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Department of Community and Family Medicine Newsletter by liaoqinmei


									                        Department of Community and Family
                        Medicine Newsletter
NOVEMBER 7, 2005                                                                             VOLUME 1, NUMBER 2

Flu Shots               The Department of Community and Family Medicine is a diverse collection of patient
are available for all   care, education and research programs focused on the common goal of improving the
employees at no         health of people in their communities. Through this newsletter, we hope to celebrate
charge in Employee
                        our diversity by sharing the accomplishments, innovations and goals of the faculty and
Health and
Wellness, 04290         staff of CFM.
Duke South (Red
zone). Hours are        AMIA Announces Distinguished Paper Awards
8:00 am to 4:00
pm Monday-Friday.                       From a field of 176 notable papers, the American Medical Informatics
Closed on                               Association selected eleven finalists for their 2005 Distinguished Paper
Wednesdays from                         Awards and two of those selections were written by Duke faculty/staff.
12:00-2:00. No
                                        The two Duke papers are ‘Identifying and Overcoming Obstacles to
appointment is
necessary.                              Point-of-Care Data Collection for Eye Care Professionals’ authored by
                                        David Lobach, Garry Silvey, Jennifer Macri, Megan Hunt, Roje Kacmaz,
                                        and Paul Lee and ‘Direct Comparison of a Tablet Computer and a
Holiday Party           Personal Digital Assistant for Point-of-Care Documentation in Eye Care’ authored by
                        Garry Silvey, Jennifer Macri, Paul Lee and David Lobach. AMIA is the premier
                        organization in the US dedicated to the development and application of medical
Holiday Party will
be held Friday, Dec     informatics in the support of patient care, teaching, research and health care
16th, 6:30-11:00        administration.
pm, at the
Washington Duke         Department Fellow Wins American Medical Informatics
Inn. RSVP by Dec.       Association Student Paper Award
12th on-line at
http://intra-                               Kensaku Kawamoto, a Ph.D. candidate working with Dr. David
                                            Lobach in the Division of Clinical Informatics, was selected as the
                                            winner of the annual student paper competition of the American
                                            Medical Informatics Association (AMIA). Ken presented his paper,
                                            entitled ‘Design, Implementation, Use, and Preliminary Evaluation
                        of SEBASTIAN, a Standards-Based Web Service for Clinical Decision Support,’ at the
                        annual AMIA symposium in Washington, D.C. in October, 2005. The judges made the
                        selection based on a combination of the written paper and an oral presentation. The
                        decision support framework described in Ken's paper has been used to implement a
                        diabetes management system for the outpatient setting. The framework has also been
                        used to implement a provider alerting system, patient reminder letter system, and a
                        clinic feedback report system for the Durham Community Health Network (DCHN).
                        Ken's work is also being used by the Health Level 7 Clinical Decision Support Technical
                        Committee ( as the basis of an international standard on how decision
                        support is delivered in a service-oriented architecture.
Holiday                                            DPT Students Receive Award
                                                   Kelly Caprio and Kim Laura Boyle, DPT Students, Class of
The Medical Center                                 2006, received 1st Place Poster Presentation Award at the
will observe the                                   North Carolina Physical Therapy Association Annual
Thanksgiving Day                                   Meeting in October. Their research project ‘A Comparison
holiday on Thursday,                               of Pelvic Floor Muscle Activity Between Weight-Bearing
Nov 24th. In
                                                   Female Athletes and Female Non-Athletes’ was conducted
addition, The Duke
Family Medicine                                    under the guidance of Carol Figures, PT, EdD, Associate
Center at Pickens,                                 Professor Physical Therapy and Alison Weidner, MD. Kelly
the Student Health                                 (L) and Kim (R) are shown accepting the award from Ben
clinic, the                                        Massey, American Physical Therapy Association current
Medicine & Physical
Therapy clinics in
RTP and the
offices for the
department will be
                       Ken Kawamoto Publication Selected for International Medical
closed on Friday,      Informatics Association Yearbook
Nov 25th.
                       'Improving Clinical Practice Using Clinical Decision Support Systems: a Systematic
                       Review of Trials to Identify Features Critical to Success' by Kensaku Kawamoto has
The Christmas Day      been selected for inclusion in the 2006 International Medical Informatics Association
holiday will be        Yearbook. The article was first published in the March 2005 British Medical Journal.
observed on            The research identified four features that are strongly associated with a decision
Monday, Dec 26th.      support system’s ability to improve clinical practice. These features include providing
                       decision support automatically as part of clinician workflow, delivering it at the time
                       and location of decision-making, providing actionable recommendations, and being
                       computer-based. All four of these features make it easier for clinicians to receive and
The New Year’s Day     act on system recommendations. Decision support systems significantly improved
holiday will be
                       clinical practice in 68% of trials. Of the systems possessing all four features, 94%
observed on
Monday, Jan 2, 2006    significantly improved clinical practice. The research was supported in part by the
                       Agency for Healthcare Research and Quality.

