August 7, 2018

Sound Physicians and Dartmouth Partner on NIH-Funded Research on Advance Care Planning

The overarching goal is to improve the quality of decision making for seriously-ill, hospitalized older patients

Tacoma, Wash. – August 8, 2018 – Sound Physicians and The Dartmouth Institute of Health Policy & Clinical Practice have partnered on a 5-year, national study to better understand best practices in advance care planning (ACP). Funded by the National Institute on Aging, part of the National Institutes of Health (NIH), as part of a longstanding program grant to Dartmouth, the collaboration marks Sound Physicians’ first foray into a large-scale, federally-funded research study aimed at improving quality and reducing costs of health care for the elderly. The goal of ACP is to understand patients’ values and help ensure that their preferences are reflected in health care decisions, which is particularly important for older, seriously ill patients.

Based at dozens of U.S. hospitals partnered with Sound Physicians, this study will first examine how physicians currently approach ACP discussions and how ACP impacts patient experience, outcomes, and costs. The study will then develop, implement, and test new tools and programs for helping physicians become more comfortable and effective with ACP discussions. Dr. Amber Barnato, the Susan J. and Richard M. Levy Distinguished Professor of Health Care Delivery at The Dartmouth Institute and an expert in physician communication and decision making in serious illness, will be leading the study.

“Although the importance of ACP is widely appreciated, physicians vary in their threshold for making goals of care discussions a major priority during a hospital admission,” says Barnato. “With its size, national scope, and commitment to quality, Sound Physicians provides an ideal clinical laboratory for innovating around physician education interventions that can decrease variability in ACP and thereby increase the alignment between medical decisions and patients’ goals and values.”

Dr. John Birkmeyer, Chief Clinical Officer at Sound Physicians and an Adjunct Professor at The Dartmouth Institute, is a co-investigator. “Taking the time to understand a patient’s goals of care is among the most important aspects of high-quality care for older patients hospitalized with serious medical illnesses,” says Birkmeyer. “Sound has a long tradition of clinical innovation in ACP, but this new partnership with the Dartmouth team will bring new energy, creativity, and scientific rigor as we look to continuously improve.”

The research study began in May of this year and will run through 2023. This research is supported by the National Institute of Aging of the National Institutes of Health under award number P01AG019782 and in the amount of $12 million. Additional funding, $60,500, for the development of the physician education intervention is provided by The Patrick and Catherine Weldon Donaghue Medical Research Foundation.

About “Causes and Consequences of Healthcare Efficiency” (P01AG019782)

This 5-year grant from the National Institutes of Health to The Dartmouth Institute, led by economist Jonathan Skinner, PhD, identifies efficiency and inefficiency in U.S. health care by applying sophisticated empirical methods to more than 1 billion person-years of health data. The overarching topics related to health care delivery efficiency include: 1) an exploration of challenges in clinical decision making to identify systematic underuse of effective care and overuse of ineffective care; 2) an examination of the role of the health care delivery environment – patient-sharing networks, payment models, and regulations – on patient health; and 3) a better understanding of the limitations of policy analysis arising from a focus on just Medicare or private (commercial) data.


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