Reimagination Update: A Tour of This Issue of The Permanente Journal

Over the past months, The Permanente Journal editorial and publication teams have been working very hard to provide a new Journal website appearance with enhanced content for its national and international readers. The website has been completely redesigned, the submission and review processes streamlined, and expansion of the Editorial Board is firmly underway. We will be utilizing multiple forms of contact to potential authors and reviewers, which we trust will allow us to expand significantly into the new content of the Journal’s “reimagination” by the leadership of The Permanente Federation. This new content emphasis includes, but is not limited to, topics on health care delivery and delivery science innovations, value-based health care, integrated delivery systems, quality improvement and practice change, and applied research. The Journal also encourages submission of research in equity, diversity, and inclusion in medicine, evidence-based guidelines, and health policy research pertaining to current health care challenges across the globe.

The Journal continues to value topics of interest to clinicians in their daily delivery of health care, in particular review articles, systematic reviews, and the team approach to efficient and effective health care delivery.

This issue of The Permanente Journal represents the growing content of population-based, and team-coordinated, health care delivery. Two studies in particular reflect these emphases and bear a brief introduction for your interest. Dr Nancy E Gin, executive vice president of quality and chief quality officer for The Permanente Federation, has authored an Invited Commentary entitled “The intersection of quality and research in the era of COVID-19: A virtuous cycle.” Her commentary reflects upon the considerable challenges to health care delivery over the course of the pandemic, overlaid by lagging efforts in health care reform over the years. The pandemic forced physicians and health care delivery systems to respond quickly and properly to the requirements of a growing infectious disease outbreak that threatened and took the lives of more than 1 million Americans. As Dr Gin points out, this loss of life was unprecedented in contemporary medicine in the United States and required a high speed of innovation from the health care industry. She rightfully indicates that the national research community, in step with public health, clinicians, and health care institutions, was able to create a confluence of safe and effective patient care in a quality- and value-based manner. Finally, Dr Gin urges a constant readiness of research communities, including physician researchers, to respond to, and engage with, clinical delivery scientists and practitioners for future response capabilities and to “ensure the enduring advancement of quality.” I urge you to read her timely and important commentary.

In another article related to lessons learned from the pandemic, Dr Tracy A Lieu, director of research in the Division of Research, The Permanente Medical Group, and her colleagues, address the challenges of serving large and diverse populations through video visits. The article is titled “Strategies facilitating video visit implementation by a medical group serving a diverse population.” Their study of physicians and staff members identified a number of key strategies that may assist the adoption of effective and long-term utilization procedures for video care in clinical practice, including innovation, collaboration across disciplines and expertise, and the same empathetic approach utilized by clinicians for in-person visits. The use of video visits within a diverse patient population requires planning and clear articulation of goals and expectations. As you are reading this article, you may be thinking about how your own institution pivoted to expand into telehealth during the onset of the pandemic, and what lessons were learned.

This issue also features a very special expert panel discussion on “Gun violence and mass shootings as a public health priority in the United States.” The article contains comments and insights from a panel of national and international experts on gun violence and mass shootings, convened to address the issues germane to physicians and other health care providers following the mass shootings in Uvalde, Texas; Highland Park, Illinois; Tulsa, Oklahoma; and many others. This panel of experts was convened to provide perspectives for physicians who practice in communities where concern for the safety of children, staff, families, and first responders are foremost on their minds. Physicians and surgeons tend to the injured, they counsel the survivors and console the friends and families, and they bear the burden of loss themselves. In this transcribed article, the panel members have provided insights developed over decades of experience, and we appreciated their willingness to share their thoughts. The distinguished panelists included: Mary Ellen O’Toole, PhD, professor of forensic science at George Mason University and retired FBI profiler; Georges C Benjamin, MD, an emergency medicine physician and executive director of the American Public Health Association; David C Grossman, MD, vice president of social health and equity, national program in community health and quality and professor of health system science at the Kaiser Permanente School of Medicine; and Joseph V Sakran, MD, MPH, MPA, vice-chair of clinical operations and associate professor of trauma surgery at Johns Hopkins Medicine. For the clinician who is interested in better understanding the psychology of mass shooters, the events that drive them to violence, and how the medical community can play a role in preventing these tragedies, this article is a must-read.

I urge you to examine these and all the articles in this issue of The Permanente Journal, as each provides a unique educational body of clinical information for consideration and possible utilization in your practice. The Permanente Journal strives to provide research and clinical content that is current, impactful, and of value to the care of patients.