• Introduction
• Improving Care for the Chronically Ill
  • Improving Care of the Chronically Ill
  • Team Care Recognizes and Embraces Complexity
  • Team Care is Cost-Effective Care
  • Making Team Care the Standard of Care
• History of Commitment to Team Care
• Team Care Models
• Model 1: Care Transitions
  Improving Transitions Across Sites of Geriatric Care
  • Model 1: Care Transitions
    Improving Transitions Across Sites of Geriatric Care
  • The Four Pillars of Care Transitions
  • Illustration: Care Transitions Model
  • Measuring the Success of Care Transitions
  • Moving the Model from Two Sites to 100
  • A Transition Coach Makes Recovery from Surgery Faster, Easier
• Model 2: Care Management Plus
  Using Technology to Improve Outpatient Care for Older Adults
  • Model 2: Care Management Plus
    Using Technology to Improve Outpatient Care for Older Adults
  • Description of the Model: Care Management Plus
  • Illustration: Care Management Plus Model
  • Measuring the Success of Care Management Plus
  • The National Search for Quality Health Care Finds Care Management Plus
  • Tracking Care Over Time Helps Avoid Serious Disability
• Model 3: Senior Health & Wellness Clinic
  Managing Care of Older Patients in the Clinic by Fostering Team Care
  • Model 3: Senior Health & Wellness Clinic
    Managing Care of Older Patients in the Clinic by Fostering Team Care
  • Senior Health and Wellness Center: Total Care Under One Roof
  • Team Care Approach at Senior Health and Wellness Center
  • Measuring the Success of Senior Health and Wellness Clinic
  • Illustration: Senior Health and Wellness Clinic
  • Customizing Team Care to Work Locally
  • From Clinic Volunteer to Clinic Patient, But Always a Member of the Team
• Model 4: Virtual Integrated Practice
  Implementing Team Care Across Practices and Virtually
  • Model 4: Virtual Integrated Practice
    Implementing Team Care Across Practices and Virtually
  • Virtual Integrated Practice: The Community Response
  • Measuring the Success of Virtual Integrated Practice
  • Illustration: Virtual Integrated Practice Model
  • Building Community Capacity
  • VIP: A Seamless System of Resources
• Senior Resource Team
  Important Role Foundations Play in Taking Risk
• Looking Toward the Future of Team Care

Featured Initiative:

Virtual Integrated Practice Model:

Measuring the Success of Virtual Integrated Practice

Having implemented the VIP model, Dr. Rothschild and the team at Rush sought to measure how well primary care practices that use VIP can modify their approach to chronic disease care. They collected data from four practices using the VIP model and compared them to practices engaged in usual care. The study focused on care of patients with type 2 diabetes, chronic obstructive pulmonary disease, or urinary incontinence. In the practices using the VIP model, patients reported more satisfaction with their care. Patients also had greater understanding about their medications and how to manage their disease. More patients in the VIP practices reported that they knew how to get help if they had a problem.

Primary care physician Dr. Rothschild referring his patients to dietician Kristin A. R. Gustashaw virtually.

Among patients with poor physical functioning (about 13 percent of all patients), those who were not treated in the VIP practices were far more likely to use the emergency room; their usage of the ER was twice that of those in the VIP practices. Reducing use of the emergency room has huge potential to reduce health care costs.

The VIP approach targets a reduction in crisis intervention and acute care management for frail elders. Moreover, as each member of the team already bills for the care they provide, the Virtual Integrated Practice is cost-neutral for providers while supporting improved health outcomes.
Next: Illustration: Virtual Integrated Practice Model ›
"The word 'virtual' might be misleading, because it isn't virtual to the patient. We see the patient in an office, just not the same office as the physician. What is virtual is the well coordinated communication systems in place among the various care providers."
Kristin A. R. Gustashaw, MS, RD, CSG
Rush Nutrition and Wellness Center
Department of Food and Nutrition Services