More presentations!

Amanda Kennedy and Charles Maclean. Integrating Pharmacists Into Primary Care: A Demonstration Emphasizing Population Management. North American Primary Care Research Group (NAPCRG) Annual Meeting, Ottawa, ON, November 9-13, 2013

Do you have a presentation coming up? A paper? Something to brag about? Post it here or (if you are too shy) send it to Sylvie (sylvie.frisbie@uvm.edu) or me (benjamin.littenberg@uvm.edu) and we'll do the honors for you.

Many congratulations to the authors of these two abstracts, which have been accepted for presentation at The North American Primary Care Research Group annual meeting this fall:

 MacLean CD, Littenberg B, Kennedy AG, Van Eeghen C, Mayo F. Population Reporting of Opioid Prescribing Using Electronic Medical Record Data. North American Primary Care Research Group (NAPCRG) Annual Meeting, Ottawa, ON, November 9-13, 2013

Van Eeghen C, Kennedy AG, Pasanen M, Littenberg B, MacLean CD. Using Lean Management to Improve Opioid Prescribing for Pain in Ambulatory Care. North American Primary Care Research Group (NAPCRG) Annual Meeting, Ottawa, ON, November 9-13, 2013

New grant for Rodger Kessler and company

Many congratulations to Rodger Kessler, PhD, Assistant Professor of Family Medicine. He is the PI on a new grant from the National Institutes of Mental Health entitled "A Toolkit to Implement Behavioral Health in Primary Care."  His co-investigators include Connie van Eeghen, Assistant Professor of Medicine, Peter Callas, Associate Professor of Mathematics, and Benjamin Littenberg, Henry and Carleen Tufo Professor of Medicine.

Good NYT Article on the use of Tweets for Public Health Surveillance

There's a Fly in My Tweets... by Henry Kautz at the University of Rochester

Clinical Research Oriented Workshop for June 12, 2013

Ben, Charlie, Abby, and Marianne were present. 

Marianne distributed an overall view of criteria to support CTS students in basic information competencies required in the Designing, Conducting and Reporting Clinical Research Core classes.  (See Marianne for a detailed outline.)   

These competencies: 

1) emphasize use of PubMed to identify relevant literature, find full text of articles, and download citations and articles to a reference manager and 

2) emphasize use of EndNote to manage literature found and to cite properly and efficiently when writing grant proposals, IRB proposals and journal articles. 

3) identify other sources of information  The idea is to have a website linkable from the Blackboard instance of the class. 

Marianne also showed the preliminary work she has done on the website which is not yet publicly viewable.

Those attending agreed that this could be useful. One suggestion was to include a few self-test questions for students on each tab or topic. Marianne was most appreciative of the time and feedback.

Recorder, Marianne Burke

Clinical Research Oriented Workshop (CROW) SUPPLEMENTAL Meeting: June 13, 2013

Present:  Abby Crocker,  Rodger Kessler, Ben Littenberg, Charlie MacLean, Connie van Eeghen

Guests: Wilson Pace MD, Director of NRN, Professor of Family Medicine and the Green-Edelman Chair for Practice-based Research at the University of Colorado.

               David West PhD, the Director for COHO (Colorado Health Outcomes) and Faculty at the School of Medicine, University of Colorado.   Associate Chair for Departmental Affairs for the Department of Medicine.  Past experience in alternatives to FFS funding mechanisms.

               Lisa Shilling, MD, University of Colorado, Director SAFTINet project in 3 or 4 states, collecting claims and clinical data for CE research

1.                  Start Up: Introductions and summary of common interests from the previous meeting: opiate patient groups; geographic data, pilot data for anti-psychotics

2.                  Opportunity Development: Rodger arranged this meeting to give CROW participants a chance to talk with Wilson Pace, Director, Dave West, and Lisa Shilling from the largest practice based research network, sponsored by American Academy of Family Physicians, with access to Medicaid data base.

a.       Background: SAFTINet project now includes 9 FAHC clinics, plus all FQHC clinics; other areas of interest: patient engagement

                                                  i.      Helpful contacts to date: FAHC medical information CIO, DIVA, Green Mountain Care Board discussion about different collaborative care models supported by different financial models; Liz Chen and Neil Sarkar; and others.

b.      Opioid study opportunity: modeling use of urine screening to predict when its use is helpful; how to humanize the experience for patients; how to systematize learning and change (e.g. toolkits)

                                                  i.      Outcome measures: county-wide arrest rates for opioid diversion?  Process measure: telephone call traffic?

