A5068839345- Primary Care and Health Outcomes
- Electronic Health Records Systems
- Diabetes Management and Education
- Chronic Disease Management Strategies
- Healthcare Systems and Technology
- Innovations in Medical Education
- Health Systems, Economic Evaluations, Quality of Life
- Health Policy Implementation Science
- Diabetes Management and Research
- Medical Coding and Health Information
- Clinical practice guidelines implementation
- Healthcare Policy and Management
- Diabetes Treatment and Management
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Pharmaceutical Practices and Patient Outcomes
- Nursing Roles and Practices
- Interprofessional Education and Collaboration
- Patient Satisfaction in Healthcare
- Medication Adherence and Compliance
- Healthcare cost, quality, practices
- Patient-Provider Communication in Healthcare
- Telemedicine and Telehealth Implementation
- Biomedical Text Mining and Ontologies
- Political Influence and Corporate Strategies
- Cultural Competency in Health Care
Agency for Healthcare Research and Quality
2023-2024
Purdue University West Lafayette
2022-2023
Virginia Commonwealth University
2014-2020
Mathematica Policy Research
2013-2017
Oregon Health & Science University
2010-2014
Kaiser Permanente Center for Health Research
2014
Johnson University
2007-2013
Rutgers, The State University of New Jersey
2002-2012
San Francisco General Hospital
2012
University of California, San Francisco
2012
Much research does not address the practical needs of stakeholders responsible for introducing health care delivery interventions into organizations working to achieve better outcomes. In this article, we present an approach using Consolidated Framework Implementation Research (CFIR) guide systematic that supports rapid-cycle evaluation implementation and produces actionable findings intended improve in a timely manner.To our approach, describe formative cross-case qualitative investigation...
OBJECTIVE Reasons for failing to initiate prescribed insulin (primary nonadherence) are poorly understood. We investigated barriers initiation following a new prescription. RESEARCH DESIGN AND METHODS surveyed insulin-naïve patients with controlled type 2 diabetes, already treated two or more oral agents who were recently insulin. compared responses respondents prescribed, but never initiating, (n = 69) those dispensed 100). RESULTS Subjects commonly reported misconceptions regarding risk...
Electronic health records (EHRs) must support primary care clinicians and patients, yet many remain dissatisfied with their system. This article presents a consensus statement about gaps in current EHR functionality needed enhancements to care. The Institute of Medicine attributes were used define needs meaningful use (MU) objectives functionality. Current focused on disease rather than the whole person, ignoring factors such as personal risks, behaviors, family structure, occupational...
To examine demographic, socioeconomic, and biological risk factors for all-cause, cardiovascular, noncardiovascular mortality in patients with type 2 diabetes over 8 years to construct prediction equations.Beginning 2000, survey medical record information was obtained from 8,334 participants Translating Research Into Action Diabetes (TRIAD), a multicenter prospective observational study of care managed care. The National Death Index searched annually obtain data on deaths an 8-year follow-up...
<b>PURPOSE</b> Care of patients with diabetes requires management complex clinical information, which may be improved by the use an electronic medical record (EMR); however, actual relationship between EMR usage and care quality in primary settings is not well understood. We assessed a sample family medicine practices. <b>METHODS</b> conducted cross-sectional analyses baseline data from 50 practices participating practice improvement study. Between April 2003 December 2004 chart auditors...
<i>Background:</i> Helping patients navigate the complex and fragmented US health care system coordinating their are central to patient-centered medical home. We evaluated pilot use of a patient navigator (PN), someone who helps effectively efficiently, in primary practices. <i>Methods:</i> This study was cross-case comparative analysis 4 community practices that implemented navigation. Project meeting notes, PN activity logs debriefings, physician interviews, patient/family member...
<b>PURPOSE</b> Electronic medical record (EMR) systems offer substantial opportunities to organize and manage clinical data in ways that can potentially improve preventive health care, the management of chronic illness, financial primary care practices. The functionality EMRs as implemented, however, vary substantially from envisaged by their designers even those who purchase programs. purpose this study was explore how unique aspects a family medicine office culture affect initial...
To examine racial/ethnic and economic variation in cost-related medication underuse among insured adults with diabetes.We surveyed 5,086 participants from the multicenter Translating Research Into Action for Diabetes Study. Respondents reported whether they used less because of cost past 12 months. We examined unadjusted adjusted rates underuse, using hierarchical regression, to determine race/ethnicity differences still existed after accounting economic, health, other demographic...
