# Pulmonary Specialist-Health Coach Consult (PuSHCon) model to improve access to specialist consultation and receipt of recommended evidence-based care for vulnerable patients with COPD and asthma

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2021 · $768,207

## Abstract

Project Summary/Abstract
 The proposed parallel arm, clustered randomized controlled trial will evaluate the effectiveness
of a novel model for pulmonary specialist-health coach (PuSHCon) with respect to access to specialist
recommendations and the provision of evidence-based care for patients with chronic obstructive
pulmonary disease (COPD) and/or asthma receiving care at federally qualified health centers (FQHCs).
The PuSHCon model was developed in partnership between patients, investigators, primary care
clinicians, specialists, and FQHCs within the San Francisco Health Care Network during a randomized
controlled trial of health coaching for patients with moderate to severe COPD. In the PuSHCon model, a
trained, non-professional (unliscenced) health worker, meets with the patient at the patient’s own clinic
to gather extensive information needed by the pulmonary specialist to make an assessment and
recommendation for evidence-based care for COPD and/or asthma. The health coach then meets with
the hospital-based pulmonary specialist who can assess the patient and make evidence-based
recommendations without requiring the patient to be seen. These recommendations are communicated
electronically to the patient’s primary care provider (PCP). The health coach communicates with the PCP
and meets with the patient to explain the recommendations and support their implementation.
 The proposed study will be conducted in the San Francisco Health Network, at 10 clinic sites that
share an electronic medical record and a single electronic referral process (eReferral). The specific aims
of the study are to compare the use of evidence-based care and of patient reported 16 weeks after the
referral. In addition, the study will evaluate the number of patients seen under each model and the cost
per patient in each model.
 The PuSHCon model combines desirable attributes of patient-centered care, team-based care,
and coordinated specialty consultation to improve guideline-based care for at-risk patients with COPD
and/or asthma. This model has been specifically developed to function within a safety-net system. It is
designed to be practical and adaptable to other FQHCs and FQHC networks, and to be effective despite
financial, technological, and resource constraints. If the proposed study shows that the PuSHCon model
increases the use of evidence-based care, it can be widely implemented to increase guideline
concordant, evidence-based care not just for patients with COPD or asthma, but also for patients with
other chronic conditions that would benefit from specialist consultation.

## Key facts

- **NIH application ID:** 10215610
- **Project number:** 5R01HL143366-03
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** GEORGE SU
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $768,207
- **Award type:** 5
- **Project period:** 2019-09-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10215610

## Citation

> US National Institutes of Health, RePORTER application 10215610, Pulmonary Specialist-Health Coach Consult (PuSHCon) model to improve access to specialist consultation and receipt of recommended evidence-based care for vulnerable patients with COPD and asthma (5R01HL143366-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10215610. Licensed CC0.

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