Thursday, June 17, 2010
Clinical Research Oriented Workshop (CROW) Meeting: June 16, 2010
Present: Abby Crocker, Kairn Kelley, Ben Littenberg, Carole McBride, Charlie McLean
1. Round table discussion
2. Discussion of Kairn's F31 proposal development for August submission
Lessons of the day:
Action for Kairn: evaluate the existing evidence for Fast ForWord intervention before deciding which question to ask.
Next Week: Run Charts (Control Charts) discussion led by Abby. Ben requests that all attending bring a sequence of measures over time for demonstration. Could be your weight, the temperature at noon... anything where the collection method was the same each time. The data could be in Excel or on a piece of paper!
1. Round table discussion
2. Discussion of Kairn's F31 proposal development for August submission
Lessons of the day:
- If you select the worst cases to study, you will see improvement no matter what the intervention. (Regression to the mean) RCTs avoid over-interpreting this improvement by comparing the amount of change between groups.
- Don't conflate marketing with evidence.
- Design research that answers the question you intend to ask.
Action for Kairn: evaluate the existing evidence for Fast ForWord intervention before deciding which question to ask.
Next Week: Run Charts (Control Charts) discussion led by Abby. Ben requests that all attending bring a sequence of measures over time for demonstration. Could be your weight, the temperature at noon... anything where the collection method was the same each time. The data could be in Excel or on a piece of paper!
Wednesday, June 16, 2010
AHRQ’s Outstanding Achievement in Healthcare Research Award
· Calling published researchers and graduate students who have used Healthcare Cost and Utilization Project (HCUP) data!
· Nominations and Applications accepted through July 16.
To celebrate its 20th year of HCUP data, AHRQ will be honoring researchers who have addressed healthcare research and policy issues using HCUP data, software, or tools.
AHRQ encourages published researchers to apply in two areas: Scientific Contributions and Policy Impact. Graduate students can only apply for the scientific contribution award.
AHRQ encourages published researchers to apply in two areas: Scientific Contributions and Policy Impact. Graduate students can only apply for the scientific contribution award.
Award recipients will be honored at the AHRQ Annual Meeting (September 27-29, in Bethesda, Maryland). They will have the opportunity to present their research at a session during the meeting. Transportation and accommodations will be provided.
Apply and get more information here: http://www.hcup-us.ahrq.gov/hsra.jsp.
Tuesday, June 15, 2010
Fw: Informatics Grand Rounds - Tuesday, June 29th 4PM-5PM
-Benjamin Littenberg
From: Liz Chen
To: Liz Chen
Sent: Tue Jun 15 15:17:16 2010
Subject: Informatics Grand Rounds - Tuesday, June 29th 4PM-5PM
An inaugural "Informatics Grand Rounds" will be held on Tuesday, June 29th, 2010 from 4 PM to 5 PM in UVM/FAHC Medical Education Center Room 300. This monthly series is a joint initiative between the University of Vermont (Center for Clinical and Translational Science – Informatics Unit, Continuing Education, and Dana Medical Library), Fletcher Allen Health Care, and the State of Vermont.
Please feel free to forward the below announcement (or following URL) to others who may be interested:
http://www.uvm.edu/~ccts/web/informatics/grandrounds
If you have any questions or wish to be removed from this mailing list, please let me know (liz.chen@uvm.edu or 802-656-8286).
Best,
-Liz
~~~~~~~~
INFORMATICS GRAND ROUNDS
http://www.uvm.edu/~ccts/web/informatics/grandrounds
"Bioinformatics and Health Informatics Across the State of Vermont"
Date:
Tuesday, June 29th, 2010
Time:
4:00 PM – 5:00 PM
Location:
UVM/FAHC Medical Education Center Room 300 (Reardon Classroom)
http://www.uvm.edu/map/
Speakers:
Indra Neil Sarkar, PhD, MLIS (University of Vermont)
James D. Michelson, MD (University of Vermont and Fletcher Allen Health Care)
Hunt Blair (Office of Vermont Health Access)
Abstract:
The University of Vermont (Center for Clinical and Translational Science – Informatics Unit, Continuing Education, and Dana Medical Library), Fletcher Allen Health Care, and the State of Vermont are pleased to introduce a monthly Informatics Grand Rounds series that will provide a venue for learning about concepts and activities across the spectrum of biomedical informatics, from bioinformatics to clinical informatics to public health informatics. This series will feature the latest research and applications in informatics by local, regional, national, and international speakers.
