Arthur Kaufman - Academia.edu (original) (raw)

Papers by Arthur Kaufman

Research paper thumbnail of Taking Innovation To Scale In Primary Care Practices: The Functions Of Health Care Extension

Health affairs (Project Hope), Feb 1, 2018

Health care extension is an approach to providing external support to primary care practices with... more Health care extension is an approach to providing external support to primary care practices with the aim of diffusing innovation. EvidenceNOW was launched to rapidly disseminate and implement evidence-based guidelines for cardiovascular preventive care in the primary care setting. Seven regional grantee cooperatives provided the foundational elements of health care extension-technological and quality improvement support, practice capacity building, and linking with community resources-to more than two hundred primary care practices in each region. This article describes how the cooperatives varied in their approaches to extension and provides early empirical evidence that health care extension is a feasible and potentially useful approach for providing quality improvement support to primary care practices. With investment, health care extension may be an effective platform for federal and state quality improvement efforts to create economies of scale and provide practices with more...

Research paper thumbnail of Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes

Journal of Community Health

Research paper thumbnail of Addressing Social Determinants of Health in a Clinic Setting: The WellRx Pilot in Albuquerque, New Mexico

Journal of the American Board of Family Medicine : JABFM

Although it is known that the social determinants of health have a larger influence on health out... more Although it is known that the social determinants of health have a larger influence on health outcomes than health care, there currently is no structured way for primary care providers to identify and address nonmedical social needs experienced by patients seen in a clinic setting. We developed and piloted WellRx, an 11-question instrument used to screen 3048 patients for social determinants in 3 family medicine clinics over a 90-day period. Results showed that 46% of patients screened positive for at least 1 area of social need, and 63% of those had multiple needs. Most of these needs were previously unknown to the clinicians. Medical assistants and community health workers then offered to connect patients with appropriate services and resources to address the identified needs. The WellRx pilot demonstrated that it is feasible for a clinic to implement such an assessment system, that the assessment can reveal important information, and that having information about patients' so...

Research paper thumbnail of Producing a socially accountable medical school: AMEE Guide No. 109

Medical Teacher, 2016

Health systems worldwide are confronted with challenges due to increased demand from their citize... more Health systems worldwide are confronted with challenges due to increased demand from their citizens, an aging population, a variety of health risks and limited resources. Key health stakeholders, including academic institutions and medical schools, are urged to develop a common vision for a more efficient and equitable health sector. It is in this environment that Boelen and Heck defined the concept of the "Social Accountability of Medical Schools" - a concept that encourages schools to produce not just highly competent professionals, but professionals who are equipped to respond to the changing challenges of healthcare through re-orientation of their education, research and service commitments, and be capable of demonstrating a positive effect upon the communities they serve. Social Accountability calls on the academic institution to demonstrate an impact on the communities served and thus make a contribution for a just and efficient health service, through mutually beneficial partnerships with other healthcare stakeholders. The purpose of this Guide is to explore the concept of Social Accountability, to explain it in more detail through examples and to identify ways to overcome obstacles to its development. Although in the Guide reference is frequently made to medical schools, the concept is equally applicable to all forms of education allied to healthcare.

Research paper thumbnail of Guest Editorial: The Role and Impact of Indigenous Community Health Workers

Education For Health, Aug 1, 2009

Research paper thumbnail of Web-based primary care referral program associated with reduced emergency department utilization

Family Medicine, Apr 1, 2006

Research paper thumbnail of Diethylstilbestrol in the treatment of rape victims

Western Journal of Medicine, Oct 1, 1976

Research paper thumbnail of Gasoline Sniffing Among Children in a Pueblo Indian Village

Research paper thumbnail of Ambulatory medical education

J Gen Intern Med, 1990

This paper deals with the varied sites and teachers that can and should be used in educating resi... more This paper deals with the varied sites and teachers that can and should be used in educating residents and medical students in ambulatory care. A basic premise is that sites other than academic medical centers and teachers other than physician faculty members should be among those used. The paper describes how institutions have used nontraditional sites and teachers. Then, after

Research paper thumbnail of Gasoline Sniffing Leading to Increased Lead Absorption in Children

Research paper thumbnail of Health extension in rural New Mexico: Where the rubber hits the dirt road

