Matching Patients And Their Records
Despite widespread adoption of electronic health records and increasing exchange of health care data, the benefits of interoperability and health information technology have been hampered by the inability to match patients and their records reliably. The Pew Charitable Trusts contracted with the RAND Corporation to investigate "patient-empowered" approaches to record matching — solutions that have some additional, voluntary role for patients beyond simply furnishing demographics to their health care providers — and to select a promising solution for further development and pilot testing. A report recommends adopting a three-stage approach that aims to: improve the quality of identity information; establish new smartphone app functionality to facilitate bidirectional exchange of identity information and health care data between patients and providers; and create advanced functionality to improve value further. The report also suggests that because the solution contains multiple components involving diverse stakeholders, a governance mechanism likely will be needed to provide leadership, track pilot tests, and evaluation, along with convening key parties to build consensus where consensus is needed. The report can be obtained at https://www.rand.org/pubs/research_reports/RR2275.html.

Reasonable Patient Care Under Uncertainty
An article published on August 2, 2018 in the journal Health Economics discusses how limited ability to predict illness and treatment response may affect the welfare achieved in patient care. The discussion covers both decentralized clinical decision-making and care that adheres to clinical practice guidelines. The author explains why predictive ability has been limited, calling attention to questionable methodological practices in the research that supports evidence‐based medicine. Research is summarized on identification whose objective is to yield credible prediction of patient outcomes. Recognizing that uncertainty will continue to afflict medical decision making, basic decision theory is applied to suggest reasonable decision criteria with well‐understood welfare properties. The article can be obtained at https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.3803.

Patient-Centered Medical Homes And Accountable Care Organizations
Patient-centered medical homes (PCMHs) and accountable care organizations (ACOs) often were considered to be competing models for reforming health care delivery. It increasingly has become apparent, however, that one helps the other, according to the main finding from the new Patient- Centered Primary Care Collaborative (PCPCC) 2018 evidence report, “Advanced Primary Care: A Key Contributor to Successful ACOs,” the first study of its kind to look at how the role of advanced primary care, such as the PCMH, may contribute to the success or failure of ACOs. While these two leading models are transforming health care delivery and payment, little research has been done on how these models interact to promote lower costs and better quality for populations. Using qualitative and quantitative methods, researchers at the Robert Graham Center and IBM Watson Health found that: The attributes of successful ACO’s are necessary to transform the practice of primary care, successful ACO’s are more likely to be built on the basis of high- quality primary care, Medicare ACOs with a higher proportion of PCMH primary care physicians were more likely to generate savings, and Medicare ACOs with a higher proportion of PCMH primary care physicians demonstrated higher quality scores, including on a significant number of process and outcome measures. The report was published with support from the Milbank Memorial Fund for the fifth time. The document can be obtained at https://www.milbank.org/wp-content/uploads/2018/08/advanced_primary_care_report_080118.pdf.

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