Biomedical Informatics has become a core element across the spectrum of biomedicine, from bench biology to medicine to public health. This transdisciplinary and integrative field combines biomedicine and health care with computer science, management and decision science, cognitive and social science, biostatistics, engineering, and information and communication technology. Recent national emphasis on personalized medicine, clinical and translational science, electronic health records, health care reform, public health surveillance, and global health has further highlighted the value and need for advancing informatics methods and applications.
In this inaugural session, the speakers will provide a brief history of biomedical informatics and its sub-disciplines (e.g., bioinformatics, clinical informatics, and public health informatics) and discuss the role of informatics in the context of: (1) Translational Medicine, (2) Electronic Health Records (EHR), and (3) Health Care Reform (specifically, Health Information Technology [HIT] and Health Information Exchange [HIE]).
Speaker Bios:
Indra Neil Sarkar is Director of Biomedical Informatics at the Center for Clinical and Translational Science, Assistant Professor of Microbiology & Molecular Genetics, and Assistant Professor of Computer Science at the University of Vermont. His work is dedicated to furthering a biomedical informatics research agenda across the entire spectrum of biomedicine, from molecules to populations. Specific research involves the development and use of a range of computational techniques (including knowledge gathering and discovery methods, phylogenetics, information theory, ontology development, semantic indexing, and natural language processing) to facilitate the analysis and linking of molecular and public health data. Ultimately, Dr. Sarkar's research aims to enable the creation of testable models of disease and provide a framework to enable the assessment of comparative hypotheses across the spectrum of biomedicine and health care.
James D. Michelson is Professor of Orthopaedics and Rehabilitation at the University of Vermont, Medical Informaticist at Fletcher Allen Health Care, and a practicing Orthopaedic Surgeon. He has been a primary leader in the development and successful implementation of electronic health record systems at Johns Hopkins and Fletcher Allen Health Care. As the Medical Informaticist at Fletcher Allen Health Care, a large part of Dr. Michelson's responsibility is to identify and develop opportunities in clinical research using the EHR. His primary interests currently include developing effective surveillance methodologies for adverse medical events (including medication errors, post-surgical infections, and mortality), with the further goal of developing risk stratification models based on those data.
Hunt Blair is Deputy Director for Health Care Reform in the Office of Vermont Health Access. Active in Vermont health care and Medicaid policy since 1992, he joined the Douglas administration in January 2009 as Deputy Director for the Division of Health Care Reform in the Office of Vermont Health Access. The Division is also the state lead for HIT and HIE policy, planning, and oversight. Previously, Mr. Blair served as Vermont Director of Public Policy at the Bi-State Primary Care Association where he enjoyed "a front row seat" in the Vermont legislature for the creation and refinement of the state's landmark health care reform legislation. He continues to work closely with the legislature in his new role. The New England Rural Health Roundtable awarded Mr. Blair its Leadership Award in 2008 for his work on Vermont health care reform.