Research paper thumbnail of Commentary on “making doctors—a new approach”

Http Dx Doi Org 10 1080 10401338909539383, Nov 3, 2009

Research paper thumbnail of Innovative generalist programs: academic health care centers respond to the shortage of generalist physicians

Journal of General Internal Medicine

ABSTRACT

Research paper thumbnail of Planning and Implementing a Public Health Certificate (PHC) for All Medical Students at the University of New Mexico

poster presentation Context The University of New Mexico School of Medicine (UNM SOM) will requir... more poster presentation Context The University of New Mexico School of Medicine (UNM SOM) will require that all medical students graduate with a Public Health Certificate (PHC). Strategies to overcome identified barriers to implementation of the Certificate have been identified. Objectives - To illustrate the process involved in implementing the PHC - To share the planning and implementation outcomes Setting - Southwestern, U.S. Institution of Higher Education (IHE), the UNM SOM in collaboration with one other IHE, community agencies and organizations interventions - Assess and modify institutional policies and resources that may hinder implementation of the PHC - Identify where PHC curriculum elements can be integrated into existing courses and training venues - Develop evaluation measures to measure outcomes Main Outcomes Integration of the PHC in the medical school curriculum; inter and intra collaboration of the various programs, divisions, and departments; graduate all medical stud...

Research paper thumbnail of The homebound aged: a medically unreached group

Annals of internal medicine, 1975

Research paper thumbnail of Teaching preclinical medical students in a clinical setting

The Journal of family practice, 1977

Research paper thumbnail of Role of community partnerships in addressing health problems in developing countries and the U.S

Progress in community health partnerships : research, education, and action, 2009

Research paper thumbnail of A public health certificate for all medical students: concepts and strategies

Education for health (Abingdon, England), 2007

The goal of integrating a Public Health Certificate (PHC) into the medical school curriculum is m... more The goal of integrating a Public Health Certificate (PHC) into the medical school curriculum is meant to provide basic public health skills and knowledge to all future physicians, ultimately broadening the health workforce's capacity to address community health needs. The faculty at the University of New Mexico's (UNM) School of Medicine (SOM), in collaboration with multiple community stakeholders, created a PHC equivalent to 15 graduate level units. The PHC will be required of all medical students matriculating in 2010. The authors, community leaders, university administrators, faculty, staff, and students met to address the many tasks required of such broad curricular and policy change. The tasks required piloting innovations in curriculum design and implementation, working within the bureaucratic structure, fostering collaboration, nurturing leadership skills, marketing the new ideas, and designing credible evaluation strategies. We have engaged the stakeholders; surveyed...

Research paper thumbnail of Effect of high up front charges on access to surgery for poor patients at a public hospital in New Mexico

International journal for equity in health, Jan 23, 2006

A public hospital in New Mexico required collection of 50% of estimated costs prior to elective s... more A public hospital in New Mexico required collection of 50% of estimated costs prior to elective surgeries for self-pay patients. This study assesses the impact of this policy on access to elective surgical procedures. Chi-square tests determined if there was a statistically significant difference between the number of self-pay and insured patient cancellations for financial reasons. A multivariate binomial regression model was used to calculate risk ratios and confidence limits for effects of race/ethnicity, and insurance status, controlling for gender, on these cancellations. Of the 667 cancellations, there were 99 self-pay and 568 insured patients. Cancellations for financial reasons occurred in 55.6% of self-pay and 9.3% of insured patients (p < 0.0001). Inability to pay 50% up front accounted for 76.4% of self-pay patient cancellations for financial reasons. Self-pay, non-Hispanic whites and minority race/ethnicities were 8.76 and 8.61 times more likely to cancel for financia...

Research paper thumbnail of The educational opportunities in a departmental program of health care for the homeless

Family medicine

Persons who live on the streets and are homeless present many challenges to providers of health c... more Persons who live on the streets and are homeless present many challenges to providers of health care. This paper describes a 14-year ongoing project in the Department of Family, Community, and Emergency Medicine at the University of New Mexico School of Medicine. This small clinic started in an inner-city rescue mission and subsequently has progressed to a much larger health care project for the homeless. Experience in this setting demonstrates that such a site can provide service to the homeless, while at the same time providing educational experiences for medical students and residents and an opportunity for academic research. This project can be duplicated in any academic medical center to provide both service and education.

