Figure 1
Scoping review flow chart.
Table 1
Triple Aim assessment (step 2) before implementation of PHM interventions for type 2 diabetes.
| PHM INITIATIVES WITH TRIPLE AIM ASSESSMENT | ASSESSMENT ACTIONS |
|---|---|
| PROPS Study (Partnerships for Reducing Overweight and Obesity with Patient-centred Strategies) [PHM] [3940] | Quality of care: eligible patients were asked about their motivation to lose weight and only patients who were motivated were eligible (responsiveness) |
| Project Endo ECHO: Telementoring for care providers [PM] [32333441] | Quality of care: prior to the launch, the primary care clinicians and community health workers participated in a 2-day face-to-face training (safety) |
| Integrated disease management [PM] [46] | Quality of care: dissemination of program in three phases, each building on prior experiences (initial design, formal pilot, broad program dissemination) |
| INtegrating DEPrEssioN and Diabetes treatmENT (INDEPENDENT) care [PHM] [3556] | Quality of care: potential participants were approached whether they were interested to participate (responsiveness), cultural modifications were made based on formative research (responsiveness), prior to patient enrolment teams at each site received training in process measures and treatment measures within the initiative (safety) |
| Integrated diabetes care pilot [PHM] [55] | Quality of care: clinical audit to help target resources |
| Mobile health (mHealth) Self-Management Intervention [PHM] [47] | Quality of care: all intervention components were designed to be culturally sensitive, and content addressed self-management facilitators and barriers common in this population (responsiveness), eligible patients could opt out of the study (responsiveness) |
| Population-based evidence-based medicine [PM] [48] | Quality of care: patients had the option to decline starting or increasing lisinopril therapy (responsiveness) |
| Preventing Heart Attacks and Strokes Everyday (PHASE) program [PHM] [3750] | Quality of care: specially trained diabetes care manager nurses and pharmacists support the primary care team (safety) |
| The Diabetes Master Clinician Program (DMCP) [PM] [51] | Quality of care: training for clinicians, medical assistants, nurses (safety) |
| International community health service PHM program (multilingual) [PHM] [52] | Quality of care: PHM interventions could be offered, received, or refused (responsiveness) |
| Registry population management [PM] [53] | Quality of care: pre-existing problems related to effectiveness (unclear effectiveness of interventions, inefficient tracking and managing patient data, and poor information exchange) and accessibility (no tracking and fewer interventions for non–pay-for-performance patients) were addressed |
Table 2
Domains of the Triple Aim assessed for impact evaluation in PHM initiatives for type 2 diabetes.
| Population health | Health outcomes | • | • | • | • | • | • | • | • | • | • | • | • | • | • | • | • | ||
| Disease burden | |||||||||||||||||||
| Behavioural/psychological factors | • | • | • | ||||||||||||||||
| Participation | • | • | |||||||||||||||||
| Functioning/QoL | • | • | |||||||||||||||||
| Quality of care | Quality of care | • | • | • | • | • | • | • | |||||||||||
| Patient safety | • | ||||||||||||||||||
| Effectivity | • | • | • | • | • | ||||||||||||||
| Responsiveness | • | • | • | • | • | • | |||||||||||||
| Timeliness | |||||||||||||||||||
| Support | • | • | • | ||||||||||||||||
| Accessibility | • | • | |||||||||||||||||
| Costs | Costs of care | • | • | • | • | ||||||||||||||
| Volume | |||||||||||||||||||
| Costs PM organization | • | • | |||||||||||||||||
| Productivity losses (indirect) | • | ||||||||||||||||||
| PHM initiatives refs: | [38] | [3940] | [32333441] | [54] | [42] | [4344] | [45] | [46] | [3556] | [55] | [47] | [48] | [49] | [3750] | [51] | [52] | [53] | [16] | |
[i] Notes: • indicates that the specific domain was evaluated in the initiative. Empty cells indicate that the specific domain was not evaluated in the initiative. Grey areas indicate that no domains of that Triple Aim dimension were evaluated in the initiative.