This prospective randomized controlled study will focus on the diffusion of innovation of cancer preventive services in the primary physician's practice. The intermediary organization will be the Medical College of Virginia Education Sciences Center led by the Department of Family Practice in collaboration with the Office of Continuing Education and the Massey Cancer Center. This organization has a unique history of connectedness with regional primary physicians and will collaborate with the Virginia Primary Care Association, Inc., a consortium of community health center practices, and the Virginia Insurance Reciprocal, a physician medical malpractice insurance company. Project goals include: 1. To demonstrate improved patient cancer prevention for cancer of the breast, cervix, oral cavity, and colon and rectum with supporting educational services as compared to control practices. 2. To diffuse the HealthTouch patient-initiated computer system with supporting educational services in all primary physician practices within the geographic sphere of influence of the Medical College of Virginia Health Sciences Center. 3. To integrate the HealthTouch system into the care of all practice patients age 18 and over. 4. To integrate the HealthTouch system into the patient care activities of receptionists, nurse, physician extenders, physicians and other members of the office health care team. 5. To maintain utilization of HealthTouch system as an integral part of the patient care activities in the practice after the intervention period. 6. To initiate the placement of the HealthTouch system into as many primary physician practices as possible with the state of Virginia. 7. To introduce the HealthTouch system into primary physician practices in contiguous and other states by the MCV office of Continuing Education in Medicine, Department of Family Practice, and Massey Cancer Center. The study population will include non-academic fee-for-service primary physicians and community health center practices within the geographical sphere of influence of the organization. This area has demonstrated increased cancer mortality time trends as compared to the United States at large. The innovation will be the integration of the HealthTouch system with supporting educational services into the existing core patient care activities in the primary physician practice. The method of diffusion will include demonstrations, regular site visits, and continuing communication with the MCV primary care academic faculty and trained liaison nurses. Evaluation will include focused interviews with physician decision makers and staff, quantitative utilization studies, chart audit, lab log audit, and patient telephone survey.
| Williams, R B; Boles, M; Johnson, R E (1998) A patient-initiated system for preventive health care. A randomized trial in community-based primary care practices. Arch Fam Med 7:338-45 |
| Williams, R B; Boles, M; Johnson, R E (1995) Use of prostate-specific antigen for prostate cancer screening in primary care practice. Arch Fam Med 4:311-5 |
