Summaries of Independent Scientist (K) Awards

Linder, Jeffrey

Institution:  Brigham and Women's Hospital
Grant Title:  Improving Care for Acute Respiratory Infections
Grant Number:  K08 HS014563
Duration:  5 years (2004-2009)
Total Award: $669,600

Project Description: This project has four main goals:

1. To develop the Acute Respiratory Infection (ARI) Smart Form, which will standardize documentation of care and give providers easy access to clinical information, online decision support, and patient education materials.
2. To perform a randomized controlled trial (RCT) of the ARI Smart Form to assess its effectiveness in decreasing antibiotic prescribing in primary care practices.
3. To connect the ARI Smart Form with a national disease surveillance program, the National Bioterrorism Syndromic Surveillance Demonstration Project, to provide an automated, bi-directional link between the personal and public health systems.
4. To perform an RCT of providing clinicians with point-of-care, real-time data about the prevalence of influenza and other respiratory illnesses in an individual patient's neighborhood through the ARI Smart Form.

Career Goals:  Dr. Linder is an academic general internist. He plans to develop a multidisciplinary research program to improve the care of patients with acute respiratory infections (ARIs) while improving links between the private and public health systems to provide surveillance for naturally occurring disease clusters and bioterrorism. Dr. Linder's multidisciplinary training regimen will include acquiring new skills in informatics, advanced biostatistics, patient safety, research ethics, public health, and disease surveillance through participation in local seminars, national scientific meetings, and peer-reviewed publication of results.

Progress to Date:  Work is being done on the design, implementation, and evaluation of the ARI Smart Form, an analysis of local care of ARIs, and examining national trends in the care of patients with ARIs. Dr. Linder conducted a usability study of the ARI Smart Form and is making modifications. Results from the usability testing have been published in the Journal of Biomedical Informatics.

Future Plans: Testing of the ARI Smart Form is taking place in a randomized controlled trial during the 2005-2006 cold and flu season.

Highlights and Specific Accomplishments:

• Professional Societies:
  • Member, American College of Physicians.
  • Member, Society of General Internal Medicine.
• Provisional Medical Staff, Faulkner Hospital, Boston, MA.
• Associate Physician, Brigham and Women's Health, Boston, MA.
• Instructor in Medicine, Harvard Medical School, Boston, MA.
• 2005 Partners in Excellence Award, Exemplary Teamwork, Smart Forms Quality.
• Excellence in Teaching Award, Harvard Medical School and Harvard School of Dental Medicine, Class of 2006.
• 2006 New England Region Clinician Investigator of the Year Award, Society of General Internal Medicine.

K-Generated Publications:

• Linder JA, Bates DW, Platt R. Antivirals and antibiotics for influenza in the United States, 1995-2002. Pharmacoepidemiol Drug Safety 2005.
• Linder JA, Huang ES, Steinman MA, et al. Fluoroquinolone prescribing in the United States: 1995 to 2002. American Journal of Medicine 2005;118(3):259-68.
• Linder JA. Health information technology as a tool to improve care for acute respiratory infections. American Journal of Managed Care 2004;10(10):661-2.
• Linder JA, Atlas SJ. Health-related quality of life in patients with sinusitis. Current Allergy Asthma Report 2004;4(6):490-5.
• Linder JA, Bates DW, Lee GM, Finkelstein JA. Antibiotic treatment of children with sore throat. JAMA 2005;294(18):2315-22.
• Linder JA, Bates DW, Williams DH, Connolly MA, Middleton B. Acute infections in primary care: accuracy of electronic diagnoses and electronic antibiotic prescribing. Journal of American Medical Informatics Association 2006;13(1):61-6.
• Linder JA, Rose AF, Palchuk MB, et al. Decision support for acute problems: the role of the standardized patient in usability testing. Journal of Biomedical Informatics 2006 (in press).
• Linder JA, Chan JC, Bates DW. Appropriateness of antiviral prescribing for influenza in primary care. Journal of Clinical Pharmacy and Therapeutics 2006 (in press).
• Linder JA, Chan JC, Bates DW. Evaluation of pharyngitis in primary care practice: the difference between guidelines is largely academic. Archives of Internal Medicine 2006 (in press).

AHRQ Research Portfolio:  Informatics; Care Management; Training
AHRQ Goals:  Safety and Quality

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