WMJ: Impact of Race and Racism on Health

Identifying Substantial Racial and Ethnic Disparities in Health Outcomes and Care in Wisconsin Using Electronic Health Record Data

Identifying Substantial Racial and Ethnic Disparities in Health Outcomes and Care in Wisconsin Using Electronic Health Record Data

Although Wisconsin ranks highly in overall health care quality, the state performs poorly with respect to health disparities. To eliminate health disparities in Wisconsin, it is critical to understand where disparities exist.

Measuring disparities in health outcomes and care allows for benchmarking of current performance and monitoring changes over time. Measurement also allows stakeholders to prioritize efforts and develop and implement programs for the populations that are most impacted by disparities. Authors including HIP Investigator, Dr. Maureen Smith identified racial and ethnic disparities in health outcome and care measures in Wisconsin.

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Co-designing to advance community health and health equity in Wisconsin: Building the Neighborhood Health Partnerships Program

Co-designing to advance community health and health equity in Wisconsin: Building the Neighborhood Health Partnerships Program

Engaging communities can increase the speed of translating health and health equity research into practice. Effective engagement requires a shared understanding of neighborhood health care quality and outcomes. Creating this shared understanding can be challenging without timely and accurate local health data, or ways to provide the data that are directly applicable to improving community health.

In this publication, authors including HIP Investigator, Dr. Maureen Smith discuss how an effective co-design strategy can lead to increased usability and adoption of CTSA resources, enabling a shared understanding of community health and ultimately leading to the successful translation of research into practice.

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Small hospital meeting

Effect of Resident Physicians in a Supervisory Role on Efficiency in the Emergency Department

Effect of Resident Physicians in a Supervisory Role on Efficiency in the Emergency Department

Patient throughput and emergency department (ED) length of stay (LOS) are recognized as important metrics in the delivery of efficient care in emergency medicine. However, academic centers must balance expeditious care delivery with the educational mission of training the next generation of emergency physicians.

In this article, HIP Investigator, Dr. Brian Patterson et al. sought to examine the impact of a staffing model involving a supervisory resident “pre-attending” (PAT) on ED throughput and LOS, as this model offers a valuable educational experience for residents, but may do so at the expense of operational efficiency.

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Elderly patient with nurse

Management of Fecal Incontinence

Management of Fecal Incontinence

Fecal incontinence negatively affects quality of life and mental health and is associated with increased risk of nursing home placement. Nine percent of adult women experience episodes of fecal incontinence at least monthly. Even among women with both urinary and fecal incontinence presenting for urogynecologic care, the rate of verbal disclosure of fecal incontinence symptoms remains low.

HIP Investigator, Dr. Heidi Brown et al. provides an overview of the evaluation and management of fecal incontinence for the busy obstetrician–gynecologist, incorporating existing guidance from the American College of Obstetricians and Gynecologists, the American College of Gastroenterology, and the American Society of Colon and Rectal Surgeons.

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Woman getting vaccinated in hospital

A prioritization algorithm for healthcare personnel for the CDC’s COVID-19 Phase 1a vaccine distribution plan

A prioritization algorithm for healthcare personnel for the CDC’s COVID-19 Phase 1a vaccine distribution plan

The National Academies of Sciences, Engineering, and Medicine, in its Framework for Equitable Allocation of COVID-19 Vaccine, suggests using an index such as the Social Vulnerability Index (SVI) to prioritize individuals living in locations identified as vulnerable in order to incorporate variables that are most linked to the disproportionate impact of COVID-19 on people of color.

In this paper, authors including HIP Investigator Dr. Maureen Smith, developed an algorithm that can be used to equitably distribute COVID-19 vaccinations to healthcare personnel (HCP) during Phase 1a of the Center for Disease Control and Prevention’s (CDC) coronavirus vaccine distribution plan, if not enough vaccine is available to immunize an entire group of employees with similar job-related risk exposure. The algorithm prioritizes individuals with the highest risk of mortality using Social Vulnerability Index (SVI) and age.

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Sustaining Gains in Diabetic Eye Screening: Outcomes from a Stakeholder-Based Implementation Program for Teleophthalmology in Primary Care

Sustaining Gains in Diabetic Eye Screening: Outcomes from a Stakeholder-Based Implementation Program for Teleophthalmology in Primary Care

Diabetic eye disease is the leading cause of blindness among working-age adults in the United States, primarily because of lack of access to eye screening. Teleophthalmology is a validated form of diabetic eye screening shown to prevent blindness but is significantly underutilized in U.S. primary care clinics.

In this article, authors including HIP Investigators Dr. Yao Liu and Dr. Maureen Smith hypothesized that a stakeholder-based implementation program could increase teleophthalmology use and diabetic eye screening rates through improved integration of teleophthalmology into primary care workflows.

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Novel Decision Support Interventions for Low-risk Thyroid Cancer

Novel Decision Support Interventions for Low-risk Thyroid Cancer

The treatment paradigm for low-risk thyroid cancer increased in complexity following release of the 2015 American Thyroid Association Guidelines for Adults with Differentiated Thyroid Cancer. Although the intention of the guidelines were to “complement informed, shared patient-healthcare provider deliberation” when making treatment decisions, patient-clinician deliberation can fail to meet patients’ needs and may exclude available treatment.

In this research letter, Dr. Susan Pitt and Megan Saucke examined a patient-oriented intervention to support decision-making about low-risk thyroid cancer treatment. The duo held 16 stakeholder meetings between July 2016 and December 2017 to develop a 1-page treatment comparison chart and a trifold pamphlet containing a question prompt list (available at https://www.hipxchange.org/ThyroidCancerTreatmentChoice).

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Father and son wearing masks

COVID-19 and the Well-being of Children and Families

COVID-19 and the Well-being of Children and Families

Pandemics disturb individual and community well-being through direct effects of the illness and through emotional isolation, economic loss, work and school closure, and inadequate distribution of needed resources, among others.

Because data suggest that children might less frequently transmit or become severely ill from the virus, the unique consequences that COVID-19 exerts on children risk being overlooked. In this article, HIP Investigator Dr. Ryan Coller and Dr. Sarah Webber review findings on how COVID-19 has affected the physical and emotional health of US parents and children.

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Sick senior woman fallen

Comparing Strategies for Identifying Falls in Older Adult Emergency Department Visits Using EHR Data

Comparing Strategies for Identifying Falls in Older Adult Emergency Department Visits Using EHR Data

Emergency department (ED) visits for falls among older adults are often sentinel events for poor health trajectories; however, challenges exist in defining fall‐related visits in the ED. Authors including HIP Investigators Dr. Brian Patterson and Dr. Maureen Smith developed and validated a simple rules‐based Natural language processing system that accurately identified falls from the text of ED physician notes.

The goal of the study was to compare performance characteristics of several fall identification strategies using EHR data from ED visits using manual chart abstraction as a gold standard.

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Burned out physician

Physician Burnout and Timing of Electronic Health Record Use

Physician Burnout and Timing of Electronic Health Record Use

Burnout among primary care physicians is a major problem in the United States. In addition to negatively impacting physician health, burnout is also associated with reduced quality of patient care and increased physician turnover, further contributing to health care costs and the shortage of physicians.

The PATH group conducted a study to determine the association between physician burnout and timing of EHR use in an academic internal medicine primary care practice. The group hypothesized that increased time spent in the EHR, particularly outside of normal work-hours, would be associated with higher levels of burnout.

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