For complex patients with multiple competing concerns, the 15-minute primary care appointment can be a challenge – what to prioritize, what to ask, how to make sure the patients’ needs are being met. As a result, primary care patients with complex multimorbidities often report poor relationships with their providers and that they do not have all of their needs addressed in the brief primary care setting. Wittink and colleagues (2016) developed a tool called Customized Care (CC), which involves patients completing a series of adaptive questions on an iPad designed to help them prioritize their concerns and items they’d like to address at today’s appointment. In this presentation, we will first describe in more detail how CC works, including information about its efficacy in non-VA and non-integrated settings. We will then discuss the current project of conducting formative feedback evaluations, which used Proctor’s implementation model to guide questions, with six primary care physicians, six primary care nurses, and two primary care administrative assistants recruited from VA integrated primary care settings. Questions focused on feasibility, acceptability, and barriers to implementing CC in a VA primary care setting. Overall, 13/14 participants thought that CC could be used, or could be adapted to be used, in VA primary care. Common themes of benefits of CC included helping complex patients narrow in on 1-2 key items to discuss, helping patients to remember their priorities, and helping patient/providers have a more efficient, goal-driven conversation. Nine of fourteen participants stated that technology barriers may prevent some veterans, particularly older veterans, from using the iPad, and four participants believed a non-computerized version would work better in their setting. Using CC as a tool to improve access to the integrated care provider was also discussed as a common potential benefit of implementing CC in VA primary care clinics. Overall, interviewees thought that CC would generally be a valuable addition to their clinical practice and had thoughts about using it flexibly in their setting with different patients. Participants in this session will learn about what types of concerns providers had when considering how to fit CC into their clinics, as well as how such tools are thought to streamline processes to link patients to integrated care providers. These results, and other themes, will be discussed, as will our plan for altering CC based on these data to pilot in VA primary care clinics.
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