                       David Coniglio Named to Oncology Society Membership

                                       The American Society of Clinical Oncology named David Coniglio, PA-C
                                       to its Membership Committee for a three year term. This is the first
                                       time a Physician Assistant has been appointed to an ASCO committee.
                                       ASCO represents physicians and other health care providers who treat
                                       people with cancer. David attributed the invitation to serve on the
                                       committee to his work as American Association of Physician Assistants
                                       liaison to ASCO. He considers the appointment an honor which is the
                       result of years of hard work by other PA’s in oncology. He hopes that his service will
                       increase the opportunity for PA service on other ASCO committees.
Kathy Shipp Invited To Attend NIH Osteoporosis Meeting

On November 3, Kathy Shipp, PT, PhD attended a special meeting at the NIH with
members of the British royal family, Prince Charles and the Duchess of Cornwall. Also
attending were the Director of Health and Human Services, the Surgeon General, and
the Director of the NIH. Kathy was invited as an osteoporosis clinical researcher. HRH
the Duchess of Cornwall has been an advocate for osteoporosis research, education,
prevention, and treatment for many years. She currently serves as president of the
National Osteoporosis Society in the UK.

Chad Cook Receives Distinguished Authorship Award

                                           Chad Cook, PT, PhD, MBA, OCS received
                                           the highly prized J. Warren Perry
                                           Distinguished Authorship Award at the
                                           Association of Schools of Allied Health
                                           Professions (ASAHP) meeting in Houston,
                                           Texas held on October 21. 2005. In the
                                           photo (L-R) -- Kevin Lyons, PhD (Editor of
                                           the J Allied Health), Chad Cook, PT, PhD,
                                           MBA, OCS, Assistant Professor in Physical
                                           Therapy, David Gale. M.D., President of
                                           Association of Schools of Allied Health

Rose Casey Honored in Courageous Women

               Rose Casey, Administrative Assistant to the Chairman, was honored by
               the Sisters of Notre Dame de Namur with a brief biography in their
               publication Courageous Women. The biography highlighted Rose’s
               service to mankind through a twenty year career in teaching and
               education administration and her second career here at Duke. While at
               Duke, Rose worked in the School of Nursing and Department of
               Pathology before joining the Department of Community and Family
Medicine about 10 years ago. She continues her lifelong service contribution through
her administrative role in the Chair’s office and her volunteer activities in the

Hypertension Identification/Treatment Project Gets Underway

A collaborative group from Family Medicine, Occupational & Environmental Medicine,
Employee Occupational Health and Wellness, Live-for-Life, Duke Clinical Research
Institute, Durham Regional Hospital and the Duke primary care groups has been asked
by Chancellor Dzau to develop a project to identify and control hypertension in the
Duke workforce. Active CFM participants include Lloyd Michener, Sam Moon, George
Jackson, Brian Caveney, Maggie Gradison, Woody Warburton, Julie Joyner, Libby
Gulley, John Dement and Rose Casey. Building on the robust Live for Life programs in
place, screenings of targeted employee groups are scheduled to identify employees
with high blood pressure, provide education and counseling about hypertension,
facilitate appropriate and timely referrals to providers, record screening data in
eBrowser, enhance provider awareness of JNC-VII treatment guidelines, track quality
metrics by CFM chart audits, and assess barriers to receiving optimal care from both
the employee/patient and provider perspective. As Duke system efficiencies improve,
there may be an opportunity to broaden the scope of the project to include various
community hypertension screening and treatment programs.
African-American Health Improvement Partnership Grant