                                                ii.      Center for Implementation Science in CO, Allie Kemp

c.       The science of studying implementation – successes and failures

d.      The activation of patient engagement – a natural history experiment in the market place

                                                  i.      Using data to identify and change patient/provider behavior (diabetics)

                                                ii.      The same with respect to chronic kidney disease

e.       Maternal/child health, including opioid use, disease surveillance (diabetes; funding available through CDC)

3.                  Next Workshop Meeting(s): Wednesday, 11:30 a.m. – 1:00 p.m., at Given Courtyard South Level 4. 

a.       June 19: Abby: Update on data analysis of “Exploration of analytical plan for Natural History of Acute Opioid Use” (Kairn to phone in)

b.      June 26: Connie: Manuscript review of “Integrating Behavioral Health in Primary Care Using Lean Workflow Analysis: A Quality Improvement Case Study” (Kairn to phone in)

a.       July 3: (no Connie)

b.      July 10: Marianne: Review of literature review (no Connie)

c.       July 17:

d.      July 24:

e.       July 31:

f.       August 7

g.      August 14

h.      August 21

i.        August 28

j.        Future agenda to consider:

                                                  i.      Peter Callas or other faculty on multi-level modeling

                                                ii.      Charlie MacLean: demonstration of Tableau; or Rodger’s examples of Prezi

                                              iii.      Journal article: Gomes, 2013, Opioid Dose and MVA in Canada (Charlie)

                                              iv.      Ben: Tukey chapter reading assignments, or other book of general interest

                                                v.      Summer plan: each week, one person will send out an article or prezi ahead for review or discussion by all.  Alternatively, if a participant is working on a key document for their professional development, this is also welcome (e.g. K awards, F awards, etc.)

Recorder: Connie van Eeghen

Clinical Research Oriented Workshop (CROW) Meeting: May 30, 2013

Present:  Marianne Burke, Kairn Kelley, Rodger Kessler, Ben Littenberg, Charlie MacLean, Connie van Eeghen

1.                  Start Up: New aptonym: a speech/hearing researcher name Dr. Speaks! 

2.                  Journal Article Review: Journal article by Feldman, 2013, “Impact of Providing Fee Data on Laboratory Test Ordering,” JAMA Internal Medicine (not the same as JAMA)

a.       Classic study to test method of reducing unnecessary lab orders, repeated here by attaching Medicare charges; no evaluation of effect on patient care

b.      Result: reduce by 1/3 of a test/day: significant difference

c.       Problems:

                                                  i.      Test panels were not symmetrical; numbers of tests (70) too low for comparable groups.  This may have been due to poor stratification.

                                                ii.      Financial benefit found was probably limited

                                              iii.      No measure of impact on patient: did the providers reduce orders for unnecessary tests?  Did they reduce orders for necessary tests?

                                              iv.      Not novel: a change in signal usually does result in a long term change in behavior. 

d.      Useful?  Do ACO’s want to reduce lab tests, when a missed test result could end up with a patient in the hospital instead?  Will they want to focus on the protocols for populations that generate lab orders?

e.       How to change this study re: changing behavior by displaying charges?  Leaving the research question alone, randomize 100 AMCs, half of which get displayed charges.  Time series analysis, or phased “turn on” individual lab tests.  Also, re-examine the relationship between the tests from a clinical perspective. 

3.                  Next Workshop Meeting(s): Wednesday, 11:30 p.m. – 1:00 p.m., at Given Courtyard South Level 4. 

a.       Wednesday, June 5: NOTE: New summer schedule starts: Wednesdays, 11:30 – 1:00.  Abby: Journal article (no Connie, Ben; Kairn to phone in)

b.      Wednesday, June 12: Marianne: Feedback on ideas for web site that will help CTS students (faculty, and fellows too)  find/know /access, evaluate/apply content and literature they need for courses and research (Kairn to phone in)

c.       Thursday, June 13: 2:00 – 3:30 Wilson Pace, Director & Dave West from the largest practice based research networks from American Academy of Family Physicians; access to Medicaid data base.  Kairn, Abby, Charlie can all make it. 

d.      Wednesday, June 19: (Kairn to phone in)

e.       June 26: (Kairn to phone in)

f.       July 3:

g.      July 10: Marianne: Review of literature review (no Connie)

h.      July 17:

i.        July 24:

j.        July 31:

k.      August 7

l.        August 14

m.    August 21

n.      August 28

o.      Future agenda to consider:

                                                  i.      Abby and Charlie: data analysis of Exploration of analytical plan for Natural History of Acute Opioid Use

                                                ii.      Peter Callas or other faculty on multi-level modeling

                                              iii.      Charlie MacLean: demonstration of Tableau; or Rodger’s examples of Prezi

                                              iv.      Journal article: Gomes, 2013, Opioid Dose and MVA in Canada (Charlie)

                                                v.      Ben: Tukey chapter reading assignments, or other book of general interest

                                              vi.      Summer plan: each week, one person will send out an article or prezi ahead for review or discussion by all.  Alternatively, if a participant is working on a key document for their professional development, this is also welcome (e.g. K awards, F awards, etc.)

Recorder: Connie van Eeghen

		Come Meet the Visiting PhD Nursing Students
		Tuesday, June 18th, 2013 4:30-6 PM      UVM Rowell 107
	Learn about their educational journey and their selected area of research Prevalence and Characteristics of Pain Qualities in Older Adults with Chronic Pain. Manu Thakral, MSN, NP University of MA, Boston Automated Technology to Manage Type 2 Diabetes in Puerto Rican Adults Jalil Johnson MS, ANP-BC University of Massachusetts|Amherst|School of Nursing The Use of Communication Focused Remote Blood Pressure Technologies in Older Adults Valeria Ramdin MS, APRN-BC Northeastern University, Boston MA RSVP  mpalumbo@uvm.edu or 656-0023 Light refreshments will be provided