Summaries of Independent Scientist (K) Awards

Adams, William

Institution: Boston Medical Center
Grant Title: Using an EMR to Improve Urban Child Health
Grant Number: K02 HS013655
Duration: 3 years (2004-2007)
Total Award: $307,900

Project Description: The specific aims of this project are:

• To use a common Electronic Medical Records (EMR) in a network of urban primary care centers to improve the quality of asthma and preventive care for children.
• To describe the content and quality of EMR-based urban and adolescent primary care.
• To evaluate the efficacy of evidenced-enhanced audit and feedback to improve the delivery of multiple primary care services (preventive services and asthma care).
• To describe the perceptions of primary care clinicians and quality improvement strategies used following receipt of practiced-based audit and feedback.
• To evaluate incremental improvements in quality following the addition of point-of-care decision support to improve the delivery of multiple primary care services.
• To describe the perceptions of primary care clinicians following receipt of point-of-care decision support.

Career Goals: Dr. Adams is a pediatrician, epidemiologist, and medical informatician. During the life of the K award, he will continue his development as an independent health services researcher by enhancing his skills in research methods and advanced data analysis. Further, the grantee will expand his collaborative research networks in order to apply the emerging electronic data privacy laws to EMR-based health services research and the implementation of quality improvement. Dr. Adams' primary career goal is to improve the quality of urban pediatric primary care using computer-based technologies such as the EMR.

Progress to Date: Dr. Adams leads the Boston Pediatric Logician Users Group (PLUG) which includes clinical and IT representatives from eight community health centers as well as Boston Medical Center. These nine sites are the clinical sites for the K-supported research. During the first two years of the project, the grantee worked with the PLUG to redesign the EMR interface to support data-driven quality improvement and care. He also developed and implemented a robust data warehouse capable of integrating data for children from the nine clinical sites through a scaleable data schema and a master patient index. The project has been named "Boston Community Health Information for Improvement" (CHII). As of December 2005, the CHII data warehouse contained over 4 million data elements for 50,000 children. The first investigation of CHII data was completed and submitted for presentation. In early 2006 software development was completed for an automated performance reporting system that automatically aggregates data at the clinician and practice level and emails performance reports (confidential clinician summaries and public practice based summaries) to recipients. Performance reporting began in April 2006. Dr. Adams also received an R21-award to design and evaluate a telephone-based self-management system for overweight children and their parents. The project seeks to use telephone technology in patient homes, primary care-based clinician counseling, EMR-data summaries and counseling decision support, and behavior-change theory to improve dietary behaviors and reduce screen-time for overweight children. Dr. Adams serves as Co-Chair of the NICHQ-supported New Jersey Immunization and Preventive Services Project-a modified learning collaborative which seeks to improve the delivery of immunization services using a statewide immunization registry and partnerships between state agencies, professional organizations, and primary care practices and is a core member of the American Academy of Pediatrics Partnership for Policy Implementation (PPI) team.

Future Plans: The grantee will continue to lead the PLUG and guide the Boston CHII implementation phase during year 3 of the project. He will also work with the PLUG to develop and implement active asthma and preventive service decision support components. Analysis of the impact the first intervention phase (including clinician surveys) will begin in October 2006. Results from these analyses will be submitted for presentation at major research meetings in May 2007.

Highlights and Specific Accomplishments:

• Leads the Boston Pediatric Logician Users Group (PLUG), a Practice-based Research Network which includes clinical and IT representatives from each of the eight community health centers as well as Boston Medical Center, and are the nine clinical sites for the project.
• Has developed a set of primary care EMR templates that have been approved by all the clinical sites in the PBRN, and have substantially improved the content and ease of use of the EMR forms.
• Has developed and implemented a data warehouse that integrates data for all children receiving primary or asthma care from the nine clinical sites through a scaleable data schema and a master patient index. The project has been named "Boston Community Health Information for Improvement" (CHII).
• Has developed and implemented an automated clinician- and practice-level quality measurement and reporting system for pediatric primary care.
• The first investigation of CHII data was completed and submitted for presentation at the annual pediatric research meeting in December 2004.
• Co-Chair of the NICHQ-supported New Jersey Immunization and Preventive Services Project.
• Has joined the "Improving Performance in Practice," an initiative guided by the Center for Children's Healthcare Improvement in Chapel Hill, North Carolina.
• Is a core member of the American Academy of Pediatrics' Partnership for Policy Implementation, an initiative that seeks to place informaticians and quality improvement specialist on policy and guideline development teams.

K-Generated Publications: None thus far.
AHRQ Research Portfolios: Quality and Patient Safety; Training; Prevention
AHRQ Goals: Safety and Quality

Return to Recently Funded Career Development Award Grants
Proceed to Next Section