Under Principal Investigator Sherman A. James, PhD, Susan B. King Professor of Public
Policy at Duke, the Division of Community Health has received an NIH grant entitled
The African-American Health Improvement Partnership. This is an initial three year
grant for planning and piloting replicable interventions to improve the health of working
and middle-class African-Americans in Durham. If successful, the program may receive
five years of additional funding for full implementation, and three years for
dissemination. This program will be operated under the principles of Community-Based
Participatory Research, with a Community Advisory Board determining the interventions
and overseeing all aspects of the program. Likely areas of concentration will be
developing social supports within and across social class lines as a vehicle to achieve
sustainable improvements in health, and potential foci are diabetes and hypertension.
Elaine Hart-Brothers, MD, MPH, President of the Community Health Coalition in
Durham, is Co-Investigator; Mina Silberberg, PhD, Director of Evaluation for the
Division of Community Health is Program Director; and Susan Yaggy,MPA, Community
Health Division Chief, is an Investigator.

Fit Together Annual Meeting Held in Chapel Hill
                                  Fit Together is a statewide effort funded by the North
                                  Carolina Health and Wellness Trust Fund and Blue
                                  Cross Blue Shield of North Carolina to reduce
                                  childhood overweight and obesity in North Carolina.
                                  The Division of Community Health provides technical
                                  assistance to 21 projects as part of the Fit Together
                                  Initiative. The 2nd Annual Fit Together Meeting was
                                  held on October 27th and 28th, 2005, at the Friday
Center in Chapel Hill. Over 60 participants attended the meeting from across the state,
including: Associate Vice President for Community Affairs, Mary Ann Black;
Representative Verla Insko; Senator Bill Purcell, and representatives from the Fit
Together projects. The meeting opened with the official release of “Childhood Obesity
in North Carolina: A Report of Fit Families NC: A Study Committee for Childhood
Overweight/Obesity.” This report has been instrumental in guiding legislative and
policy recommendations to improve the health of North Carolinians. Based on
recommendations from this report, the State Board of Education recently adopted a 30-
minute, daily physical activity requirement for all K-8 students in North Carolina.

For more information on the Fit Together Initiative, visit or
contact the Duke Technical Assistance Team at 919. 681.3023.

Warburton Elected Vice-Chair of NC Institute of Medicine

               Woody Warburton, MD has been elected to serve as Vice Chair of the
               Board of Directors of the North Carolina Institute of Medicine. His term
               will be three years with two renewals possible. Bill Atkinson, CEO of
               Wake Med is the board chair replacing Harvey Estes, MD who is
               stepping down after ten years as chair.
                       David Lobach Participates in Federal Clinical Decision Support
                       Policy Development Session

                       On October 26 and 27, 2005, Dr. David F. Lobach, Chief of the Division of Clinical
                       Informatics, participated as a recognized expert in a second round of a policy
                       development process to help inform Federal government about activities concerning
                       clinical decision support (CDS). The 35 meeting participants provided direction to a
                       steering committee that was tasked to provide recommendations back to the Office of
                       the National Coordinator for Health Information Technology (ONC) of the Department
                       of Health and Human Services in the form of a National Action Plan on Clinical Decision
                       Support. This work will produce a roadmap for CDS in the context of widespread
                       adoption of interoperable electronic health records, including future CDS studies that
                       may be pursued by ONC, Agency for Healthcare Research and Quality, National
                       Institutes of Health, Centers for Disease Control or the Food and Drug Administration.
                       The meeting was jointly sponsored by the American Medical Informatics Association
                       and the Office of the National Coordinator for Health Information Technology.

