Rebecca D. Onie (
Risa Lavizzo-Mourey is the Robert Wood Johnson Foundation Penn Integrates Knowledge Professor of Health Equity and Health Policy at the University of Pennsylvania, in Philadelphia, and president emerita of the Robert Wood Johnson Foundation, in Princeton, New Jersey.
Health Aff (Millwood). 2018 Feb;37(2):240-247. doi: 10.1377/hlthaff.2017.1113.
The US health care system has recently begun to account for patients' unmet social needs in care delivery and payment reform. This article presents a twenty-year qualitative case study of five stages of diffusion-testing and learning, standardization, replication, shifting from doing to enabling, and catalyzing broad adoption-of a practical approach for integrating social needs into clinical care. This case study of Health Leads and its funders confirms the importance of focusing on a clear aim, investing in model testing and standardization to enable subsequent responsiveness to the market, and the willingness of innovators and their investors to cede control of a model to allow local adaption and accelerate broad adoption.
美国医疗保健系统最近开始在医疗服务提供和支付改革中考虑患者未满足的社会需求。本文通过对 Health Leads 及其资助者的 20 年定性案例研究，展示了将社会需求融入临床护理的实用方法的五个阶段的扩散测试和学习、标准化、复制、从执行到赋能的转变，以及推动广泛采用。该案例研究证实了专注于明确目标、投资于模型测试和标准化以实现对市场的后续响应的重要性，以及创新者及其投资者愿意放弃对模型的控制以允许本地调整并加速广泛采用的意愿。