Research paper thumbnail of Taking Innovation To Scale In Primary Care Practices: The Functions Of Health Care Extension

Health affairs (Project Hope), Feb 1, 2018

Health care extension is an approach to providing external support to primary care practices with... more Health care extension is an approach to providing external support to primary care practices with the aim of diffusing innovation. EvidenceNOW was launched to rapidly disseminate and implement evidence-based guidelines for cardiovascular preventive care in the primary care setting. Seven regional grantee cooperatives provided the foundational elements of health care extension-technological and quality improvement support, practice capacity building, and linking with community resources-to more than two hundred primary care practices in each region. This article describes how the cooperatives varied in their approaches to extension and provides early empirical evidence that health care extension is a feasible and potentially useful approach for providing quality improvement support to primary care practices. With investment, health care extension may be an effective platform for federal and state quality improvement efforts to create economies of scale and provide practices with more...

Research paper thumbnail of Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes

Journal of Community Health

Research paper thumbnail of Addressing Social Determinants of Health in a Clinic Setting: The WellRx Pilot in Albuquerque, New Mexico

Journal of the American Board of Family Medicine : JABFM

Although it is known that the social determinants of health have a larger influence on health out... more Although it is known that the social determinants of health have a larger influence on health outcomes than health care, there currently is no structured way for primary care providers to identify and address nonmedical social needs experienced by patients seen in a clinic setting. We developed and piloted WellRx, an 11-question instrument used to screen 3048 patients for social determinants in 3 family medicine clinics over a 90-day period. Results showed that 46% of patients screened positive for at least 1 area of social need, and 63% of those had multiple needs. Most of these needs were previously unknown to the clinicians. Medical assistants and community health workers then offered to connect patients with appropriate services and resources to address the identified needs. The WellRx pilot demonstrated that it is feasible for a clinic to implement such an assessment system, that the assessment can reveal important information, and that having information about patients' so...

Research paper thumbnail of Producing a socially accountable medical school: AMEE Guide No. 109

Medical Teacher, 2016

Health systems worldwide are confronted with challenges due to increased demand from their citize... more Health systems worldwide are confronted with challenges due to increased demand from their citizens, an aging population, a variety of health risks and limited resources. Key health stakeholders, including academic institutions and medical schools, are urged to develop a common vision for a more efficient and equitable health sector. It is in this environment that Boelen and Heck defined the concept of the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Social Accountability of Medical Schools&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; - a concept that encourages schools to produce not just highly competent professionals, but professionals who are equipped to respond to the changing challenges of healthcare through re-orientation of their education, research and service commitments, and be capable of demonstrating a positive effect upon the communities they serve. Social Accountability calls on the academic institution to demonstrate an impact on the communities served and thus make a contribution for a just and efficient health service, through mutually beneficial partnerships with other healthcare stakeholders. The purpose of this Guide is to explore the concept of Social Accountability, to explain it in more detail through examples and to identify ways to overcome obstacles to its development. Although in the Guide reference is frequently made to medical schools, the concept is equally applicable to all forms of education allied to healthcare.

Research paper thumbnail of Guest Editorial: The Role and Impact of Indigenous Community Health Workers

Education For Health, Aug 1, 2009

Research paper thumbnail of Web-based primary care referral program associated with reduced emergency department utilization

Family Medicine, Apr 1, 2006

Research paper thumbnail of Diethylstilbestrol in the treatment of rape victims

Western Journal of Medicine, Oct 1, 1976

Research paper thumbnail of Gasoline Sniffing Among Children in a Pueblo Indian Village

Research paper thumbnail of Ambulatory medical education

J Gen Intern Med, 1990

This paper deals with the varied sites and teachers that can and should be used in educating resi... more This paper deals with the varied sites and teachers that can and should be used in educating residents and medical students in ambulatory care. A basic premise is that sites other than academic medical centers and teachers other than physician faculty members should be among those used. The paper describes how institutions have used nontraditional sites and teachers. Then, after

Research paper thumbnail of Gasoline Sniffing Leading to Increased Lead Absorption in Children

Research paper thumbnail of Health extension in rural New Mexico: Where the rubber hits the dirt road

Research paper thumbnail of Commentary on “making doctors—a new approach”

