment, Plan, Subjective, Objective) notes in the inpatient and outpatient academic and community settings. This study evaluated APSO (Assessment, Plan, Subjective, Objective) as a novel note type that could decrease the time clinicians spend in chart review by placing the integral assessment and plan components at the top of the note.

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4. Telemedicine and its Role in Revolutionizing Healthcare Delivery

Given the current focus on efforts to contain costs, improve the delivery of care, and meet consumer demand, telemedicine is an attractive tool to use for success in these areas. Telemedicine significantly contributes to the provision of healthcare in underserved areas through services such as telestroke, telecardiology, teledermatology, telepediatrics, telepsychiatry, and teleneonatology care. Among other benefits, the use of telemedicine improves follow-up care, ensures patient access to services, and allows providers to treat patients at home and in remote areas.

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3. Creating Successful Alternative Payment Models

The success of alternative payment models (APMs) will depend heavily on how they are designed and implemented—just because a payment model is different does not mean it will be better. The authors draw on the experience of past and present payment reforms to suggest 5 principles for successfully designing APMs.

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2. Consult Coordination Affects Patient Experience

Given that accountable care organizations (ACOs) will be rated on patient experience and wait times for specialist consults are associated with patient satisfaction, ACOs should monitor this process. Because patients often report high levels of powerlessness and uncertainty while waiting for consultation, these wait times are an important patient-centered access metric for ACOs to consider. ACOs should have systems and tools in place to streamline the referral process and increase care coordination.

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1. Evolving Health Workforce Roles in Accountable Care Organizations

This qualitative study draws on interviews with clinical staff to examine health workforce use within ACOs and identifies common roles that support value-based care. ACOs report considerable changes in health workforce roles to meet the aims of value-based payment models, but significant differences between models remain. Due to the need to tailor care models to the needs of the local population, a single model of care is unlikely to emerge.

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