Strategies Implemented by Prescription for Health Projects by Domain of the Chronic Care Model
| Domain | Implementation Strategies |
|---|---|
| PDA = personal digital assistant (ie, handheld computer). | |
| Community resources | Locally based community health advisors Web-based directories of community resources Web links to relevant information or resources outside community (regional or national) |
| Health care organization | Practicewide assessments Clinician assessments (attitudes, satisfaction, readiness to change) Evaluation of use of specific tools or techniques Negotiated support from insurers for project activities |
| Self-management support | Patient-centered goal setting and action plans Motivational interviewing techniques Physical activity and dietary logs Community resource directories Local walking club Periodic follow-up from health change facilitators, educators, or advisors Telephone and e-mail follow-up and support Pedometers Tailored behavior change educational materials or information |
| Delivery system design | Patient questionnaires before visit and ongoing (Web-based) Staff role changes and education Health advisors, educators, coaches/health change facilitators Brief interventions Periodic health assessments (vital signs and others) Prescription pads for health behaviors Group visits Telephone and e-mail follow-up support |
| Decision support | Patient-reported health behavior information (before, during, and between visits) Relevant preventive services guidelines Patient readiness-to-change assessments Streamlined evidence-based assessment and screening tools Tailored scripts and techniques Patient-tailored care recommendations Targeted evidence-based recommendations Electronic (Web, PDA) decision-support tools |
| Clinical information systems | Patient registries Reminder systems (electronic, posters, assessments, patient-reported behavior indicators, other) Patient-completed screening tools Logs and behavioral questionnaires Expanded vital signs to include risky health behaviors |