Projects
Current Projects
Primary Care-Practice Based Research Network (PBRN) – This is a master task order contract that brings together five North Carolina-based PBRNs, three based at UNC-CH, one based at Duke University, and one based at Carolinas HealthCare System. Although no core funds are allocated, it places UNC on a “short list” for contract work from AHRQ over the next 3-5 years, and multiple research projects will result.
Principal Investigator: Philip D. Sloane, M.D., M.P.H.
Funding Source: Agency for HealthCare Policy and Research (AHRQ)
Total Project Period: 01/29/07 – 1/28/12
American College of Surgeons (ACS) Institute for Health Policy Research – The Institute is a consortium of the American College of Surgeons and the Cecil G. Sheps Center for Health Services Research. It will provide expert advice, data analysis, and original research to the ACS. The goal of this project is to create a data driven, knowledge based, scholarly assessment of the role of surgery and surgical services in the evolving health care environment. A data system will be developed that regularly collects, analyzes and reports on the state of the surgical profession and the surgical workforce in the United States and, where appropriate, other nations. Annually, the Institute will summarize and report on trends in the profession and practice of surgery and the surgical workforce at the international, national, state, and regional levels.
Director: George Sheldon, M.D., F.A.C.S.
Administrative Director: Thomas C. Ricketts, III, M.P.H., Ph.D.
Funding Source: American College of Surgeons
Total Project Period: 03/08– 12/11
North Carolina Healthcare Quality Alliance Contract - The North Carolina Healthcare Quality Alliance (NCHQA) is a collaboration of leaders in the delivery of healthcare in North Carolina. NCHQA is developing quality measures for the treatment of chronic diseases, recruiting primary care practices to adopt these measures, and providing training and support to practices for improving quality of care, including support for implementing electronic medical records systems compliant with federal guidelines. NCHQA currently relies on contracts with outside organizations, including UNC-CH, for staff to support its work. Activities under this contract will be of a statewide nature and involve collaborating and working with multiple external entities. The contractor will be responsible for providing the following services to NCHQA: 1. Management and Planning; 2. Financial; 3. Data Collection, Analysis and Presentation
Principal Investigator: Warren Newton, MD, MPH
Funding: North Carolina Healthcare Quality Alliance
Total Project Period: 07/01/2010 – 06/30/2011
Transforming Primary Care Practice in North Carolina - The Patient-Centered Medical Home (PCMH) model involves complete primary care practice redesign with the ultimate goal to improve the quality of patient care and reduce cost. Detailed information on the best methods of practice transformation is needed to help the growing number of practices as they plan to go through this process. The overall objective of this study is to evaluate the adoption and process of transformational change in primary care practices belonging to the North Carolina Improving Performance in Practice program (NC IPIP). examine how specific components of the change relate to key health outcomes and explore environmental, organizational and financial conditions that are conducive to transformational change. The aims of this study are to 1) confirm the transformational change process that has occurred within 40 selected practices in the NC IPIP, 2) evaluate which components of change are most linked with improvement in the quality care indicators for diabetes and asthma, 3) for a subset of 12 practices that evidence varying degrees of success in implementing transformational change, utilize quantitative and qualitative methods to obtain a richer understanding of the change process, examine the effect of environmental conditions, organizational characteristics and financial resources on the change process and describe the costs involved in transformational change at the practice level, and 4) provide a set of recommendations that can be applied at the individual practice level and at the health care organization level to assist in the PCMH transformation process. The ultimate goal and the significance of this study is to describe the transformation process and arrive at a set of implementable recommendations that can be shared broadly to assist individual practices and health care organizations moving toward the PCMH model.
Principal Investigator: Katrina Donahue
Funding: A HRQ
Total Project Period: 8/1/10-7/31/12
Use of Affordable Open Source Systems by Rural/Small-Practice Health Professional - Work in a collaborative manner with Dr. Williams on issues related to study design, construct measurement and statistical analyses, as well as provide consultation on conceptual issues related to: current and anticipated needs of rural practices that system developers of electronic health care applications need to have in order to create a sustainable product, experiences of NC practices with open source health care record systems, current electronic interoperability problems and barriers to the use of electronic health record systems in primary are practice, interventions and contacts with NC primary care practice via the North Carolina Network Consortium.
Principal Investigator: Jacquie Halladay, PhD
Funding: North Carolina State University via AHRQ
Total Project Period: 09/30/2010 – 09/29/2011
Technical Support for Health Costs and Access Disparities in Appalachian - UNC-CH Sheps staff will construct a county level database for the Appalachian region using publicly available and proprietary data sources and use these data to develop indices of health care needs and capacity. Methods developed by UNC-CH Sheps for measuring primary care shortages and health care access problems will be combined with other data to characterize counties in terms of health care costs and access variations. The database will be employed by PDA and the ARC to construct indices and maps to analyze, understand, and explain health care cost and access disparities between the US and the ARC region and within the ARC region. UNC-CH Sheps staff will perform some statistical analyses and review data developed by PDA. The data will be used to provide information to ARC policy analysts who are developing priorities and advocating for policy initiatives related to health reform that affect communities and states within the Appalachian region and its subregions. ARC, a state/federal partnership that reports to the White House and 13 State Governors, is particularly concerned about the impact of health reform on state budgets and the impact of federal reimbursement policies on service availability.