Monday, June 14, 2010
Clinical Research Oriented Workshop (CROW) Meeting: June 9, 2010
Clinical Research Oriented Workshop (CROW) Meeting: June 9, 2010
Present: Abby Crocker, Kairn Kelley (by phone), Rodger Kessler, Ben Littenberg, Carole McBride, Charlie McLean, Connie van Eeghen
1. Round Table: Following up on Rodger’s May 5 discussion about his upcoming study
2. Rodger’s Discussion:
a. The discussion focused on a figure to support questions of the perceptions regarding improvement in care and change in cost from the experiences of practice, patient, and system in making a change to the behavioral health access, identification, and treatment.
i. Inquiring into health status: can have a narrow interpretation, implying specific metrics
ii. Inquiring into outcomes: broad interpretation, includes clinical and cost changes. Past models agree on three basic groups from Peek (2008) and Berwick (2008):
1. Clinical/Care
2. Operational/Health
3. Financial/Cost
4. Other candidates: patient centeredness, social justice…
b. What is the focus of our communication? It depends on the clarity of:
i. The Audience
ii. The Medium (e.g. graphic)
iii. The Message
c. Collaborative Care Metrics: how do the measures line up with the three perspectives listed above?
i. Access (needs specification)
ii. Screening
1. Score distribution
2. % completing screens
3. % positive screens
4. disposition of docs when high score
5. 6 month follow up scores [code whether BH only or also CHT]
iii. Finance
1. RVU’s month
2. distribution of time codes( type and length of visits)
3. payer mix
iv. Clinical/operational
1. % ref'd out
2. % ref'd out where we have evidence of outside tx initiation
3. % ref’d out with evidence of communication from clinician
4. % with chronic disease co morbidity & distribution
5. prior treatment episodes
6. operations
7. time from referral to 1st visit
8. average time between visits
9. no show rate
a. No show 1st appointment, no show by # of sessions
10. average # of sessions
v. From the three perspectives (per Charlie)
1. What was the patient experience
a. Number seen (characterize the population)
b. What was the intervention (staff, method, practice)
c. What was it like (perception)
2. Later: What are the trends over time
3. Much later: determine the details of costs and the population specific outcomes
vi. Analytic planning
1. What tool (EMR) and collection (data queries)
2. What assessment (run charts-with outcomes over time) based on numbers, scores, or numerators that can be turned into rates or ratios
3. What are the input values to DocSite
d. Next steps: Clean up the measures, present to Randy Messier, select best, find sources by 10/10
3. Next Fellows Meeting(s): Wednesday, 2:00 – 3:30 p.m., at Given Courtyard Level 4
a. June 16: Kairn – fellowship proposal for Aug submission (no Connie, Matt, Rodger, Amanda)
b. June 23: Abby: run charts (no Connie or Matt or Amanda or Kairn)
c. June 30: Rodger: mixed methods article (no Connie)
d. July 7: (no Abby)
e. July 14:
f. July 21: Carol – data collection/analysis (no Matt through Aug 21)
g. Future agenda to consider:
i. How to predict medical events effectively (Ben)
ii. Future: Review of different types of journal articles (lit review, case study, original article, letter to editor…), when each is appropriate, tips on planning/writing (Abby)
iii. Future: Informed consent QI: Connie to follow up with Nancy Stalnaker, Alan Rubin will follow up with Alan Wortheimer or Rob McCauly
iv. Kairn will ask a librarian to join us for selected issues
4. Fellows document – nothing this time – to be reviewed after trialing Wednesday meeting times, which started May 5, 2010.
Recorder: Connie van Eeghen
Present: Abby Crocker, Kairn Kelley (by phone), Rodger Kessler, Ben Littenberg, Carole McBride, Charlie McLean, Connie van Eeghen
1. Round Table: Following up on Rodger’s May 5 discussion about his upcoming study
2. Rodger’s Discussion:
a. The discussion focused on a figure to support questions of the perceptions regarding improvement in care and change in cost from the experiences of practice, patient, and system in making a change to the behavioral health access, identification, and treatment.
i. Inquiring into health status: can have a narrow interpretation, implying specific metrics
ii. Inquiring into outcomes: broad interpretation, includes clinical and cost changes. Past models agree on three basic groups from Peek (2008) and Berwick (2008):
1. Clinical/Care
2. Operational/Health
3. Financial/Cost
4. Other candidates: patient centeredness, social justice…
iii. Ben’s graphic:
b. What is the focus of our communication? It depends on the clarity of:
i. The Audience
ii. The Medium (e.g. graphic)
iii. The Message
c. Collaborative Care Metrics: how do the measures line up with the three perspectives listed above?
