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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 Department 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 fam.mc.duke.edu/h Lobach in the Division of Clinical Informatics, was selected as the oliday_rsvp.asp 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 (www.hl7.org) as the basis of an international standard on how decision support is delivered in a service-oriented architecture. Holiday DPT Students Receive Award Schedule 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 Occupational president. Medicine & Physical Therapy clinics in RTP and the administrative 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 Committee 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 Professions). 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 community. 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 Awarded 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 www.fittogethernc.org 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 (http://researchethics.mc.duke.edu). 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, www.grants.gov, 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 email@example.com with additional grant specific requirements requested via a Funding Opportunity .edu 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: Faculty 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 Staff 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 Hospital Tyra Morgan, Clinic Assistant Sr. in Community Health Jennifer Prish, Dietitian Clinician in Live-for-Life at Durham Regional Hospital Publications A full list of faculty publications for July 1, 2005 through September 30, 2005 is available on the web at http://cfm.mc.duke.edu/publications/CFMPublicationsJul_Sept2005.pdf 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. Fax (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. Warre005@mc.duke.edul J. Lloyd Michener, MD, Chairman We’re on the Web! http://cfm.mc.duke.edu “NC/SC Community Nutrition Network”, Fullerton Foundation, $410,530 over two years.
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