Principal Investigator: Thomas Ricketts, PhD
Funding: Appalachian Regional Commission via PDA, Inc.
Total Project Period: 10/1/10-9/30/11
Total Funding: Total: $75,283; Direct: $67,217; Indirect: $8,066
Assessing the Workforce Needs of Patient Centered Medical Homes in North Carolina - This group of leaders will draw on the nationally recognized health workforce data, the analytic capabilities of the North Carolina Health Professions Data System (HPDS) and the expertise of health workforce researchers and policy experts from the University of North Carolina's Cecil G. Sheps Center for Health Services Research to: 1. assess the range, number and activities of professionals needed to staff the full scope of services coordinated by patient centered medical homes (PCMHs); 2. draw together actionable information on the State's current workforce size, adequacy, growth trends and future needs for health professionals serving on the patient centered medical home team; 3. assess the adequacy of the number of extant training positions, as well as the workforce development needs of the workforce already practicing in PCMHs; 4. Identify which health care services, such as patient education and case management, might be undertaken by disciplines with various skill mixes; 5. Assess the potential for new roles—such as the community health worker—that would enhance the functioning of the patient centered medical home in NC.
Principal Investigator: Erin Fraher, PhD
Funding: North Carolina Dept of Commerce via HRSA
Total Project Period: 11/18/2010 – 11/17/2011
Total Funding: Total: $144,594; Direct: $92,781; Indirect: $44,534
North Carolina Health Professions Data System – One of the most comprehensive and few continuously maintained state-level data systems available to track the supply and distribution of health professionals in the nation, this up-to-date inventory of all licensed health professionals in the State has been used continuously for the past 30+ years for planning and evaluation of health professions distribution. Each year, the Sheps Center has produced the North Carolina Health Professions Data Book, which details county and regional data, notes changes in trends from year to year, and describes the data collected on licensed health professionals. Additional special reports, fact sheets and presentations are produced as interest and funding allow. These publications are widely used by state policymakers, researchers, media, and professionals in the health care industry as the official source of health professions statistics in North Carolina. Link to NC Health Professions Data Systems web site: http://www.shepscenter.unc.edu/hp.
Project Director: Erin P. Fraher, M.P.P.
Funding Source: NC Area Health Education Centers Program and UNC-CH Office of the Provost (Health Affairs)
Total Program Period: 10/74 – on-going
Recently Completed Project
Reducing Inappropriate Prescribing of Antibiotics by Primary Care Clinicians (PBRN Task Order) - The proposed project addresses the second goal of the RFTO: to design and pilot test an innovative approach for reducing inappropriate prescribing of antibiotics in the treatment of patients residing in long-term care (LTC) settings. Our proposal is highly responsive to the RFTO request and offers in addition a widely published and recognized research team with expertise in designing and testing interventions in primary care and across nursing home and assisted living settings.
Principal Investigator: Phil Sloane, PhD
Primary Funding Source: AHRQ
Total Project Period: 08/24/09 – 08/23/11
Initiative to Identify and Eliminate Racial Ethnic Disparities within UNC Health Care – Disparities in the health and health care of racial and ethnic minorities in the U.S. are well recognized and their causes are known to be many, but there are few tested models for reducing disparities, particularly for patients within a particular practice organization. This project aims to 1) use analyses of a wide variety of available health care system data to identify differences in access to care, use of health care services and care experiences for African American, Hispanic and non-Hispanic white patients of UNC Health Care; 2) use analysis of health system data and the methods of continuous quality improvement (CQI) to help clinical departments identify the causes for identified racial-ethnic disparities in care and design, implement and monitor interventions to reduce the disparities; and 3) to formally evaluate the usefulness of these approaches in identifying and reducing racial-ethnic disparities in care within UNC Health Care and to broadly disseminate the findings.
Co-Principal Investigators: Donald E. Pathman, M.D., M.P.H.
Funding Source: UNC School of Medicine, Investments in the Future
Total Project Period: 07/07 – 06/11
Study of the Medical Schools that Train Physicians for RuralAppalachian – The West Virginia School of Osteopathic Medicine (WVSOM) and the Cecil G. Sheps Center of the University of North Carolina at Chapel Hill (UNC-CH) will collaborate to carry out analyses of the medical school origins of the physician workforce in rural Appalachia. The project is led by Helen Baker and leadership of the WVSOM. Analyses will be carried out at UNC under the direction of Donald Pathman.