i. Access (needs specification)
ii. Screening
1. Score distribution
2. % completing screens
3. % positive screens
4. disposition of docs when high score
5. 6 month follow up scores [code whether BH only or also CHT]
iii. Finance
1. RVU’s month
2. distribution of time codes( type and length of visits)
3. payer mix
iv. Clinical/operational
1. % ref'd out
2. % ref'd out where we have evidence of outside tx initiation
3. % ref’d out with evidence of communication from clinician
4. % with chronic disease co morbidity & distribution
5. prior treatment episodes
6. operations
7. time from referral to 1st visit
8. average time between visits
9. no show rate
a. No show 1st appointment, no show by # of sessions
10. average # of sessions
v. From the three perspectives (per Charlie)
1. What was the patient experience
a. Number seen (characterize the population)
b. What was the intervention (staff, method, practice)
c. What was it like (perception)
2. Later: What are the trends over time
3. Much later: determine the details of costs and the population specific outcomes
vi. Analytic planning
1. What tool (EMR) and collection (data queries)
2. What assessment (run charts-with outcomes over time) based on numbers, scores, or numerators that can be turned into rates or ratios
3. What are the input values to DocSite
d. Next steps: Clean up the measures, present to Randy Messier, select best, find sources by 10/10
3. Next Fellows Meeting(s): Wednesday, 2:00 – 3:30 p.m., at Given Courtyard Level 4
a. June 16: Kairn – fellowship proposal for Aug submission (no Connie, Matt, Rodger, Amanda)
b. June 23: Abby: run charts (no Connie or Matt or Amanda or Kairn)
c. June 30: Rodger: mixed methods article (no Connie)
d. July 7: (no Abby)
e. July 14:
f. July 21: Carol – data collection/analysis (no Matt through Aug 21)
g. Future agenda to consider:
i. How to predict medical events effectively (Ben)
ii. Future: Review of different types of journal articles (lit review, case study, original article, letter to editor…), when each is appropriate, tips on planning/writing (Abby)
iii. Future: Informed consent QI: Connie to follow up with Nancy Stalnaker, Alan Rubin will follow up with Alan Wortheimer or Rob McCauly
iv. Kairn will ask a librarian to join us for selected issues
4. Fellows document – nothing this time – to be reviewed after trialing Wednesday meeting times, which started May 5, 2010.
Recorder: Connie van Eeghen
Sunday, June 13, 2010
RE: CoNNECT Grant
Congratulations Rodger - outstanding news. Tom
-----Original Message-----
From: Littenberg, Benjamin
Sent: Saturday, June 12, 2010 5:22 PM
To: CCTS Blog (benjamin.littenberg.uvmcts@blogger.com); Galbraith,
Richard A.; Peterson, Thomas C; Morin, Frederick C; Messier, Randall S.
Subject: CoNNECT Grant
Congratulations to Rodger Kessler and his colleagues from around the
country for being awarded an R24 grant from AHRQ. The project is called
CoNNECT (Collaborative National Network Examining Comparative
Effectiveness Trials) and includes UVM as well as the University of
Colorado, the American Academy of Family Practice, the Collaborative
Care Research Network (CCRN) and the Distributed Ambulatory Research and
Therapeutics Network (DARTNet). Great work!
Ben
Saturday, June 12, 2010
CoNNECT Grant
Congratulations to Rodger Kessler and his colleagues from around the country for being awarded an R24 grant from AHRQ. The project is called CoNNECT (Collaborative National Network Examining Comparative Effectiveness Trials) and includes UVM as well as the University of Colorado, the American Academy of Family Practice, the Collaborative Care Research Network (CCRN) and the Distributed Ambulatory Research and Therapeutics Network (DARTNet). Great work!
Ben
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