A5074302925- Chronic Disease Management Strategies
- Primary Care and Health Outcomes
- Health Policy Implementation Science
- Diabetes Management and Education
- Cardiac Health and Mental Health
- Mental Health Treatment and Access
- Mental Health and Patient Involvement
- Schizophrenia research and treatment
- Electronic Health Records Systems
- Clinical practice guidelines implementation
- Health Systems, Economic Evaluations, Quality of Life
- Artificial Intelligence in Healthcare
- Diabetes Treatment and Management
- Health Promotion and Cardiovascular Prevention
- Interprofessional Education and Collaboration
- Diabetes Management and Research
- Health, psychology, and well-being
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Pharmaceutical Practices and Patient Outcomes
- Machine Learning in Healthcare
- Emergency and Acute Care Studies
- Data Quality and Management
- Medication Adherence and Compliance
HealthPartners
2000-2022
University of Minnesota, Duluth
2021
Regions Hospital
2012-2015
The objective of this study was to identify the number people with diabetes from a DataLink developed as part SUPREME-DM (SUrveillance, PREvention, and ManagEment Diabetes Mellitus) project, consortium 11 integrated health systems that use comprehensive EHR data for research.
The many randomized trials of the collaborative care model for improving depression in primary have not described implementation and maintenance this model. This paper reports how degree to which process changes were implemented maintained 75 clinics participating DIAMOND Initiative (Depression Improvement Across Minnesota-Offering a New Direction).Each clinic was trained implement seven components participated ongoing evaluation facilitation activities. For study, assessment clinical...
OBJECTIVE This study uses novel methods to examine the frequency of diagnosis and treatment prediabetes in real-world clinical settings using electronic health record (EHR) data. RESEARCH DESIGN AND METHODS We identified a cohort 358,120 adults with incident (fasting plasma glucose [FPG] 100–125 mg/dL or glycated hemoglobin 5.7–6.4% [39–46 mmol/mol]) between 2006 2010 examined rates 6 months after identification. RESULTS In identification prediabetes, 18% patients had their blood levels...
Medication nonadherence is a major obstacle to better control of glucose, blood pressure (BP), and LDL cholesterol in adults with diabetes. Inexpensive effective strategies increase medication adherence are needed.In pragmatic randomized trial, we randomly assigned 2,378 diabetes mellitus who had recently been prescribed new class for treating elevated levels glycated hemoglobin (A1C) ≥8% (64 mmol/mol), BP ≥140/90 mmHg, or ≥100 mg/dL, receive 1) one scripted telephone call from educator...
<h3>PURPOSE</h3> Scale-up and spread of evidence-based practices is one the most important challenges facing health care. We tested whether a statewide initiative, Depression Improvement Across Minnesota–Offering New Direction (DIAMOND), to implement collaborative care model for depression in 75 primary clinics resulted patient outcome improvements corresponding those reported randomized controlled trials. <h3>METHODS</h3> Health plans provided new monthly payment participating after 6-month...
<h3>Importance</h3> Adults with schizophrenia, schizoaffective disorder, or bipolar collectively termed<i>serious mental illness</i>(SMI), have shortened life spans compared people without SMI. The leading cause of death is cardiovascular (CV) disease. <h3>Objective</h3> To assess whether a clinical decision support (CDS) system aimed at primary care clinicians improves CV health for adult patients <h3>Design, Setting, and Participants</h3> In this cluster randomized trial conducted from...
Abstract Background In this paper we describe the use of Consolidated Framework for Implementation Research (CFIR) to study implementation a web-based, point-of-care, EHR-linked clinical decision support (CDS) tool designed identify and provide care recommendations adults with prediabetes (Pre-D CDS). Methods As part large NIH-funded clinic-randomized trial, identified convenience sample interview participants from 22 primary clinics in Minnesota, North Dakota, Wisconsin that were randomly...
Engaging stakeholders in the research process has potential to improve quality of care and patient experience. Online community surveys can elicit important topic areas for comparative effectiveness research. Stakeholder meetings with substantial representation, as well representation from health delivery systems funding agencies, are a valuable tool selecting refining pilot improvement projects. Giving deciding vote topics helps ensure their 'voice' is heard. Researchers leaders should...
There are few proven strategies to reduce the frequency of potentially preventable hospitalizations and Emergency Department (ED) visits. To facilitate strategy development, we documented these events among complex patients factors that contribute them in a large care-improvement initiative.Observational study with retrospective audits selective interviews by patients' care managers 12 diverse medical groups California, Minnesota, Pennsylvania, Washington participated an initiative implement...
To demonstrate a rigorous methodology that optimally balanced internal validity with generalizability to evaluate statewide collaborative implemented an evidence-based, care model for depression management in primary care.Several operational features of the DIAMOND (Depression Improvement Across Minnesota, Offering New Direction) Initiative suggested Study use staggered implementation design repeated cross-sections patients across clinical settings. A multilevel recruitment strategy elicited...
IN BRIEF We sought to fill critical gaps in understanding primary care providers' (PCPs') beliefs regarding diabetes prevention and cardiovascular disease risk the prediabetes population, including through comparison of attitudes between rural non-rural PCPs. used data from a 2016 cross-sectional survey sent 299 PCPs practicing 36 clinics that are part randomized control trial predominately northern Midwestern integrated health system. Results showed few significant, but clinically marginal,...
Objective: The spread of evidence-based care is an important challenge in healthcare. We evaluated large-scale multisite collaborative model for patients with depression and diabetes and/or cardiovascular disease (COMPASS). Methods: Primary comorbid or were recruited. Collaborative teams used management tracking systems systematic case reviews to track intensify treatment not improving. Targeted outcomes remission response (assessed the Patient Health Questionnaire-9) control by HbA1c) blood...
The ability to aggregate clinical data across multiple diverse organizations and use it for performance measurement, quality improvement, evaluation, research is rapidly becoming a national necessity, but there are few examples of how do that. This article uses lessons from effort implement the collaborative care management model patients with both depression diabetes or heart disease 8 partner organizations, 18 medical groups, more than 170 clinics in states identify challenges provide...
Leif Solberg1, Lauren Crain1, Jurgen Unutzer2, Arne Beck3, Nancy Jaeckels4, Robin Whitebird1, Rebecca Rossom1, Kris Ohnsorg1, Lisa Rubenstein5 and Michael Maciosek1 1HealthPartners 2University of Washington 3Kaiser Permanente Colorado 4Institute for Clinical Systems Improvement 5RAND
Purpose: We designed, implemented, and evaluated impact of a prediabetes clinical decision support system on identification control major cardiovascular (CV) risk factors in adults with receiving care primary clinics. Methods: randomized 34 clinics 18,229 study-eligible patients age 40-75 years at index encounter laboratory evidence to usual (UC) or (PreD-CDS) intervention condition. Study-eligible their clinician (PCC) were given patient-specific treatment suggestions diagnosis PreD...
Patrick O’Connor1, Jay Desai1, JoAnn Sperl-Hillen1, Renuka Adibhatla1, Mary Becker1, Kris Ohnsorg1 and Gabriela Vazquez Benitez1 1HealthPartners
Abstract Background The early detection and management of uncontrolled cardiovascular risk factors among prediabetes patients can prevent disease (CVD). Prediabetes increases the CVD, which is a leading cause death in United States. CVD clinical decision support (CDS) primary care settings has potential to reduce with while potentially saving clinicians time. objective this study understand clinician (PCC) perceptions CDS system designed adults prediabetes. Methods We administered pre-CDS...