Ryan Buell, Kamalini Ramdas, Nazli Sonmez, Kavitha Srinivasan, Rengaraj Venkatesh

Unlike promising new drugs or devices, high-potential operational innovations in care delivery are often slow to spread, due in part to difficulties in evaluating their impact. We scientifically examine the impact of a little-known yet potentially high-impact and scalable care delivery innovation. In a shared medical appointments (SMA), a group of patients with similar chronic conditions meets with their doctor at once, and each in turn receives one-one care, albeit not in private.  In a 1,000-patient, multi-stage, randomized controlled trial of shared medical appointments vs. traditional one-on-one appointments for regular glaucoma follow up at the Aravind Eye Hospital in Pondicherry, India, we  find that SMAs increase patients’ satisfaction, knowledge and healthy behaviors. A key barrier to wider adoption of SMAs is the concern – raised by both patients and doctors - that patients may engage less due to lack of privacy. We use verbal and nonverbal engagement measures coded from 20,000 minutes of video data covering every  trial appointment to throw light on how interactions in the SMAs arm of our trial differ from those in one-on-one appointments arm, and to gain insight into how these interactions predict healthy behaviors. We will discuss how our approach could be used in the context of other care delivery innovations.