To promote relevant research to improve patient care, medical education, and community service.
At UC San Diego’s Division of family medicine we believe strongly that research is most useful when it addresses current clinical questions, helps direct resources to those who would benefit the most, and critically evaluates the benefits as well as possible costs of intervention. Therefore our efforts for the last decade have been not only on rigorous randomized controlled trials, but also on quality improvement projects that can be implemented and continued in practice independent of outside research funding. We assess the true impact of our educational efforts, examine how best to integrate research findings into our clinics and practices, and critically examine how our care best results in optimal outcomes.
We invite patients and research investigators to collaborate on designing projects that will have maximal impact on scientific and clinical communities as well as patient populations. In ways that protect patient privacy we examine information collected as part of routine clinical care at UCSD to uncoverpatterns of best practices in treatment and achievement of outcomes that promotes continuous improvement in our delivery of health care.
4 areas of focus:
- Improving Clinical Care
- Mental/Behavioral Health
- Chronic Illness
- Community Medicine
In Family Medicine we conduct ongoing evaluation of the care we provide. We collect information that is both directly useful in delivering optimal care for patients and can be analyzed to identify how to improve our practices. While we collaborate on randomized trials we emphasize more a quality improvement perspective that maintains the direct relevance of the research we do to the patients we serve.
- Colorectal Cancer (CRC) Screening
- The CRC screening project was a pre-visit approach to patient education and decision making where we mailed web access to a decision aid video to patients prior to their visit with their primary care physician. We found that those who watched the video were more likely to get screened (35%) than those who didn’t (17%).
- Using collaborative care (behavioral health) coaches as outreach providers we showed that simple messages of encouragement by phone can be an effective means of increasing self-management behaviors in patients with type 2 diabetes.
- We have built a system to utilize the patient web portal in UCSD’s Electronic Health Record to administer health behavior questionnaires. Patients completing these questionnaires then can be directed to services that fit their specific needs (e.g., group medical visits, behavioral health therapist).
- Group Medical Visits (GMVs) are designed to increase self-management behaviors in patients with chronic illness. However such groups are not consistently found to be helpful. Our group medical visits provide a group setting for patients to learn self-management skills, discuss goal setting and review their progress. Our analysis found that numerous barriers exist to successful implementation of GMVs and that overcoming the operational and financial obstacles to offering GMVs is necessary before they can be promoted as essential elements in a patient-centered medical home.
- We are in the planning stages of comparing health coaching to patients with multiple chronic illnesses by telephone or by in-clinic visits. Given the prevalence of patients with multiple health problems, it will be important to provide the best access to care to patients where mobility may be a challenge.
- The UCSD Center for Integrative Medicine is committed to contributing to the growing body of scientific research in the field of integrative health. Our scientists focus on evaluating integrative treatments that address multiple, whole-person aspects of wellness—biological, psychological, social and spiritual. To further support this burgeoning field, the Center’s research team has created a system to collect and analyze data derived from our clinical efforts in order to study the real-world patterns and outcomes of complementary and integrative medicine (CIM) use and support evidence-based integration into practice and care.
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