Patient-Centered Design of Medical Management Programs at Cambridge Health Alliance

Client: Cambridge Health Alliance (CHA)
Topic Areas: Behavioral health and substance use; Healthcare delivery systems
Services: Assessment and Planning, Training and Technical Assistance

Cambridge Health Alliance (CHA) is a safety-net healthcare system serving an ethnically and linguistically diverse patient population in Boston’s metro-north region. As part of its population health management strategy, CHA developed medical management programs with the goal of improving quality and reducing cost of care for chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), diabetes, opioid use disorder (OUD), and chronic pain.

During the program design phase, ICH provided support to help CHA gather qualitative patient input to understand how best to engage patients in care and support them to have an active role in the management of their health conditions. ICH first facilitated discussions with medical management program designers to identify key areas for patient input and feedback. ICH then developed interview guides and conducted brief interviews with patients who had COPD, CHF, diabetes, OUD, or chronic pain. Interviews focused on the experience of living with the health condition in question, strategies for self-management, interactions with the healthcare system, and input on services and supports that would be helpful for patients. ICH summarized interview data in patient profiles that helped CHA understand the day-to-day experience of living with each health condition and the factors that are most important to patients’ health and overall quality of life. The data also helped CHA understand barriers and facilitators to program engagement and disease self-management.

CHA used the interview data to guide the design of the disease management programs and identify specific interventions and services that would add value from the patient perspective and support patient engagement. Overall, ICH’s TA helped CHA ensure that the medical management program design process included the voices of patients and that the priorities and needs of the populations served were taken into account during programmatic decision-making.

Related Resources

COPD Patient Profile - 84 year old female: COPD-Patient-Profile-84-year-old-female.pdf