said Marci Nielsen, PhD, of the Patient-Centered Primary
Care Collaborative, an organization in Washington, D.C., that
promotes patient-centered medical homes within primary care.
Several speakers advocated for bundled payments based on the
effectiveness of the treatment versus current fee-for-service
payments, as well as more equal pay for providers of primary
services versus specialists.
But before that can happen, more research is needed to
show that integrated care is improving patient outcomes.
James Witter, MD, chief science officer of the Patient-Reported
Outcomes Measurement Information System (PROMIS), an
initiative of the National Institutes of Health’s Roadmap for
Medical Research, explained that the payment system is based
on how patients view their symptoms and quality of life. It is
being tested in a dozen clinical sites.
“There are common core health outcomes that can be
“Googling [a disease] is a sign of patient engagement. If they’re
measurable in all patients,” he said. “We focus on domains like
physical function, pain, anger and anxiety.”
Ultimately, patients are the main stakeholders in their care.
To that end, providers should help patients educate themselves,
helping people use such tools as Web information and online
forums so that they can be “equipped, engaged, empowered
Dave” — an author and advocate for patient engagement.
not good at it, do we smack them down and say, ‘Stop that,’ or
do we coach them?” he asked.
A number of attendees called for APA to lead future
efforts, including crafting a global mission statement for
integrated health. Summit conveners are now working on
recommendations from the meeting’s working groups that they
hope to share in interdisciplinary journals. In addition, there
are plans to develop continuing-education materials such as
webinars, and possibly hold future meetings that also involve
stakeholders outside of health, such as professional and labor
“Some of the work has to be done at the visionary level and
some of it at the boots-on-the-ground level. If we can pursue
both, that would be ideal,” said Mary Ann McCabe, PhD,
associate clinical professor of pediatrics at George Washington
University and chair of the summit’s planning committee. n
Watch a video of the summit at www.apa.org