ACCORDS Program Leads Selected for Anschutz Acceleration Initiative

ACCORDS faculty at the University of Colorado School of Medicine are set to launch and support 10 distinct projects over the next five years that aim to develop patient-centered decision support tools across various clinical domains as part of the recently-awarded Anschutz Acceleration Initiative (AAI).

Dan Matlock, MD, MPH, professor in the Division of Geriatrics, and Russ Glasgow, PhD, research professor in the Department of Family Medicine, collaborated on their proposal Making Personalization the Standard Through Rapid Design, Implementation, Testing and Maintenance after both submitted letters of interest last summer.

“The objective is exportable, generalizable, resources for rapid development, testing, implementation, and dissemination of patient-centered strategies,” Matlock says.

The duo say that their work, which will incorporate several others in ACCORDS, will work to better focus the health care system around patients.

Leveraging expertise to transform care

Rather than create new cores within ACCORDS, Glasgow and Matlock elected to build upon the established cores and programs and integrate them to work together towards a larger goal.  

Matlock, director of the Colorado Program for Patient-Centered Decisions (CPPCD) at ACCORDS, focuses his research on patient-centered care through clinician education and patient-directed tools.

“I have spent my career trying to figure out how to make sure patients are better informed when they are offered big procedures,” he says.

Developing, testing, and disseminating sustainable and equitable solutions to real world health problems is the mission of the ACCORDS Dissemination and Implementation (D&I) Science Program, which is directed by Glasgow. The D&I program is nationally known for its development, use, and evaluation of interactive tools and resources.

Support for the projects will come from several researchers and faculty members, including co-directors of the Learning Health System Core, Michael Ho, MD, PhD, professor in the Department of Medicine and Katy Trinkley, PharmD, PhD, associate professor in the Department of Family Medicine.

Liza Creel, PhD, MPH, associate professor in the Division of Health Care Policy and Research and director of the Economic Analysis Core and Kathryn Colborn, PhD, MSPH, associate professor in the Division of Health Care Policy and Research and director of the Biostatistics and Analytics Core will also collaborate.

Using the expertise of the cores and programs, the team will advance each project through three specific objectives: rapidly and rigorously design a host of tools to improve the patient-centeredness of care; rapidly and rigorously implement and test interventions in real-world settings using pragmatic research; and rapidly and rigorously disseminate and sustain project delivery and outcomes.

Alignment with guiding principles

While striving to improve health care decision-making and outcomes, benefiting patients, providers, and health care systems, the team has adopted four guiding principles to be integrated across all projects: patient-centered personalization; rapid, rigorous, and pragmatic methods; sustainable processes and tools; and equity and multilevel partner engagement.

Patient-centered personalization will focus on providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.  

Rapid, rigorous, and pragmatic methods will integrate business and academic approaches. The includes rapid development and dissemination to ensure that tools are quickly implemented but involve rigorous evaluation and documentation.

In addition to the specific patient-centered 10 tools and implementation strategies being developed or refined for the program, the team will create sustainable processes and documentation, which will allow for generalizable processes and resources that others can adopt.

To address and enhance equity, each tool developed will require diverse multilevel partner engagement that considers multiple perspectives in all phases, including diverse patients, clinicians and staff, administrators, leaders, and policy makers.

Patient-centered tools

The initial four projects were chosen based on established criteria and the expertise of team members. They cover various clinical domains including primary care, specialty care, tertiary care, and late-life care. 

• Amy Huebschmann, MD, MS, associate professor in the Division of Internal Medicine and Glasgow will lead project one, Providing Whole Person Care via Digital Technology, Implementation Support, and Partner Engagement to Enhance Primary Care for Patients with Multiple Chronic Conditions. This project addresses critical gaps in access to data about patient’s health risks, behaviors, preferences, and social environment needed to make personalized, informed, and equitable health care decisions.
  
  
• The specialty care project is Shared Decision Making for Carotid Stenting in Response to Recent Proposed CMS Mandate for an Evidence-based Decision Aid, led by Christopher Knoepke, PhD, MSW, assistant research professor in the Division of Cardiology and Michelle Fullard, MD, MSCE, assistant professor in the Department of Neurology. This project supports the Centers for Medicare and Medicaid Services proposed mandate, which requires a documented use of a patient decision aid prior to patients receiving any treatment options for carotid artery stenosis. 
  
  
• The third project, covering tertiary care, is Developing a Heart Transplantation Decision Aid in an Era of Increasing Mechanical Alternatives, led by Larry Allen, MD, MHS, professor in the Division of Cardiology and Colleen McIlvennan, PhD, DNP, associate professor in the Division of Cardiology. The researchers previously developed a successful decision aid for patients considering left ventricular assist device, and this new tool will assist patients considering heart transplantation.
  
  
• A Decision-making Roadmap to Support Patients and Care Partners of People Living with Alzheimer’s Dementia, is the fourth project, led by Matlock, Laura Scherer, PhD, associate professor in the Division of Cardiology, and Channing Tate, PhD, MPH, assistant professor in the Division of Internal Medicine. Given the increasing prevalence of Alzheimer’s dementia or related disorder (ADRD), and the complexities of navigating the many decisions that patients and families with dementia face, there is a need for anticipatory guidance for ADRD patients and their families to traverse these issues. 

There will be an additional six pilot projects funded using a competitive process over the next 3-5 years. The team anticipates that pilot project applications will be accepted sometime in 2025. The pilot projects will have to meet the same entry criteria as the initial four projects to be considered. The established criteria include issues related to high-stakes importance, multi-level engagement, patient and family centered focus, likelihood of future funding, scalability, sustainability, and equity. 

“Through these first four projects we will refine and streamline the methods used to create the patient support tools and then through the second six, we will test those methods and continue to refine them,” Matlock says.

A vision for greater impact

Beyond the goal of applying their expertise to the first 10 projects, the investigators have a mission to make ACCORDS and the University of Colorado Anschutz Medical Campus the national go-to academic center for rapid and rigorous development, evaluation, implementation, and dissemination of personalized care innovations. 

“We want to come up with methods that are exportable, so that someone knows to come to our site, use our methods, and can take this from concept to dissemination in two years,” Matlock says.