COIN Investigators & Staff
COIN Investigators
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Linnaea Schuttner, MD, MS
- Title: Core Investigator, Career Development Awardee
Assistant Professor, University of Washington School of Medicine - Contact: linnaea.schuttner@va.gov
- Location: Seattle
- University of Washington webpage
See Dr. Schuttner's Dimensions profile that includes: publications, grants, datasets, patents and clinical trials
My research interests focus on the patient-centeredness, appropriateness, and quality of primary care delivered to patients, particularly high-risk and complex patients with multimorbidity (multiple chronic diseases).
Grants
Integrating personal values into primary care for Veterans with multimorbidity
Role: PI
Patients with multiple chronic health conditions (i.e., multimorbidity) and their primary care providers (PCPs) must deal with numerous, often competing health concerns. With many competing health concerns, focusing healthcare on the outcomes patients prefer can help avoid burdensome, unwanted, or harmful care.
This project develops an intervention (Vet-Align) to align what Veterans with multimorbidity find meaningful and their preferred health outcomes with the routine clinical care provided by PCPs. This study:
— clarifies Veteran perspectives on how what is significant in life affects their health decisions,
— designs an evidence-informed tool and pathways to guide Veterans and PCPs in making health decisions consistent with Veteran-preferred health outcomes,
— tests the intervention’s acceptability and feasibility for patients and staff at two VA primary care clinics.
This research promotes a person-centered care approach for Veterans with multimorbidity by aligning care with what matters most to patients, with long-term potential to improve care quality and patient engagement.
Funder: Veterans Affairs
NIH website
Consortium for Applied Training to Advance the Learning Health System
Role: Scholar/Trainee
Goals: Develop core competences in learning systems research; individual research on quality and appropriateness of primary care for patients with complex multimorbidity.
Funder: Agency for Healthcare Research and Quality (AHRQ)
Fogarty International Clinical Research Scholars and Fellows Program
Role: Scholar/Trainee
Foundational training in clinical research; participation in stepped-wedge cluster randomized trial of health systems strengthening in rural primary care clinics.
Funder: National Institutes of Health
Recent Publications
2024
Reddy A, Geyer J, Wheat C, Schuttner L, Chen A, Deeds S, Liao JM, Agrawal N, Nelson KM. Behaviorally Informed Text Message Nudges to Schedule COVID-19 Vaccinations: A Randomized Controlled Trial. J Gen Intern Med. 2024 Nov 4. doi: 10.1007/s11606-024-09170-2. Epub ahead of print. PMID: 39496851.
PMID: 39496851.
Schuttner L, Mayfield B, Jaske E, Theis M, Nelson K, Reddy A. Primary Care Telehealth Initiation and Engagement Among Veterans at High Risk, 2019-2022. JAMA Netw Open. 2024 Jul 1;7(7):e2424921. doi: 10.1001/jamanetworkopen.2024.24921. PMCID: PMC11292453.
PMID: 39083271.
2023
Deeds S, Schuttner L, Wheat C, Gunnink E, Geyer J, Beste L, Chen A, Dominitz JA, Nelson K, Reddy A. Automated Reminders Enhance Mailed Fecal Immunochemical Test Completion Among Veterans: a Randomized Controlled Trial. J Gen Intern Med. 2023 Sep 20. doi: 10.1007/s11606-023-08409-8. Epub ahead of print.
PMID: 37731137.
Deeds S, Liu T, Schuttner L, Wheat C, Gunnink E, Geyer J, Beste L, Chen A, Dominitz JA, Nelson K, Reddy A. A Postcard Primer Prior to Mailed Fecal Immunochemical Test Among Veterans: a Randomized Controlled Trial. J Gen Intern Med. 2023 Jun 8:1–7. doi: 10.1007/s11606-023-08248-7. Epub ahead of print. PMCID: PMC10249919.
PMID: 37291363.
Golob AL, Geyer J, O'Keeffe C, Nelson K, Song C, Vanderwarker C, Britton J, Reddy A, Wong E, Schuttner L. Automatic medication refills to improve glycaemic control among patients with diabetes and low medication adherence. BMJ Open Qual. 2023 Feb;12(1):e001985. doi: 10.1136/bmjoq-2022-001985.