                       New Research Ethics Module

                       A new module has been posted on the Research Ethics web page
                       ( The new module, "Conflict of Interest," deals with
                       conflict of interest issues, concerns, and reporting requirements. "It is important for
                       everyone involved in research to be aware of these ethical issues and regulatory
                       requirements for reporting potential conflicts when doing clinical research," says
                       Julianne Tenney, associate dean for compliance in the School of Medicine. Please
                       remember that all faculty participating in research involving human subjects must
                       complete two research ethics modules annually.

                       IRB Submissions

                       Please remember to send all IRB submissions to George Parkerson, Jr., MD, MPH, or
                       Jan Gwyer, PT, PhD (for PT submissions). They will review them and forward them to
                       Lloyd Michener for review. Rita Baur will notify you when reviews are complete and the
                       submissions are ready for pickup.

                       Changes Coming in Federal Grant Application Process

                       The Federal government has announced sweeping changes in the grant announcement
Other News             and application process to be phased in from April 2006 through May 2007. Through a
                       website,, some 900 grant programs from 26 federal grant-making
Do you have items
                       agencies that award over $350 billion annually will be combined with the intent of
you would like
included in the next   streamlining the application/award process. The new process is expected to reduce
newsletter? Please     cost, shorten the time between receipt of an application and the award, save an
send them to Rob       estimated 200 million pieces of paper per year and nearly countless hours of human
Warren at              effort. Much of the basic application information will be standardized across agencies
                       with additional grant specific requirements requested via a Funding Opportunity
                       Announcement (FOA) package. When fully implemented, all submissions will be made
                       electronically. Research Administration (formerly Grants & Contracts) will guide the
                       transition process. Details will follow in the coming months.
                         Welcome to the Newest Team Members

                         Please welcome our newest team members:


                         Bernard Fuemmeler, PhD., MPH, joined the Research group as an Assistant Professor.
                         He comes to us from the National Cancer Institute, Division of Cancer Prevention. His
                         research focus will include epidemiological studies, outcomes research and behavioral
                         intervention trials, primarily in the areas of obesity, cancer and other chronic diseases.
                         His office is in Hanes House


                         Endris Ashford, Staff Specialist in Community Health

                         Shannon Bush, Community Health Worker for Durham Community Health Network

                         Sherry Davis, LPN in Community Health

                         Karen Haith, Nurse Practitioner in Student Health

                         Susan Harvey, Occupational Health Nurse in Employee Health & Wellness at Durham
                              Regional Hospital

                         Jackie Miller-Klein, Staff Specialist in Employee Health & Wellness at Durham Regional

                         Tyra Morgan, Clinic Assistant Sr. in Community Health

                         Jennifer Prish, Dietitian Clinician in Live-for-Life at Durham Regional Hospital


                         A full list of faculty publications for July 1, 2005 through September 30, 2005 is
                         available on the web at

                         New Grant Awards

The Department of        Richard Clendaniel, PT, PhD, Doctor of Physical Therapy Program
Community and Family
Medicine                 “Vestibular Adaptation and Compensatory Mechanisms”, NIH, $72,680, one year.

Duke University          Sherman James, PhD, Community Health
Medical Center
Box 2914                  “African-American Health Improvement Partnership”, NIH, $1,594,277 over three
Durham, NC 27710         years.

Phone                    Victoria Kaprielian, MD, Family Medicine
(919) 681-3178
                         “Interprofessional Disaster Preparedness Training”, HRSA, $567,303 over three years.
(919) 681-3371           David Lobach, MD, PhD, MS, Clinical Informatics
E-mail                   “Evidence Based Design of a XML Decision Support System”, NIH, $43,534 one year.
                         J. Lloyd Michener, MD, Chairman
We’re on the Web!   “NC/SC Community Nutrition Network”, Fullerton Foundation, $410,530 over two years.

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