Relevant Footnotes for Wasson, Schwarz, and Hearst

Patient-Powered Quality Improvement Technology

for

Remodeling Primary Care

Pressures on Primary Care

A recent international survey of primary care that includes nations with very different payment systems confirms that the cumulative adverse impacts of “time spent processing insurance payments, getting patients medications or treatments because of coverage restrictions, and reporting clinical or quality of care data to external entities."

When primary care physicians were recently surveyed about the value of a well-intentioned 70 measure on-line patient health assessment, almost half reported that the results were not helpful, and more than half heard complaints about it from their patients. Their comments are telling: "We are screening for things for which we have nothing to offer. We don't have resources to help with education, housing, safety and so on," and "We need to really think about data we can do something with!"

Munira Gunja et al., Stressed Out and Burned Out: The Global Primary Care Crisis — Findings from the 2022 International Health Policy Survey of Primary Care Physicians (Commonwealth Fund, Nov. 2022). https://doi.org/10.26099/j2ag-mx88

Mou D, Horn DM, Heng M, et al.(2022) Primary care physician’s (PCP) perceived value of patient-reported outcomes (PROs) in clinical practice: a mixed methods study. BMJ Quality & Safety. 31:221-229.

Waste and Sludge

Pfeffer J, Witters D, Agrawal SA, Harter JK. Magnitude and Effects of "Sludge" in Benefits Administration: How Health Insurance Hassles Burden Workder and Cost Employers. 220, Vol G, No. 3, 325-340. https://journals.aom.org/doi/10.5465/amd.2020.0063

Shrank WH, Rogstad TL, Parekh N. Waste in the US Health Care System: Estimated Costs and Potential for Savings. JAMA. 2019;322(15):1501–1509. doi:10.1001/jama.2019.13978

The Broad Spectrum of Bias and Dishonesty

Krauss, Alexander (2018) Why all randomized controlled trials produce biased results. Annals of Medicine. ISSN 0785-3890. DOI: https://doi.org/10.1080/07853890.2018.1453233

Once-Weekly Semaglutide in Adults with Overweight or Obesity

John P.H. Wilding, D.M., Rachel L. Batterham, M.B., et.al. N Engl J Med 2021;384:989-1002

Meite A, Herren M, Jafari MD, Pigazzi A. Discrepancies in Conflict-of-Interest Disclosures Among Physicians Receiving Compensation for Monoclonal Antibody Drugs. J Gen Intern Med. 2024 May;39(7):1135-1141. doi: 10.1007/s11606-023-08523-7. Epub 2023 Nov 14. PMID: 37962731; PMCID: PMC11116311.

Wasson JH. (2019) Insights from Organized Crime for Disorganized Health Care. Journal of Ambulatory Care Management, 42, 138-146

The Need for and the Opportunities Offered by a SAINT

SEE ATTACHED: Wasson JH. (2020) Standardized Assessment, Information, and Networking Technologies (SAINTs) Lessons from Three Decades of Development and Testing" Quality of Life Research 2020. (DOI: 10.1007/s11136-020-02528-z)

For More Information Contact: John.H.Wasson@Dartmouth.edu

JHW declares no conflicts of interest. Under license with the Trustees of Dartmouth College, JHW develops and freely distributes HowsYourHealth.org and related websites for research and clinical practice. When academic or clinical users modify the material, the Trustees of Dartmouth College request that the source be attributed. Commercial users are requested to obtain a license.

AS and EH declare no conflicts of interest.