Senior woman waiting for treatment in hospital

Increasing SBP variability is associated with an increased risk of developing incident diabetic foot ulcers.

Increasing SBP variability is associated with an increased risk of developing incident diabetic foot ulcers.

Excessive SBP variability may offer a potential new target for mitigating end-organ damage associated with microvascular and macrovascular disease, such as diabetic foot ulcers. Targeting SBP variability in addition to the absolute value, may help reduce the high risk of vascular complications faced by patients with diabetes. The goal of this study by HIP Investigator, Dr. Meghan Brennan et al. is to determine whether the risk of incident diabetic foot ulceration increases as SBP variability increases.

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Doctor talking to older woman

If We Don't Ask, They Won't Tell: Screening for Urinary and Fecal Incontinence by Primary Care Providers.

If We Don't Ask, They Won't Tell: Screening for Urinary and Fecal Incontinence by Primary Care Providers.

More than half of older adults experience urinary (UI) or fecal incontinence (FI), but the majority have never discussed symptoms with health care providers. Little is known about primary care providers' (PCPs') screening for UI and FI. Given the prevalence and significant negative impact of UI and FI, availability of effective treatment options, and the limited rates of spontaneous care seeking for these conditions, HIP Investigator, Dr. Heidi Brown et al. sought to quantify screening rates, attitudes, beliefs, and behaviors for these conditions among PCPs in our health care system.

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Doctor explaining prescription

Longitudinal trends and predictors of statin use among patients with diabetes.

Longitudinal trends and predictors of statin use among patients with diabetes.

Patients with diabetes have a well-established elevated risk of cardiovascular disease. Statins reduce morbidity and mortality among patients with diabetes, but their use remains suboptimal. In this study, HIP Investigator Dr. Meghan Brennan et al. sought to understand trends in statin use to inform strategies for improvement. They found that Statin use is slowly increasing among patients with diabetes, and at varying rates within subgroups of this population. Policies that prioritize these subgroups for statin promotion may help guide future, intervention-based research to increase compliance with current guidelines.

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Doctor breaking cigarette

Patient Perspectives on Smoking Cessation and Interventions in Rheumatology Clinics.

Patient Perspectives on Smoking Cessation and Interventions in Rheumatology Clinics.

Although smoking is a risk factor for cardiovascular and rheumatic disease severity, only 10% of rheumatology visits document cessation counseling. HIP Investigator, Dr. Christie Bartels et al. identified themes and categories of patient and health system-level facilitators/barriers to smoking cessation. Participant-reported barriers and facilitators to cessation involved psychological, health, and social and economic factors, and healthcare messaging, and resources.

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The importance of health insurance claims data in creating learning health systems: evaluating care for high-need high-cost patients using the National Patient-Centered Clinical Research Network (PCORNet)

The importance of health insurance claims data in creating learning health systems: evaluating care for high-need high-cost patients using the National Patient-Centered Clinical Research Network (PCORNet)

Case management programs for high-need high-cost patients are spreading rapidly among health systems. PCORNet has substantial potential to support learning health systems in rapidly evaluating these programs, but access to complete patient data on health care utilization is limited as PCORNet is based on electronic health records not health insurance claims data. Because matching cases to comparison patients on baseline utilization is often a critical component of high-quality observational comparative effectiveness research for high-need high-cost patients, limited access to claims may negatively affect the quality of the matching process. HIP Investigator, Dr. Maureen Smith and team (including HIP Investigator, Dr. Menggang Yu) sought to determine whether the evaluation of programs for high-need high-cost patients required claims data to match cases to comparison patients.

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Yao Liu with camera

Scaling Up Teleophthalmology for Diabetic Eye Screening: Opportunities for Widespread Implementation in the USA

Scaling Up Teleophthalmology for Diabetic Eye Screening: Opportunities for Widespread Implementation in the USA

Teleophthalmology is an evidence-based form of diabetic eye screening. This technology has been proven to substantially increase diabetic eye screening rates and decrease blindness. However, teleophthalmology implementation remains limited among U.S. health systems. In this paper, HIP Investigator Dr. Yao Liu et al. discuss opportunities to address key barriers to widespread implementation of teleophthalmology programs for diabetic eye screening in the United States (U.S.).

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Doctor with arms crossed and blue ribbon on medical coat

Primary care colorectal cancer screening correlates with breast cancer screening

Primary care colorectal cancer screening correlates with breast cancer screening

In a retrospective cohort study, Dr. Jennifer Weiss et al. examined 90 primary care providers (PCPs) and over 33,000 patients eligible for colorectal cancer (CRC) screening to determine whether PCP colorectal cancer screening practices correlate with other preventive and chronic care needs. The investigators looked at CRC screening rates in comparison to five other PCP quality metrics—breast cancer screening, cervical cancer screening, HgbA1c and LDL testing, and blood pressure control—and found that PCP CRC screening rates have a strong correlation with breast cancer screening rates and a weak correlation with the other metrics. These results indicate that efforts to increase PCPs' CRC screening rates could be bundled with breast cancer screening improvement interventions to increase their impact.

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Blood pressure cuff and pills

Hypertension control after an initial cardiac event among Medicare patients with diabetes

Hypertension control after an initial cardiac event among Medicare patients with diabetes

In this study co-authored by Drs. Heather Johnson and Maureen Smith, investigators used EHR and Chronic Conditions Warehouse Medicare data to determine rates & predictors of achieving hypertension control among patients with diabetes and hypertension after they were discharged from the hospital for an initial cardiac event. They found that Medicare patients with diabetes were more likely to achieve hypertension control when prescribed beta-blockers at discharge, or if they had a history of more specialty visits., and adults who were 80 years or older were more likely to achieve control with diuretics.

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Elderly person falling

Using the Hendrich II inpatient fall risk screen to predict outpatient falls after ED visits

Using the Hendrich II inpatient fall risk screen to predict outpatient falls after ED visits

Dr. Brian Patterson et al. used electronic health record data to evaluate whether routinely collected Hendrich II fall scores can predict returns to the emergency department (ED) for falls within 6 months. The investigators found that using the score alone, the odds of returning to the ED for a fall in 6 months were 1.23 times as high for every 1-point increase in the Hendrich II score. When routinely collected data on other fall risk factors was combined with the fall risk score, the screening performed much better. 

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File folder marked "Claims" in front of computer keyboard

Can claims data algorithms identify the physician of record?

Can claims data algorithms identify the physician of record?

Eva DuGoff and co-authors investigated the agreement of primary care providers (PCPs) identified by claims algorithms and in EHR data. This study looked at Medicare fee-for-service beneficiaries with diabetes age 65+ and found agreement was higher for algorithms based on primary care visits. The algorithms perform less well among vulnerable populations and those experiencing fragmented care.

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