Pilot-Testing a New Program for Providing Personalized and Patient-Centered Preventive Care

Although preventable morbidity and mortality in the United States is substantive, evidence-based preventive care is underutilized, as seen in the underutilization of the 60 distinct services recommended by the US Preventive Services Task Force (USPSTF).1-3 For example, only 48% of patients are screened for colorectal cancer, 40% of qualified patients take aspirin, and 28% of patients receive help to quit smoking.4 Further, health disparities are worsened due to unequal distribution of preventive care.4,5

These preventive care deficits may arise partially from limited time for clinicians and patients to address relevant issues.3 Additionally, recommendations for the best patient-centered care6 will sometimes differ from patient to patient, adding further complexity. For example, a general clinical quality metric may encourage tight blood sugar control for a frail 80-year-old female with diabetes, when in practice, for her particular situation, this recommendation might cause more harm than benefit or conflict with her preferences.7,8

It is increasingly appreciated that while primary care should become more personalized and patient-centered, time constraints may oppose these goals. Therefore, our objective was to develop and test the feasibility of a new program for providing personalized and patient-centered preventive care in a busy urban ambulatory clinic. We designed our program to be compatible with emerging care models, including the patient-centered medical home model, and to be applicable to diverse point-of-care settings.