NEJM Catalyst

The May 2024 issue of NEJM Catalyst Innovations in Care Delivery highlights climate change, integrating AI to improve clinical note quality, a new quality initiative, cancer care in rural settings, lung cancer screening in urban systems, overdose prevention centers in the U.S., and focused care teams for alcohol-related conditions in the U.K.: https://nej.md/4avdyM8 Read or listen to the editor letter, The Macro Trends Driving Care Delivery: https://nej.md/4cSmkVY Climate Change Action: Important but Lagging https://nej.md/3Jm4tcg with Kathy Gerwig, Health Care Without Harm, and Lisa Patel, MD, MESc, Stanford Medicine Children’s Health The Benefits of Environmental Sustainability Efforts https://nej.md/4as3zHg with Frederik Wenz, University Medical Center Freiburg, William Weppner, Boise Veterans Affairs Medical Center, and Jimmy Chung, MD, MBA, FACS, FABQAURP, CPE, CMRP, Advantus Health Partners NYC’s Overdose Prevention Centers: Data from the First Year of Supervised Consumption Services https://nej.md/4cUg3ce with Jonathan McAteer, Shivani Mantha, Brent Gibson, Casey Fulmer, Alex Harocopos, Kailin See, Sam Rivera, Ajani Benjamin, Angela Jeffers, Jonathan Giftos, and Dr. Ashwin Vasan, NYC Department of Health and Mental Hygiene and OnPoint NYC Scaling Note Quality Assessment Across an Academic Medical Center with AI and GPT-4 https://nej.md/3vTyKMD with Jonah Feldman MD, FACP, Katherine Hochman, Benedict Vincent Guzman, Adam Goodman, Joseph Weisstuch, and Paul Testa, NYU Langone Health Population Health Nurse–Driven Lung Cancer Screening https://nej.md/3PVgwRx with Emily Jansen, MPH, Judith Bolivar, Sandra Auguste, Mary Clancy, Lauren Kearney, Leila Henderson MHA, MSN, RN, PCMH CCE, CPHQ, CPPS, CPHIMS, Katrina Steiling, and Nicholas Cordella, Boston Medical Center (BMC) The Alcohol Care Team Model: A Holistic Approach to Address Alcohol Dependence and Withdrawal https://nej.md/3UfTsj5 with Darren Quelch, Carol Appleyard, Bev John, Gareth Roderique-Davies, Sally Bradberry, and Arlene Copland, Sandwell & West Birmingham NHS Trust The Case for Decentralizing Cancer Care: The Rural Oncology Home https://nej.md/3Q26Ncq with Wade Swenson, Melissa Lindow, Joe Reycraft, Lisa Bjerga, Zachary Schroeder, Abigail Swenson, and Emily Westergard, DO, Lakewood Health System Rural Cancer Institute  Elevating Quality, Outcomes, and Patient Experience Through Value-Based Care: CMS Innovation Center’s Quality Pathway https://nej.md/3xoXUmU with Susannah Bernheim, Noemi Rudolph, Jake Quinton, Julia Driessen, Purva Rawal, and Elizabeth Fowler, Centers for Medicare & Medicaid Services

Although supervised consumption spaces have achieved successes in preventing overdose deaths through wraparound services centered in a harm-reduction approach, the precarious nature of funding streams, legal status, and community concerns presents challenges to sustainability for the overdose prevention center model: https://nej.md/4cUg3ce

NEJM Catalyst Insights Council members in the United States and Germany discuss sustainability efforts in health care: https://nej.md/4as3zHg

Most NEJM Catalyst Insights Council members say that environmental sustainability is personally important to them. Read more about health care's progress toward going green: https://nej.md/3Jm4tcg

The May 2024 issue of NEJM Catalyst Innovations in Care Delivery highlights macro trends affecting care delivery and care across different settings: https://nej.md/4avdyM8

