Ashley Duggan and Allen Shaughnessy are developing an innovative organizational and research structure to test the theoretical model that changes how we think about primary care.  In particular, their model shifts the way we think about innovation in the structure and delivery of primary care and builds an “interaction design” model of relationship-centered/patient-centered healthcare.  To that end, they give research-based innovation to how we consider and communicatively enact primary care in medicine.  This Communication and Family Medicine Research Division is a Collaborative built on a very positive, ten-year relationship with Duggan and Shaughnessy.  Supported by the Tufts University School of Medicine Department of Family Medicine and an Ignite grant for innovation at Boston College, this new division of research is a shared initiative between Ashley Duggan and Allen Shaughnessy, whose particular expertise is in evidence-based medicine.  The combination of writing a large-scale volume integrating the social science on health and illness in close relationships and being the designer of the family medicine research division allows for their team to propose and implement large-scale vision for the future of communication in primary care.  The Boston College / Tufts University School of Medicine Communication and Family Medicine collaborative allows for the interdisciplinary grounding and large-scale implementation.  The project brings cohesiveness and implementation to interdisciplinary understanding of relationship-centered / patient-centered healthcare. 

 

They are building learning networks as inter-organizational, voluntary collaboratives that nurture multiple lenses of professional expertise.  In daily work, healthcare communication reveals challenging and repetitive problems for which there is not an immediate solution.  Systems thinking and the practical methods of researchers in learning networks allows a method to disentangle complexities of the situations.  Systems thinking positions understanding the problem in the context of the larger system.  To that end, they are building the conceptual and organizational foundations to track the repetitive features of communication and family medicine interactions across time and space. They integrate qualitative analysis of co-emergence and interaction design principles and reflective practice. 

 

Consistent with past research on netweavers and vision and change in systems, they include case studies of patients in each of the identified projects, reflections written by physicians multiple times per week for a year, transcriptions of audio-recorded interactions between physicians and patients across the identified projects, transcriptions of audio-recorded group visits across the identified projects, and transcriptions of interactions among teams making decisions about patient care.  They address patterns of recurrence in problems as well as in opportunities for envisioning the future.  The family medicine healthcare system is a poignant exemplar of the potential for learning networks to function differently and for connection, collaborative learning, and transformative capacity. 

 

Duggan and Shaughnessy’s combined approaches integrate the ideas of communication as co-generative, relational processes with clinical investigations and evidence-based medicine.  Thus, over time the implementation moves beyond clinical decision support to offer an innovative way of moving forward.