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Center of Excellence in Public Health Informatics
Richard Platt
DACP leads one of two CDC Centers of Excellence in Public Health Informatics (www.phiconnect.org). The Center's goal is to bridge the information gap between public health, clinicians, and individuals. One of the Center's initiatives is developing methods and computer programs to allow clinicians to notify public health agencies electronically about diseases like tuberculosis in a more timely, complete, and efficient way than is currently possible. This work is being performed with Harvard Vanguard Medical Associates and the Massachusetts Department of Public Health. Another initiative is developing new capabilities for personally controlled health records, to allow individuals to share and receive information with health departments, as well as with their own providers. The Center also works on informatics, statististical, and disease monitoring topics that support a broad range of public health needs. Institutional partners in this work include the Massachusetts Department of Public Health, the Children's Hospital Informatics Program, the Harvard-MIT Division of Health Sciences and Technology, and the Channing Laboratory at Brigham and Women's Hospital, as well as Harvard Vanguard. Richard Platt is the Principal Investigator, and Kenneth Mandl, at Children's Hospital, is co-PI. Other DACP and HVMA participants include Allyson Abrams, FX Campion, Julie Dunn, Ken Kleinman, Michael Klompas, Ben Kruskal, Martin Kulldorff, Kimberly Lane, Colin Sox, and Katherine Yih.
MIDAS
Richard Platt
Eastern Massachusetts Prevention Epicenter
Richard Platt
Evaluating educational and technological interventions to improve quality of care:
Steven Simon
Computer technology, ranging from automated telephone modules to improve patient care and web-based educational programs, are rapidly being developed to enhance clinical practice. In addition, the electronic health record, also called an electronic or computerized medical record, is standard practice in most large medical organizations and is increasingly being adopted in medical practices throughout the United States. DACP is involved in ongoing studies that will test and measure the effect of these technological interventions on the quality of care. Steven Simon is collaborating on a number of studies that seek to determine how these technologies influence patient care and how they can best be adapted to have a positive impact on the process and outcome of clinical care.
Statewide Adoptions of Electronic Health Records (EMHR): This study will evaluate various interventions to encourage physicians to adopt EHRs in their practices throughout Massachusetts. The study team will investigate whether the EHRs reduce medication errors and improve care; whether extensive financial support for purchasing EHRs leads to rapid adoption of EHRs; and whether educational outreach can help ease the EHR implementation process for clinicians. Dr. Simon is working with the Massachusetts e-Health Collaborative on this study.
Automated Telephone Diabetes Management: This pilot study will test patient and clinician receptivity to automated telephone diabetes management with enhanced speech recognition (ATDM-SR). The study aims to (1) identify patients' perspective about factors involved in getting good diabetes care and the potential for ATDM-SR to improve that care; (2) identify physician concerns about impact of ATDM-SR on patients and clinical practice; and (3) design, develop, and implement ATDM-SR in a pilot intervention. This study will provide the preliminary information to create a full-scale intervention of ATDM-SR in a large health care organization.
Reducing Unnecessary Use of Heavily Marketed Medicines: This study will evaluate computerized prescribing alerts aimed at reducing unnecessary use of heavily marketed medicines. It will also assess the impact of group academic detailing on knowledge and attitudes regarding pharmaceutical marketing practices. This study will provide valuable data about the potential for systems-based education to change prescribing behavior in regard to heavily marketed medicines for which there exist equally effective, less expensive alternatives.
The Vaccine Safety Datalink Project - Using population-based data to ensure the safety of vaccines
Tracy Lieu
The Vaccine Safety Datalink (VSD) Project is the nation's premier system for actively monitoring vaccine safety. It is sponsored by the Centers for Disease Control and Prevention and includes Harvard Pilgrim Health Care/Harvard Vanguard Medical Associates and 7 other health plan sites around the country. The project's goals are to evaluate the safety of new vaccines in large populations under real-life practice conditions, and to do rapid studies when potential problems with vaccines are identified by patients and clinicians, or by other means. The VSD Project includes approximately 2% of the entire U.S. population. The large size of the study population provides the statistical power to study rare but potentially serious vaccine adverse events. The VSD Project has studied important and controversial topics including whether thimerosal (a preservative formerly used in vaccines) is associated with increased risk of developmental problems, including autism
(click here); whether a new vaccine against bacterial meningitis is associated with Guillain-Barre syndrome, a form of paralysis (click here); and whether rotavirus vaccine against diarrhea was associated with intussusception (click here), a rare but potentially life-threatening bowel problem. In addition to participating in individual studies, DACP maintains a coordinating center for the VSD's program of rapid assessment of complications of newly introduced vaccines. The VSD Project is led at DACP by Drs. Tracy Lieu and Richard Platt; Virginia Hinrichsen, project manager, and Rich Fox, data manager, along with 18 other faculty, staff, and clinicians from Harvard Vanguard Medical Associates listed below. Selected other VSD publications that include DACP authors are noted here.
List of VSD faculty/fellows/staff/HVMA collaborators:
Principal Investigator: Rich Platt
Co-Principal Investigator: Tracy Lieu
Project Manager: Virginia Hinrichsen
Data Manager: Rich Fox
Analysts: Renny Li and Ruihua Yin
Project Coordinators: Kate Hohman and Charlene Gay
Epidemiologists: Katherine Yih, Sharon Greene and Irene Shui
Biostatisticians: Martin Kulldorff and Ken Kleinman
Co-Investigators: Jonathan Finkelstein and Grace Lee
HVMA Collaborators: Anita Feins, Joanne Mitchell and Ben Kruskal
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