Principal Investigator: Donald Pathman, MD, MPH
Funding Source: West Virginia School of Osteopathic Medicine
Total Project Period: 5/3/10-5/2/11
Evaluating Retention in BCRS Programs - The purpose of a quick turnaround task order contract to carry out a survey of current and past participants and site administrators of the National Health Service Corps, which is the country's premiere program providing primary care, mental health and dental health clinicians to practitioner-shortage areas. The focus of this data gathering and analysis effort is to update information on the experiences of NHSC clinicians while they serve in the Corps, understand how long they remain in their NHSC-assigned practices and in other underserved areas, and compare these experiences and retention to that demonstrated about ten years ago through an earlier study also conducted by Sheps investigators. This information will allow the NHSC to acknowledge its successes, strengthen its weaknesses, fill in information gaps, and develop strategies to enhance the program to run more effectively and to retain even more clinicians to meet the health care needs of rural and urban communities.
Principal Investigator: Donald Pathman, MD, MPH (subcontracted through Quality Resource Systems, Inc.)
Funding: Bureau of Clinician Recruitment and Service, Health Resources and Services Administration
Total Project Period:10/01/2010 – 03/31/2011
NC Medical Society CPP Evaluation – This project is an extension of a collaboration between leaders of the NC Medical Society Foundation’s Community Practitioner Program (CPP) and investigators at the Cecil G. Sheps Center for Health Services Research which is gathering, analyzing and reporting program and outcome data on the CPP. The principle initiative of the CPP is to help medical practices in physician shortage areas of North Carolina recruit and retain physicians, physician assistants and nurse practitioners. The CPP has principally used loan repayment incentives to attract practitioners. New types of program assistance are now being developed. In this collaboration, investigators at the Sheps Center will continue (a) analyzing data from the CPP’s past, (b) assisting program leaders in updating the data elements and data collection approaches used to monitor and assess program activities, (c) assisting program leaders in designing the content and analytic approaches needed for regular reports to document program progress for the program’s leaders, advisory boards and funding agencies, (d) providing periodic special reports addressing specific aspects of the program’s operations, (e) providing maps to highlight the program’s activities, and (f) assisting program leaders as they choose a new data management system.
Principal Investigator: Donald Pathman, MD, MPH
Funding Source: NC Medical Society
Total Project Period: 4/1/08 -12/31/10
Documentation of the Activities and Contributions of the NC Medical Society’s Community Practitioner Program (CPP): The First 17 Years (1989-2006) – The primary focus of the CPP is to help medical practices in physician shortage areas of North Carolina recruit and retain physicians, physician assistants, and nurse practitioners, using loan repayment incentives to attract practitioners. This project will link administrative data from the program with data from secondary sources (e.g., medical licensure files, U.S. Census) to provide in-depth descriptions of the practitioners who have participated in the program, including their backgrounds, disciplines, and careers prior to and after participating. The report will also describe the practices, towns and counties where participants have served, and the patient populations for whom they provided care.
Co-Principal Investigators: Donald E. Pathman, M.D., M.P.H.
Funding Source: North Carolina Medical Society Foundation
Total Project Period: 04/07 – 12/10
Southern Tick Associated Rash Illness (STARI) – Lyme disease is a chronic infectious disease caused by the bacterium Borrelia burgdorferi and transmitted to humans by the bite of the infected Ixodes sp. tick. Typical symptoms include fever, headache, fatigue, and, in its preliminary phase, a characteristic skin rash called erythema migrans (EM). During the past decade or so, a series of research reports have uncovered the fact that a second syndrome exists, consisting of a rash that mimics EM and that is readily confused with early Lyme disease. This syndrome, STARI, occurs in the southern United States, is associated with negative cultures and serologies for Borrelia burgdorferi, and is generally seen after the bite of a different tick, Amblyomma americanum, or the “lone star” tick. Little is known about the distribution or clinical course of STARI, and its cause remains unknown. The purpose of this project is to obtain biological specimens (skin biopsies and serological samples) from patients meeting the diagnostic criteria for STARI, so that scientists at CDC can conduct studies to help determine the etiology of the syndrome . [This is the second North Carolina Network (NCN) Consortium project.]
Principal Investigator: Philip D. Sloane, M.D., M.P.H.
Funding Source: Centers for Disease Control and Prevention
Total Project Period: 03/11/08 – 09/30/09
Improving the Integration of Evidenced-Based Clinical and Community Services to Support Healthy Behaviors – This is a randomized trial within a primary care practice-based research network (PBRN) evaluating two different interventions compared to usual practice to improve linkages with community resources addressing tobacco use, unhealthy diets, and physical inactivity. The first intervention uses an evidence-based quality improvement learning collaborative and the second uses a more informal practice strategy in which practices will receive written material (brochures, fax referral forms, and “information” prescription pads) to facilitate referral to community resources that address the selected unhealthy behaviors. Quantitative and qualitative analyses will be used to understand the impact of the interventions at the practice, provider, patient, and community resource level. The main outcome measure is the probability that a patient with an unhealthy behavior is referred to a community resource. [This is the first Primary Care-Practice Based Research Network (PBRN) project.]
Principal Investigator: Philip D. Sloane, M.D., M.P.H.
Funding Source: Agency for HealthCare Policy and Research (AHRQ)
Total Project Period: 08/07 – 9/09
