Realizing the Dream: The Future of Primary Care Research
https://www.annfammed.org/content/20/2/170
After a near-death experience, primary care is thriving and has achieved its rightful place at the center of the US health system. With burnout decreasing and joy in practice thriving, health professional students are entering primary care at record levels. This remarkable transformation has produced considerable return on investment for policy makers, payers, and health system leaders—including for themselves and their families—as the burden of navigating the health system and coordinating care has been greatly reduced.
Lessons learned from the COVID-19 pandemic together with several influential reports spurred a decade of investment, innovation, and research in primary care. A new generation of primary care researchers built upon decades of prior research to generate the critical evidence on how to consistently deliver accessible, high quality, effective, and equitable care. Widespread adoption of the Care and Learn model5 supported the evolution of primary care practices and networks to become learning health systems.
The Agency for Healthcare Research and Quality (AHRQ), as the federal agency specifically charged with conducting and supporting primary care research, plays a pivotal role in supporting the research and generating the evidence needed to advance primary care. Drawing on decades of AHRQ-supported studies, extensive stakeholder consultation, and a Primary Care Research Summit held in fall 2020, the research discussed the primary care research central to successful primary care transformation and for realizing the vision of a high-performing US health system that advances health equity to effectively serve all Americans and their communities.
To implement person- and family-centered care,3,6 primary care needs to build continuous, trusting relationships in which clinicians, patients, and families are partners in care planning. Primary care practices should play an integral role in improving and promoting the health of the communities they serve. In a primary care–centered health system, all individuals would receive comprehensive, longitudinal, and coordinated care anchored in primary care. Primary care should seek to eliminate pervasive and long-standing inequities in access, quality, and outcomes of care. Increasing access to effective health care for racial/ethnic minorities, low-income and rural communities, and other populations experiencing disparities is necessary, as are targeted improvement interventions. Ongoing advancements in health information technology and the development of digital health solutions tailored to primary care practice can enable the desired renaissance in primary care delivery.
Realizing the potential of primary care will require wise investments in primary care research. There is already a large body of primary care research and tools on which to build. Newly generated evidence needs to be rapidly incorporated into the design of the delivery system, clinical care, and community interventions.