Investigator Cheryl Stults, Ph.D.

Cheryl Stults, Ph.D., is Assistant Scientist at the Palo Alto Medical Foundation Research Institute. Her research focuses on patient-provider communication and the evaluation of primary care redesign initiatives, particularly shared medical appointments. She is a co-investigator for a study funded by the Patient Centered Outcomes Research Institute (PCORI) to help create a more patient-centered tool to assist Medicare beneficiaries in selecting a Medicare Part D prescription drug plan. She is currently working on several studies including how to create a zone of openness for patients to foster more open communication with their primary care providers and an-activity based costing of primary care transformations including shared medical appointments.

Dr. Stults earned her PhD in Sociology from Brandeis University and a MA in Sociology from Boston College. She completed her undergraduate work with University Honors in Sociology from Brigham Young University.

Sutter Health Research Enterprise
795 El Camino Real
Palo Alto, CA, 94301
(650) 853-2346
stultsc@pamfri.org

Primary Research Interests

Publications

Estimating the human resource costs of developing and implementing shared medical appointments in primary care.

Introducing new providers or a new type of SMA may require relatively modest incremental organizational resources and provider time (<8% of time and about 15% of the finances required to start the initial SMA). Time and cost could possibly be further decreased by leveraging relevant materials from existing SMAs.

Shared medical appointments: a promising innovation to improve patient engagement and ease the primary care provider shortage.

Although SMAs improve access, engagement with physicians and other patients, and knowledge of patients' health, they also help to ease the workload for physicians.

Relationships and resilience at work and at home: Impact of relational coordination on clinician work-life balance and well-being in times of crisis

Do Patients Continue to Use Video Visits? Factors Related to Continued Video Visit Use

Implementation of patient engagement tools in electronic health records to enhance patient-centered communication: protocol for feasibility evaluation and preliminary results

Patient-physician communication during clinical encounters is essential to ensure quality of care.

Impact of implementing electronic prior authorization on medication filling in an electronic health record system in a large healthcare system

We sought to evaluate the impact of implementing an ePA system on prescription filling.

The human resource costs of implementing autopend clinical decision support to improve health maintenance.

Developing, implementing the clinical decision support autopend took 3+ years, 6 managers, 3 Epic programmers, and cost $201,500 (2013, 2670 total hours).

Online consent enables a randomized, controlled trial testing a patient-centered online decision-aid for Medicare beneficiaries to meet recruitment goal in short time frame.

We report our use of online consenting to successfully enroll over 1185 Medicare beneficiaries in a short 9-week time frame for a research study.

Assessment of accuracy and usability of a fee estimator for ambulatory care in an integrated health care delivery network.

QI study: Fee estimator was easy to use and provided accurate results.

Patient experiences in selecting a Medicare Part D prescription drug plan.

Many Medicare beneficiaries expressed a desire for greater assistance with and greater simplicity in the Pt. D Rx drug plan choice process.

Using CollaboRATE, a brief patient-reported measure of shared decision making: results from three clinical settings in the United States.

CollaboRATE, brief pt-reported SDM measure, can be used in diverse primary care settings. A clinic's workflow plays a crucial role in implementation.

An evaluation of two interventions to enhance patient-physician communication using the observer OPTION5 measure of shared decision making.

Results suggest targeting patient and physician behaviors promotes SDM better than patient activation only. Improving SDM for less educated patients is crucial.

Periodic health examinations and missed opportunities among patients likely needing mental health care.

Visits with MDs who spent more time with pts, fully elicit pts’ agendas, and let pts talk were more likely to give evid-based mental health discussions.

Sharing experiences and expertise: the Health Care Systems Research Network workshop on patient engagement in research.

Engaging co-equal patient partners in research requires skills not normally used or valued in scientific research methods and requires longer timelines.

Enhancing shared decision making through carefully designed interventions that target patient and provider behavior.

Designed novel, multidimensional intervention to nudge patients and primary care providers to communicate more openly.

Comparative usability study of a newly created patient-centered tool and Medicare.gov plan finder to help Medicare beneficiaries choose prescription drug plans.

The more patient-centered prescription drug choice tool improved user experience and enabled users to choose plans more consistent with expert recommendations.

Machine-based expert recommendations and insurance choices among Medicare Part D enrollees.

Providing an online pt-centered decision-support tool increased seniors' satisfaction with choosing a Rx drug plan and increased plan switching.

Preventive visit among older adults with Medicare's introduction of Annual Wellness Visit: closing gaps in underutilization.

Evaluated changes in preventive visit utilization with Medicare's Annual Wellness Visits, begun in 2011, how coverage expansion differentially affected seniors.

How do primary care physicians respond when patients cry during routine ambulatory visits?

Although most physicians did express empathy in response to patients’ tears, some did not systematically assess patients’ mental health status and overall functioning. Physicians may want to view crying as a sign of distress and more fully evaluate whether it fits into a more complex clinical presentation of depression.

Overcoming challenges to adoption of shared medical appointments.

A physician champion, management support, and financial sustainability were judged to be the primary enablers of successful implementations of shared med appts.

Expressing uncertainty in clinical interactions between physicians and older patients: what matters?

Patients expressed more uncertainties than physicians during visits. Patients and physicians both expressed more uncertainties on mental health topics.

Three types of ambiguity in coding empathic interactions in primary care visits: implications for research and practice.

We examine challenges experienced in studying patients' expressions of emotion in a sample of periodic health exams, and the research and practice implications.

Patients with mental health needs are engaged in asking questions, but physicians’ responses vary

Little is known about the questions patients ask of their physicians; physician responses, and the relationship between patients' questions and visit outcomes.