The May 2024 issue of NEJM Catalyst Innovations in Care Delivery includes articles, case studies, and research reports on a variety of timely and important topics: climate change, integrating AI to improve clinical note quality, the U.S. Center for Medicare & Medicaid Innovation Center’s new quality initiative, cancer care in rural settings, lung cancer screening in urban systems, overdose prevention centers in the U.S., and focused care teams for alcohol-related conditions in the U.K. Read or listen to our letter from the editors to learn more: https://nej.md/4cSmkVY

Despite significant advances in cancer therapies over recent decades, the United States grapples with growing disparities in cancer-related outcomes between its rural populations and urban and suburban counterparts. These disparities can be attributed, in part, to the centralization of oncology services within urban centers, which concomitantly imposes heightened travel demands on rural patients, constricting their access to comprehensive cancer treatment and specialized care. Historically, strategies such as the visiting consultant outreach model have been deployed to improve service accessibility, yet they offer only fragmented solutions to the multifaceted challenge of equitable care distribution. In response to this challenge, the authors introduce the rural oncology home, an alternative model for rural oncology care delivery. This innovative approach is centered on a community-based, team-oriented framework that incorporates medical specialists and emphasizes supportive services. By leveraging advanced practice professionals and care coordination, the model aims to enhance the accessibility of specialized cancer care for rural patients. Such models for rural oncology care delivery are emerging, with a pronounced emphasis on leveraging telehealth technologies. The Lakewood Health System Rural Oncology Home model can potentially create a more equitable system of cancer care delivery that can bridge the rural cancer gap and improve outcomes for rural patients with cancer: https://nej.md/3Q26Ncq

In our first year, our Overdose Prevention Centers diverted up to 39K instances of public drug use, while connecting 75% of our participants to other services. Conducted in collaboration with NYC Department of Health and Mental Hygiene and OnPoint NYC staff Sam Rivera, Kailin See, and Brent Gibson, a new study provides an analysis of our OPCs and discusses key findings. View the abstract on NEJM Catalyst. https://bit.ly/3JA49GY

The U.S. Center for Medicare and Medicaid Innovation is launching a new Quality Pathway to elevate patient-centered quality goals in the design and evaluation of alternative payment models. The Quality Pathway will align model design around quality goals; elevate outcomes and experience measures, particularly patient-reported outcomes; and ensure that evaluations have the ability to assess the impact of models on primary quality goals. These determinations will help the Innovation Center make critical decisions about which models to scale or expand in the pursuit of improving the quality of care for people with Medicare and Medicaid: https://nej.md/3xoXUmU

Medical service quality and patient safety are pivotal to hospital management. Recent years have witnessed the evolution of China’s medical quality management and control system, resulting in improvements in medical services and patient safety. Based on the 2021 National Report on the Services, Quality and Safety in Medical Care System, the authors analyzed the current situation of the health care quality and safety of China’s medical services using annual hospital quality survey data and routine administrative and quality control data. The key indicators primarily focused on medical services, medical quality and safety, clinical specialty services, and regional medical services. Findings indicate a steady improvement in the supply of medical resources and systematic advances in service coverage and efficiency. Decreases were observed in both mortality rates among low–risk group patients (defined by using diagnosis-related group classifications) and rates of unplanned readmission. The authors also identified improvements in the quality of treatments for major diseases and surgical procedures. Although the technical capability of clinical specialties was largely consistent, a marginal decrease was noted in secondary hospitals. A trend toward in-province but out-of-city care has been seen in the patient populations. For patients seeking out-of-province care, the average cost per hospitalization was higher compared with their in-province counterparts. Longer hospital stays and higher mortality rates were observed for patients treated in province, but these indicators declined over time. This study suggests promising advancements in China’s health care system; it also highlights areas requiring further attention and improvement, including regional health care provision and clinical specialty services in secondary hospitals. This research underscores the need for ongoing monitoring and evaluation to ensure optimized medical resource allocation, enhanced quality management, and specific goals of quality improvement: https://nej.md/4aMMwjj