(provided by the applicant): This is an application for a K08 award for Dr. Urmimala Sarkar, a general internist at the University of California, San Francisco, who is establishing herself as a young investigator in ambulatory patient safety among vulnerable chronic disease patients. This K08 award will provide her with the support to accomplish the following goals: (1) to become expert at patient-oriented clinical research in ambulatory safety for vulnerable diabetes patients;(2) to investigate the utility of interactive health information technology for patient safety surveillance and promotion;(3) to implement advanced biostatistical methods in clinical studies;and (4) to apply novel methods such as root cause analysis and the Delphi method;and (5) to develop an independent clinical research career. She has assembled a mentoring team comprised of a primary mentor, Dr. Dean Schillinger, who conducts research in health communication and chronic disease management, and 3 co-mentors: Dr. Robert Wachter, an international expert in the field of patient safety;Dr. Eric Vittinghoff, and expert in study design and biostatistical analysis;and Dr. Mary Blegen, a researcher with expertise in patient safety promotion. Her team also includes 4 scientific advisors: Dr. Wilson Pace, a nationally renowned expert in ambulatory safety surveillance research;Dr. Kaveh Shojania, an expert in evaluation of quality improvement programs and in patient safety research;Dr. Nancy Kupka, an expert in patient safety at the Joint Commission;and Dr. Michael Blum, an expert in HIT. Little is known about the extent, nature, or evolution of adverse events among ambulatory patients, especially among vulnerable groups with chronic diseases.
In Aim 1, Dr. Sarkar will leverage an existing, interactive health information technology (HIT) self-management program to monitor safety among 500 diabetes patients. She will employ advance statistical methods to identify patients at highest risk and perform root cause analysis for detected events.
In Aim 2, she will investigate the comparative yield for several surveillance mechanisms.
In Aim 3, she will use the Delphi method to evaluate the relevance and severity of adverse events that were identified and the feasibility for prevention/amelioration. Public health relevance: Improving our understanding of the nature and etiology of patient safety problems in disadvantaged diabetes patients is critical and can guide future safety assessment and promotion in this high-risk population.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08HS017594-05
Application #
8330686
Study Section
HSR Health Care Research Training SS (HCRT)
Program Officer
Anderson, Kay
Project Start
2008-09-30
Project End
2013-09-29
Budget Start
2012-09-30
Budget End
2013-09-29
Support Year
5
Fiscal Year
2012
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Sarkar, Urmimala; Lyles, Courtney R; Parker, Melissa M et al. (2014) Use of the refill function through an online patient portal is associated with improved adherence to statins in an integrated health system. Med Care 52:194-201
Schickedanz, Adam; Huang, David; Lopez, Andrea et al. (2013) Access, interest, and attitudes toward electronic communication for health care among patients in the medical safety net. J Gen Intern Med 28:914-20
Baxi, Sanjiv; Lakin, Joshua; Lyles, Courtney R et al. (2013) Points for improvement: performance measurement for glycemic control in diabetes patients in a safety-net population. Jt Comm J Qual Patient Saf 39:109-13
Lyles, Courtney R; Schillinger, Dean; Lopez, Andrea et al. (2013) Safety events during an automated telephone self-management support intervention. J Diabetes Sci Technol 7:596-601
Lyles, Courtney R; Lopez, Andrea; Pasick, Rena et al. (2013) "5 mins of uncomfyness is better than dealing with cancer 4 a lifetime": an exploratory qualitative analysis of cervical and breast cancer screening dialogue on Twitter. J Cancer Educ 28:127-33
Detz, Alissa; Lopez, Andrea; Sarkar, Urmimala (2013) Long-term doctor-patient relationships: patient perspective from online reviews. J Med Internet Res 15:e131
Lopez, Andrea; Detz, Alissa; Ratanawongsa, Neda et al. (2012) What patients say about their doctors online: a qualitative content analysis. J Gen Intern Med 27:685-92
Sarkar, Urmimala; Schillinger, Dean; Lopez, Andrea et al. (2011) Validation of self-reported health literacy questions among diverse English and Spanish-speaking populations. J Gen Intern Med 26:265-71
Sarkar, Urmimala; Lopez, Andrea; Black, Karen et al. (2011) The wrong tool for the job: diabetes public health programs and practice guidelines. Am J Public Health 101:1871-3
Sarkar, Urmimala; Karter, Andrew J; Liu, Jennifer Y et al. (2011) Social disparities in internet patient portal use in diabetes: evidence that the digital divide extends beyond access. J Am Med Inform Assoc 18:318-21

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