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Review
. 2015 Jan 29;3(1):50-63.
doi: 10.3390/healthcare3010050.

Minimally Disruptive Medicine: A Pragmatically Comprehensive Model for Delivering Care to Patients with Multiple Chronic Conditions

Aaron L Leppin  1   2 , Victor M Montori  3 , Michael R Gionfriddo  4   5
Affiliations
Review

Minimally Disruptive Medicine: A Pragmatically Comprehensive Model for Delivering Care to Patients with Multiple Chronic Conditions

Aaron L Leppin et al. Healthcare (Basel). .

Abstract

An increasing proportion of healthcare resources in the United States are directed toward an expanding group of complex and multimorbid patients. Federal stakeholders have called for new models of care to meet the needs of these patients. Minimally Disruptive Medicine (MDM) is a theory-based, patient-centered, and context-sensitive approach to care that focuses on achieving patient goals for life and health while imposing the smallest possible treatment burden on patients' lives. The MDM Care Model is designed to be pragmatically comprehensive, meaning that it aims to address any and all factors that impact the implementation and effectiveness of care for patients with multiple chronic conditions. It comprises core activities that map to an underlying and testable theoretical framework. This encourages refinement and future study. Here, we present the conceptual rationale for and a practical approach to minimally disruptive care for patients with multiple chronic conditions. We introduce some of the specific tools and strategies that can be used to identify the right care for these patients and to put it into practice.

Keywords: care delivery models; chronic disease; complexity; healthcare delivery; minimally disruptive medicine; multiple chronic conditions.

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Figures

Figure 1
Figure 1
The cumulative complexity model.
See this image and copyright information in PMC

References

    1. Porter M.E. What is value in health care? N. Engl. J. Med. 2010;363:2477–2481. doi: 10.1056/NEJMp1011024. - DOI - PubMed
    1. Anderson G.F. Chronic Care: Making the Case for Ongoing Care. Robert Wood Johnson Foundation; Princeton, NJ, USA: 2010.
    1. Parekh A.K., Kronick R., Tavenner M. Optimizing health for persons with multiple chronic conditions. JAMA. 2014;312:1199–1200. doi: 10.1001/jama.2014.10181. - DOI - PubMed
    1. May C., Montori V.M., Mair F.S. We need minimally disruptive medicine. BMJ. 2009;339:b2803. doi: 10.1136/bmj.b2803. - DOI - PubMed
    1. Institute of Medicine Committee on Quality of Health Care in America . Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press; Washington, DC, USA: 2001.

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