Thiazolidinedione (TZD) treatment has been associated with fractures. The purpose of this study was to examine the association between TZD and fractures in type 2 diabetic patients.Using data from Translating Research into Action for Diabetes, a multicenter prospective observational diabetes care managed care, we conducted matched case-control assess odds exposure patients without We identified 786 cases based on detected health plan administrative data. Up four controls any fracture...
Abstract Accurate measurement of cancer-preventive behaviors is important for quality improvement, research studies, and public health surveillance. Findings differ, however, depending on whether patient self-report or medical records are used as the data source. We evaluated concordance between risk factors, cancer screening, behavioral counseling among primary care patients. Data from surveys were compared 742 patients in 25 New Jersey practices participating at baseline SCOPE (supporting...
Objective: To compare the experiences of e-prescribing users and nonusers regarding prescription safety workload to assess use information from two standards (for medication history formulary benefit information), as they are implemented. Design: Cross-sectional survey physicians who either had installed or were awaiting installation one commercial systems. Measurements: Perceptions about among all respondents, users, with system usability, job performance impact, amount e-prescribing....
OBJECTIVE The purpose of this study was to examine the predictors intensification antihyperglycemic therapy in patients with type 2 diabetes; its impact on A1C, body weight, symptoms anxiety/depression, and health status; patient characteristics associated improvement A1C. RESEARCH DESIGN AND METHODS We analyzed survey, medical record, plan administrative data collected Translating Research into Action for Diabetes (TRIAD). examined who were using diet/exercise or oral medications at...
<h3>PURPOSE</h3> Recent efforts to encourage meaningful use of electronic health records (EHRs) assume that widespread adoption will improve the quality ambulatory care, especially for complex clinical conditions such as diabetes. Cross-sectional studies typical uses commercially available EHRs provide conflicting evidence an association between EHR and improved effects longer-term in community-based primary care settings on are not well understood. <h3>METHODS</h3> We analyzed data from 16...
<h3>PURPOSE</h3> Successful use of electronic prescribing (e-prescribing) is a key requirement for demonstrating meaningful health records to qualify federal incentives. Currently, many physicians who implement e-prescribing fail make substantial these systems, and little known about factors contributing successful use. The objective this study was identify implementation techniques. <h3>METHODS</h3> We conducted multimethod qualitative case 5 ambulatory primary care practices identified as...
The purpose of this cross-sectional study is to explore primary care providers' (PCPs) perceptions about barriers initiating insulin among patients. Studies suggest that many patients with poorly controlled type 2 diabetes do not receive initiation by PCPs.As part the Translating Research Into Action for Diabetes study, authors conducted structured interviews in health systems Indiana, New Jersey, and California, asking PCPs importance factors affecting decision. calculated proportions...
<i>Introduction:</i> Many patients with diabetes have poorly controlled blood glucose, lipid, or pressure levels, increasing their risk for cardiovascular disease (CVD) and other complications. Relatively little is known about what physicians perceive to be barriers good CVD factor control own role in helping achieve control. <i>Methods:</i> We interviewed 34 primary care 4 states assess perceptions of patients' Interviews were coded analyzed emergent themes. <i>Results:</i> Physicians...
<b>PURPOSE</b> The Using Learning Teams for Reflective Adaptation (ULTRA) study used facilitated reflective adaptive process (RAP) teams to enhance communication and decision making in hopes of improving adherence multiple clinical guidelines; however, the failed show significant improvements. purpose this was examine qualitative data from 25 intervention practices understand how they engaged a team-based collaborative change management strategy types issues addressed. <b>METHODS</b> We...
Electronic health record (EHR) use in ambulatory care can improve safety and quality; however, problems with design, implementation, poor interface other systems lead users to develop 'workarounds', or behaviors adopt overcome perceived limitations a technical system. We documented workarounds used independent, community-based primary practices, developed typology of their key features.Comparative case study EHR seven independent practices. Field researchers spent approximately 1 month each...
OBJECTIVE To determine the frequency that diabetes is reported on death certificates of decedents with known and describe trends in reporting over 8 years. RESEARCH DESIGN AND METHODS Data were obtained from 11,927 participants who enrolled Translating Research into Action for Diabetes, a multicenter prospective observational study care managed care. (N = 2,261) National Death Index 1 January 2000 through 31 December 2007. The primary dependent variables presence ICD-10 codes listed anywhere...