PMID: 36746551.
2022
Hoerster KD, Hunter-Merrill R, Nguyen T, Rise P, Barón AE, McDowell J, Donovan LM, Gleason E, Lane A, Plumley R, Schooler M, Schuttner L, Collins M, Au DH, Ma J. Effect of a Remotely Delivered Self-directed Behavioral Intervention on Body Weight and Physical Health Status Among Adults With Obesity: The D-ELITE Randomized Clinical Trial. JAMA. 2022 Dec 13;328(22):2230-2241. doi: 10.1001/jama.2022.21177.
PMID: 36511927.
Learn more about this publication on Dimensions
Schuttner L, Lee JR, Hockett Sherlock S, Ralston JD, Rosland AM, Nelson K, Simons C, Sayre GG. Primary Care Physician Perspectives on the Influence of Patient Values, Health Priorities, and Preferences on Clinical Decision-Making for Complex Patients with Multimorbidity: A Qualitative Study. Risk Manag Healthc Policy. 2022 Nov 16;15:2135-2146. doi: 10.2147/RMHP.S380021. PMCID: PMC9675988. PMID: 36415219.
Learn more about this publication on Dimensions
Schuttner L, Guo R, Wong E, Jimenez E, Klein M, Roy S, Rosland AM, Chang ET. High-Risk Patient Experiences Associated With an Intensive Primary Care Management Program in the Veterans Health Administration. J Ambul Care Manage. 2022 Aug 27. doi: 10.1097/JAC.0000000000000428. Epub ahead of print. PMID: 36036980.
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Coley RY, Duan KI, Hoopes AJ, Lapham GT, Liljenquist K, Marcotte LM, Ramirez M, Schuttner L. A call to integrate health equity into learning health system research training. Learn Health Syst. 2022 Jul 24;6(4):e10330. doi: 10.1002/lrh2.10330. PMCID: PMC9576239. PMID: 36263258.
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Schuttner L, Hockett Sherlock S, Simons CE, Johnson NL, Wirtz E, Ralston JD, Rosland AM, Nelson K, Sayre G. My Goals Are Not Their Goals: Barriers and Facilitators to Delivery of Patient-Centered Care for Patients with Multimorbidity. J Gen Intern Med. 2022 May 23:1–8. doi: 10.1007/s11606-022-07533-1. Epub ahead of print. PMCID: PMC9126696. PMID: 35606644.
Learn more about this publication on Dimensions
Schuttner L, Hockett Sherlock S, Simons C, Ralston JD, Rosland AM, Nelson K, Lee JR, Sayre G. Factors affecting primary care physician decision-making for patients with complex multimorbidity: a qualitative interview study. BMC Prim Care. 2022 Feb 5;23(1):25. doi: 10.1186/s12875-022-01633-x. PMID: 35123398.
Learn more about this publication on Dimensions
2021
Schuttner L, Haraldsson B, Maynard C, Helfrich CD, Reddy A, Parikh T, Nelson KM, Wong E. Factors Associated With Low-Value Cancer Screenings in the Veterans Health Administration. JAMA Netw Open. 2021 Oct 1;4(10):e2130581. doi: 10.1001/jamanetworkopen.2021.30581. PMID: 34677595.
Beste LA, Chen A, Geyer J, Wilson M, Schuttner L, Wheat C, Rojas J, Nelson K, Reddy A. Best Practices for an Equitable Covid-19 Vaccination Program. NEJM Catal Innov Care Deliv. 2021 Sep 15;2(10):10.1056/CAT.21.0238. doi: 10.1056/CAT.21.0238. PMCID: PMC8443122.
Schuttner L, Coleman K, Ralston J, Parchman M. The role of organizational learning and resilience for change in building quality improvement capacity in primary care. Health Care Manage Rev. 2021 Apr-Jun 01;46(2):E1-E7. doi: 10.1097/HMR.0000000000000281. PMCID: PMC7541444. PMID: 33630509.