Http Dx Doi Org 10 1080 10401338909539383, Nov 3, 2009

Research paper thumbnail of Innovative generalist programs: academic health care centers respond to the shortage of generalist physicians

Journal of General Internal Medicine

ABSTRACT

Research paper thumbnail of Planning and Implementing a Public Health Certificate (PHC) for All Medical Students at the University of New Mexico

poster presentation Context The University of New Mexico School of Medicine (UNM SOM) will requir... more poster presentation Context The University of New Mexico School of Medicine (UNM SOM) will require that all medical students graduate with a Public Health Certificate (PHC). Strategies to overcome identified barriers to implementation of the Certificate have been identified. Objectives - To illustrate the process involved in implementing the PHC - To share the planning and implementation outcomes Setting - Southwestern, U.S. Institution of Higher Education (IHE), the UNM SOM in collaboration with one other IHE, community agencies and organizations interventions - Assess and modify institutional policies and resources that may hinder implementation of the PHC - Identify where PHC curriculum elements can be integrated into existing courses and training venues - Develop evaluation measures to measure outcomes Main Outcomes Integration of the PHC in the medical school curriculum; inter and intra collaboration of the various programs, divisions, and departments; graduate all medical stud...

Research paper thumbnail of The homebound aged: a medically unreached group

Annals of internal medicine, 1975

Research paper thumbnail of Teaching preclinical medical students in a clinical setting

The Journal of family practice, 1977

Research paper thumbnail of Role of community partnerships in addressing health problems in developing countries and the U.S

Progress in community health partnerships : research, education, and action, 2009

Research paper thumbnail of A public health certificate for all medical students: concepts and strategies

Education for health (Abingdon, England), 2007

The goal of integrating a Public Health Certificate (PHC) into the medical school curriculum is m... more The goal of integrating a Public Health Certificate (PHC) into the medical school curriculum is meant to provide basic public health skills and knowledge to all future physicians, ultimately broadening the health workforce's capacity to address community health needs. The faculty at the University of New Mexico's (UNM) School of Medicine (SOM), in collaboration with multiple community stakeholders, created a PHC equivalent to 15 graduate level units. The PHC will be required of all medical students matriculating in 2010. The authors, community leaders, university administrators, faculty, staff, and students met to address the many tasks required of such broad curricular and policy change. The tasks required piloting innovations in curriculum design and implementation, working within the bureaucratic structure, fostering collaboration, nurturing leadership skills, marketing the new ideas, and designing credible evaluation strategies. We have engaged the stakeholders; surveyed...

Research paper thumbnail of Effect of high up front charges on access to surgery for poor patients at a public hospital in New Mexico

International journal for equity in health, Jan 23, 2006

A public hospital in New Mexico required collection of 50% of estimated costs prior to elective s... more A public hospital in New Mexico required collection of 50% of estimated costs prior to elective surgeries for self-pay patients. This study assesses the impact of this policy on access to elective surgical procedures. Chi-square tests determined if there was a statistically significant difference between the number of self-pay and insured patient cancellations for financial reasons. A multivariate binomial regression model was used to calculate risk ratios and confidence limits for effects of race/ethnicity, and insurance status, controlling for gender, on these cancellations. Of the 667 cancellations, there were 99 self-pay and 568 insured patients. Cancellations for financial reasons occurred in 55.6% of self-pay and 9.3% of insured patients (p < 0.0001). Inability to pay 50% up front accounted for 76.4% of self-pay patient cancellations for financial reasons. Self-pay, non-Hispanic whites and minority race/ethnicities were 8.76 and 8.61 times more likely to cancel for financia...

Research paper thumbnail of The educational opportunities in a departmental program of health care for the homeless

Family medicine

Persons who live on the streets and are homeless present many challenges to providers of health c... more Persons who live on the streets and are homeless present many challenges to providers of health care. This paper describes a 14-year ongoing project in the Department of Family, Community, and Emergency Medicine at the University of New Mexico School of Medicine. This small clinic started in an inner-city rescue mission and subsequently has progressed to a much larger health care project for the homeless. Experience in this setting demonstrates that such a site can provide service to the homeless, while at the same time providing educational experiences for medical students and residents and an opportunity for academic research. This project can be duplicated in any academic medical center to provide both service and education.