Sustainable Methods, Algorithms, and Research Tools for Delivering Optimal Care Study (SMART DOCS) in California, 2013-2017

The Sustainable Methods, Algorithms, and Research Tools for Delivering Optimal Care Study (SMART DOCS) was designed to introduce a new Patient-Centered Outcomes and Coordinated- Care Management (PCCM) approach for the future practice of sleep medicine, and to test the PCCM approach against a Conventional Diagnostic and Treatment Outpatient Medical Care (CONV) approach in a randomized, two-arm, single-center, long-term, comparative effectiveness trial. A total of 1,836 patients 18 years or older were randomized to either the PCCM or CONV approach. Patients in the PCCM approach were provided access to new tools, tests, and technologies, for management of their sleep disorder. Patients were followed over 1 year with endpoints of improved health care performance, better health, and cost control. Improved health care performance was measured by the global rating score on the Clinician and Groups Consumer Assessment of Healthcare Providers and Systems (CGCAHPS) questionnaire. The Vitality scale score on the Short Form-36 (SF-36) questionnaire was used at baseline and end of study to measure health. In addition, provider communication, and helpfulness of provider's website and use of computers were analyzed. Out-of-pocket costs were estimated to determine cost control.