- Site Survey
on Asthma Guidelines
A one-page survey was sent to Medical Directors
of Family Medicine and Internal Medicine Sites within the Academic
Departments to assess the utility of select asthma guidelines
in their practices.
- Provider Survey
on Asthma Guidelines
A short survey will be sent to all providers in
the family medicine academic practice sites to assess their
- Buffalo Hispanic
Environmental Justice Partnership
A grant was submitted to the NIEHS to address
environmental concerns in the West Side regarding asthma. The
project will empower the community to address diesel fuel exposure,
household stressors and environmental stressors that affect asthma.
Funds will support a PEA in practices in the West Side to provide
a link between clinical and community issues.
Study of Asthma Medication Adherence
A grant was submitted to the PhRMA Foundation
to assess characteristics of patients with asthma with low-adherence
to anti-inflammatories and to identify perceived barriers to adherence
and potential solutions to improve adherence.
Asthma Care for Poor Children in Buffalo
PF and Telescopic case management. To improve patient self management
skills and physician office adherence to evidence based guidelines.
- A Telephonic
Case Management System to support Primary Care Physicians in their
treatment of lipid disorders
In partnership with a PhD in Pharmacology and
Clinical Support Services™, an African American urban practice,
a Hispanic urban practice, and a suburban practice will test if
have telephone case support for management of lipid lowering agents
will reduce Framingham risk scores (Funded by Kos Pharmaceuticals)
network) P 2 Collaborative 10 year initiative to reduce cardiovascular
risk in the Western New York region by 25%
three of Western New York’s Managed Care organizations,
the UB Department of Family Medicine, Roswell Park Cancer Institute,
two large multi-specialty groups, an urban pastor, a labor union
representative, a business leader, and head of the local broadcast
network have joined together to do a multi-level, multi-dimensional
intervention to reduce cardiovascular disease risk. There will
be community education, work-site programs, faith-based intervention,
and a best practices approach to care delivery for the purpose
of reducing Framingham risk scores in the region by 25% over a
10 year period of time.
Illness Demonstration Project
- UB Family Medicine
Research Institute and Gold Choice in partnership with UNYNET
has received a 3 year, 1.8 million dollar grant to implement a
Chronic Illness Demonstration Project (CIDP) to take 600 of the
most expensive Medicaid recipients and provide multiple services
for improved quality of care at reduced cost. 300 will be randomized
to the demonstration project and 300 will receive usual care.
Services for the demonstration project patients will include a
Practice Enhancement Associate (PEA) for the patient’s doctor
to help with preventive service and chronic disease care reminders,
a visiting nurse to the home to measure BP, weight, glucose etc.
and a 24 hour nurse available by phone for any questions. The
two groups will be compared in terms of quality and cost at the
end of three years.
Knowledge and Attitudes Regarding the Diagnosis and Treatment
of Chronic Kidney Disease
A combined qualitative and quantitative study
to assess practicing clinicians attitudes toward recognizing early
renal failure and their knowledge of and adherence to the Kidney
Disease Opportunity for Quality Improvement (K-DOQI) guidelines
Funded by AAFP Joint Grant Awards Program.
- Kidney Early
Evaluation Project 3.0 (KEEP 3.0)
Regional participation in national longitudinal cohort study.
Main objectives include determining
of and risk factors for kidney disease in a high-risk cohort
association of kidney disease and risk factors
of interventions in improving outcomes
of change in kidney disease and risk factors that determine
efficacy of different methods of providing treatment information
to patients and physicians.
As a related research project, UNYNET is conducting a qualitative
study of primary care physician attitudes toward mild renal
failure and anemia. Sponsored by the National Kidney Foundation
Chronic Kidney Guidelines work in Underserved Practices
Using PEAs and point of care guides to improve evidence based
- Chronic Kidney Disease Point of
Care Guide For The Primary Care Physician
- Chronic Kidney Disease
- A Patient's Guide (English)
- Chronic Kidney
Disease - A Patient's Guide (Spanish)
- Chronic Kidney Disease Quick
Reference Guide for the Primary Clinician
- Chronic Kidney
Disease - A Patient's Guide Brochure
- Independent Evaluation of Training to Improve Colon
Cancer Screening Systems in Primary Care Practices in New York
Dr. Laurene Tumiel-Berhalter, PI
for Diabetes Education and Telemedicine
UNYNET members are working in collaboration with
SUNY Upstate Medical University as part of a randomized, controlled
statewide trial. The purpose of this research is to determine
if computer-linked home blood glucose and blood pressure monitoring
devices, combined with teleconferences with diabetes nurses and
a dietician, will result in better outcomes and more cost-effective
care. Funded by Center for Medicare and Medicaid Services (CMS)
Evidence Based Diabetes Guidelines in Rural Practices using Practice
Enhancement Associates (PEAs)
The PEA Training Team is responsible for the development and implementation
of the incorporation of three PEA’s into 12 rural family
practice sites to facilitate the implementation of evidence based
diabetes guidelines with the Chautauqua County Health Network
(CCHN) and the Lake Plains Community Care Network in accordance
with the P2 Collaborative of Western New York’s Robert Wood
Johnson Foundation’s Aligning Forces for Quality Initiative.
The training team will be responsible for on-going training and
supervision of the PEA’s and assisting with a Diabetes Quality
Improvement Project that will serve as a model for other quality
improvement initiatives. Three PEAs were hired and trained in
the PEA concept and function, development of a core skill set,
and integration into the practice sites.
Data is aggregated based on problem list, progress notes, medication
lists, lab reports, and significant referrals and correspondence.
Recommendations are then generated to give evidence based support
to PCP. The goal of the quality improvement cycle is to improve
patient outcomes and quality of care through evidence based research.
PEAs present data and change over time to MD and office staff.
PEAs share insights from other practices working on the same project
to share best practices. Discussion of what worked and what didn’t
is done and appropriate modifications are made. Three month performance
graphs will be shared with each practice quarterly.
Medical Error Reduction
UNYNET members are working with the University
at Buffalo Patient Safety Research Center on various projects
involving the development of a “culture of safety”
in primary care practice.
Systems Engineering Approach: Improving Medication Safety with
Clinician Use of Health IT
Examine the impact of an IT-based CRM intervention on reducing
selected adverse drug events (ADEs) among geriatric patients,
thereby improving geriatric medication safety.