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Asthma

  • 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.
  • Cross-Sectional 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.
  • Improving Asthma Care for Poor Children in Buffalo
    Using PF and Telescopic case management. To improve patient self management skills and physician office adherence to evidence based guidelines.

Cardiovascular Risk Reduction

  • 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)
  • (Collaborating network) P 2 Collaborative 10 year initiative to reduce cardiovascular risk in the Western New York region by 25%

    All 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.

Chronic 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.

 

Chronic Kidney Disease

  • Physicians 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
    • prevalence of and risk factors for kidney disease in a high-risk cohort
    • cross-sectional association of kidney disease and risk factors
    • efficacy of interventions in improving outcomes
    • rate of change in kidney disease and risk factors that determine its progression
    • long-term morbidity/mortality rates
    • relative 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
  • Making Chronic Kidney Guidelines work in Underserved Practices
    Using PEAs and point of care guides to improve evidence based guidelines
  • 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

 

Colon Cancer Screening

  • Independent Evaluation of Training to Improve Colon Cancer Screening Systems in Primary Care Practices in New York State.
    Dr. Laurene Tumiel-Berhalter, PI

Diabetes Mellitus

  • Informatics 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)

Implementing Evidence Based Diabetes Guidelines in Rural Practices using Practice Enhancement Associates (PEAs)

  • Background
    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.
  • The QI Cycle
    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.

Patient Safety

  • Practice-Based 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.

 

 

 

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