Closed for Enrollment

• A Simulation Study of the Medicare Access and Chip Reauthorization Act Rochester, Minn.

  A better understanding of the changes in clinician behavior as a result of finance reform could lead to significant improvements in patient safety. In the past decade, regulators and insurers have increasingly lobbied for payment based on outcomes believing that this would improve safety and patient-centered care. However, studies have not shown improvement in performance and reduction of costs, which is likely because outcome-based payment incentives create conflict for clinicians. That is, an increased reliance on outcome-based payment incentives may misdirect clinicians’ focus from patient-centered care to outcome-centered care. The disconnect between the success of organizations without outcome-based incentives and the push for these finance models demonstrates the need for a better understanding of the fundamental drivers behind high quality care and patient safety. The goals of this project are twofold: Our short-term goal is to use healthcare simulations to improve our understanding of how outcome-based payments change clinician behavior. Healthcare simulations create a test-bed environment for new health care delivery models by replicating a health care event with patient actors. Our long-term goal is to leverage our findings to promote evidence-based payment models designed to increase patient safety by decreasing the likelihood of medical error.

• Mayo Clinic Care Network Population Health Management Rochester, Minn.

  The purpose of this study is to understand the focus and perceived gaps in population health from each of the Mayo Clinic Care Network member sites and what would be most helpful to them.

• Post-Market Surveillance With a Novel mHealth Platform Rochester, Minn.

  This is a study to pilot the feasibility of using a novel patient-led, smartphone-based mobile health platform (Hugo) for real-world surveillance of outcomes of patients after sleeve gastrectomy and catheter-base atrial fibrillation ablation.

• Shared Decision Making in Parents of Children With Head Trauma: Head CT Choice Rochester, Minn.

  The investigators will test the impact of a decision aid, Head CT Choice, to determine if its use improves parents' knowledge and engagement in decision making and safely decreases healthcare utilization in children presenting to the emergency department with blunt head trauma.

• The PCI Choice Trial: a Pilot Randomized Trial of a Decision Aid for Patients With Stable Coronary Artery Disease Rochester, Minn.

  Despite several large clinical trials clearly establishing that coronary revascularization (i.e. percutaneous coronary intervention - PCI) does not prolong survival or prevent myocardial infarction (MI) for stable coronary artery disease (CAD), patients with stable angina continue to believe that PCI is performed to improve these outcomes. Additionally, recent concerns have emerged of overuse of PCI among patients with little or no angina. Thus there is a compelling need to share with patients the risks and benefits of PCI prior to treatment to reach an informed decision.

  This study is designed to answer the question of whether a decision aid can improve patient knowledge, decisional conflict and patient satisfaction with decision-making compared to usual care for the treatment of stable angina.