: Stephen D. Persell, MD, MPH is an academic general internist, health services researcher, and practicing primary care physician. He is applying for the K08 Mentored Clinical Scientist Development Award to advance his long-term goal of developing an independent research program to design and test preventive cardiology quality improvement interventions integrated into primary care settings using tailored patient communication and information technology. ? ? This goal will be achieved through a 5-year career development program that includes didactic training and mentored research. The major objectives of this program are: 1) to acquire advanced theoretical and practical skills in health communications; 2) to gain skills and experience in the research methods used to design and evaluate information technology-based interventions performed in real-life health care settings; and 3) to develop and test an intervention designed to improve the appropriate use of aspirin and cholesterol lowering therapy in patients at high risk for cardiovascular events. This intervention will involve using a population-based information technology approach coupled with the development of individually tailored messages sent directly to patients. ? ? The objectives of the award will be advanced through the four phases of the research plan. Phase 1 consists of an analysis of the accuracy and sources of error occurring when data from a contemporary electronic medical record are used to classify patients' cardiovascular risk and identify unaddressed risk factors. Phase 2 includes a qualitative and quantitative study to elicit physician attitudes, barriers and possible solutions to the implementation of an office system to improve preventive cardiology using direct communication with patients. Phase 3 consists of a study of patients' responses to model messages. Phase 4 is a trial testing the feasibility and efficacy of a messaging intervention to improve patients' appropriate use of aspirin and cholesterol lowering therapy. The results of this research plan should justify a larger trial of this intervention and serve as a prototype for the development of other direct-to-patient interventions. The award will provide Dr. Persell with a crucial experience performing a health-care system intervention and facilitate his development of advanced skills. ? ?

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Clinical Investigator Award (CIA) (K08)
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HSR Health Care Research Training SS (HCRT)
Program Officer
Anderson, Kay
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Northwestern University at Chicago
Internal Medicine/Medicine
Schools of Medicine
United States
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Persell, Stephen D; Lloyd-Jones, Donald M; Friesema, Elisha M et al. (2013) Electronic health record-based patient identification and individualized mailed outreach for primary cardiovascular disease prevention: a cluster randomized trial. J Gen Intern Med 28:554-60
Zimmermann, Laura J; Thompson, Jason A; Persell, Stephen D (2012) Electronic health record identification of prediabetes and an assessment of unmet counselling needs. J Eval Clin Pract 18:861-5
Jean-Jacques, Muriel; Persell, Stephen D; Thompson, Jason A et al. (2012) Changes in disparities following the implementation of a health information technology-supported quality improvement initiative. J Gen Intern Med 27:71-7
Persell, Stephen D; Khandekar, Janardan; Gavagan, Thomas et al. (2012) Implementation of EHR-based strategies to improve outpatient CAD care. Am J Manag Care 18:603-10
Persell, Stephen D; Kaiser, Darren; Dolan, Nancy C et al. (2011) Changes in performance after implementation of a multifaceted electronic-health-record-based quality improvement system. Med Care 49:117-25
Persell, Stephen D; Friesema, Elisha M; Dolan, Nancy C et al. (2011) Effects of standardized outreach for patients refusing preventive services: a quasiexperimental quality improvement study. Am J Manag Care 17:e249-54
Jean-Jacques, Muriel; Persell, Stephen D; Hasnain-Wynia, Romana et al. (2011) The implications of using adjusted versus unadjusted methods to measure health care disparities at the practice level. Am J Med Qual 26:491-501
Persell, Stephen D (2011) Prevalence of resistant hypertension in the United States, 2003-2008. Hypertension 57:1076-80
Baker, David W; Persell, Stephen D; Kho, Abel N et al. (2011) The marginal value of pre-visit paper reminders when added to a multifaceted electronic health record based quality improvement system. J Am Med Inform Assoc 18:805-11
Cameron, Kenzie A; Persell, Stephen D; Brown, Tiffany et al. (2011) Patient outreach to promote colorectal cancer screening among patients with an expired order for colonoscopy: a randomized controlled trial. Arch Intern Med 171:642-6

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