Summaries of Independent Scientist (K) Awards

Adams, William

Institution: Boston Medical Center
Grant Title: Using an EMR to Improve Urban Child Health
Grant Number:  K02 HS013655
Duration: 3 years (2004-2007)
Total Award: $307,900

Project Description: The specific aims of this project are to use a common EMR in a network of urban primary care centers to:

1. Describe the content and quality of EMR-based urban and adolescent primary care.
2. Evaluate the efficacy of evidenced-enhanced audit and feedback to improve the delivery of multiple primary care services (preventive services and asthma care).
3. Describe the perceptions of primary care clinicians and quality improvement strategies used following receipt of practiced-based audit and feedback.
4. Evaluate incremental improvements in quality following the addition of point-of-care decision support to improve the delivery of multiple primary care services.
5. Describe the perceptions of primary care clinicians following receipt of point-of-care decision support. 

Career Goals: Dr. Adams is a pediatrician and epidemiologist. During the life of the K award, he will continue his development as an independent health services researcher by enhancing his skills in research methods and advanced data analysis. Further, the grantee will expand his collaborative research networks in order to apply the emerging electronic data privacy laws to Electronic Medical Record (EMR)-based health services research and the implementation of quality improvement. Dr. Adams' primary career goal is to improve the quality of urban pediatric primary care using computer-based technologies such as the EMR.

Progress to Date: Dr. Adams leads the Boston Pediatric Logician Users Group (PLUG) which includes clinical and IT representatives from eight community health centers as well as Boston Medical Center. These nine locations are the clinical sites for the K-supported research. The grantee has developed a robust data warehouse capable of integrating the data for children from the sites through a scaleable data schema and a master patient index. The project has been named "Boston Community Health Information for Improvement" (CHII). A completely revised set of Logician forms have been fully implemented in all nine primary care centers and are now in routine use. The new forms have substantially improved the content and ease of use of the EMR forms. The first investigation of CHII data has been completed and submitted for publication.

Future Plans: The grantee will continue to lead the PLUG and guide the Boston CHII implementation phase. By the end of year two (April 2006), the CHII will have a comprehensive set of base line primary care and asthma data and application development work for the "Measure Maker" application. All providers in the network will receive personalized performance run charts that will include their performance in the context for their clinic and the network overall. The data presentations will be combined with summaries of current evidence to support the need for optimal performance for measures. 

Highlights and Specific Accomplishments:

• Leads the Boston Pediatric Logician Users Group (PLUG), which includes clinical and IT representatives from each of the eight community health centers as well as Boston Medical Center, and are the nine clinical sites for the project.
• Developed a data warehouse capable of integrating the data for children from the nine clinical sites through a scaleable data schema and a master patient index.  The project has been named "Boston Community Health Information for Improvement" (CHII).
• Co-Chair of the NICHQ-supported New Jersey Immunization and Preventive Services Project—a modified learning collaborative which seeks to improve the delivery of immunization services using a statewide immunization registry and partnerships between state agencies, professional organizations, and primary care practices.
• Collaborated in the 10-month planning phase of "Improving Performance in Practice" (IPIP), an initiative guided by the center for children's healthcare Improvement in Chapel Hill, North Carolina.

K-Generated Publications: None thus far.

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