2020
Schuttner L, Wong ES, Rosland AM, Nelson K, Reddy A. Association of the Patient-Centered Medical Home Implementation with Chronic Disease Quality in Patients with Multimorbidity. J Gen Intern Med. 2020 Oct;35(10):2932-2938. doi: 10.1007/s11606-020-06076-7. Epub 2020 Aug 6. PMCID: PMC7572962. PMID: 32767035.
Hoerster KD, Collins MP, Au DH, Lane A, Epler E, McDowell J, Barón AE, Rise P, Plumley R, Nguyen T, Schooler M, Schuttner L, Ma J. Testing a self-directed lifestyle intervention among veterans: The D-ELITE pragmatic clinical trial. Contemp Clin Trials. 2020 Aug;95:106045. doi: 10.1016/j.cct.2020.106045. Epub 2020 May 28. PMID: ; PMCID: PMC7253950. PMID: 32473403
Schonberg MA, Karamourtopoulos M, Jacobson AR, Aliberti GM, Pinheiro A, Smith AK, Davis RB, Schuttner LC, Hamel MB. A Strategy to Prepare Primary Care Clinicians for Discussing Stopping Cancer Screening With Adults Older Than 75 Years. Innov Aging. 2020 Jul 7;4(4):igaa027. doi: 10.1093/geroni/igaa027. PMCID: PMC7413618. PMID: 32793815
Schuttner L, Gunnink E, Sylling P, Taylor L, Fihn SD, Nelson K. Components of the Patient-Centered Medical Home Associated with Perceived Access to Primary Care. J Gen Intern Med. 2020 Jun;35(6):1736-1742. doi: 10.1007/s11606-020-05668-7. Epub 2020 Jan 28. PMCID: PMC7280463. PMID: 31993947
Schuttner L, Reddy A, White AA, Wong ES, Liao JM. Quality in the Context of Value: Reliability of Quality Metrics in an Academic Health System Shifting Toward Value-Based Payments. Am J Med Qual. 2020 Dec;35(6):465-473. doi: 10.1177/1062860620917205. Epub 2020 May 5. PMID: 32367726
Schuttner L, Reddy A, Rosland AM, Nelson K, Wong ES. Association of the Implementation of the Patient-Centered Medical Home with Quality of Life in Patients with Multimorbidity. J Gen Intern Med. 2020 Jan;35(1):119-125. doi: 10.1007/s11606-019-05429-1. Epub 2019 Oct 30. PMCID: PMC6957610. PMID: 31667750
Wong ES, Schuttner L, Reddy A. Does machine learning improve prediction of VA primary care reliance? Am J Manag Care. 2020 Jan;26(1):40-44. doi: 10.37765/ajmc.2020.42144. PMID: 31951358
2019
Marcotte LM, Schuttner L, Liao JM. Measuring low-value care: learning from the US experience measuring quality. BMJ Qual Saf. 2020 Feb;29(2):154-156. doi: 10.1136/bmjqs-2019-010191. Epub 2019 Oct 24. PMID: 31649163
Parchman ML, Anderson ML, Coleman K, Michaels LA, Schuttner L, Conway C, Hsu C, Fagnan LJ. Assessing quality improvement capacity in primary care practices. BMC Fam Pract. 2019 Jul 25;20(1):103. doi: 10.1186/s12875-019-1000-1. PMCID: PMC6657073. PMID: 31345167
Media (Video, Podcast, Other)
VHA Primary Care Analytics Team
Low-value Cancer Screenings in the Veterans Health Administration: Rates and Factors Associated with Overuse of Breast, Cervical, Colorectal, and Prostate Cancer Testing
by Linnaea Schuttner, MD, MS
Seminar date: 1/19/2022
Description: Abstract: This presentation reviews findings from a recent observational study of low-value (i.e., guideline-discordant) cancer screening for four common cancers in the VHA: breast, cervical, colorectal, and prostate cancer. In this study, the presenters will examine rates of low-value testing occurring among VHA-enrolled patients screened for cancer, using validated definitions of low-value cancer testing. The presenters will evaluate multilevel factors potentially associated with low-value testing at the individual patient, clinician, and system-level, including domains of the VHA’s patient-centered medical home (PACT model). Target Audience: Clinicians, health system leadership, health system researchers.
