Patrick Conway, M.D. (Pediatrics) received his M.D. from Baylor College of Medicine and completed his Pediatrics residency at Boston Children’s Hospital. His interests are focused in the area of quality of care in pediatrics, with an emphasis on hospitalized children. During the reporting period Patrick has completed biostatistics, epidemiology, health measurements and critical appraisal/protocol development courses and took his MSCE comprehensive examination. Also, he took cost-effectiveness and clinical decision making classes outside of the MSCE degree, participated in the community based research, the bioethics, social science and leadership seminars series, worked on six manuscripts and engaged in several research studies. He has been working with Dr. Ron Keren on a study of "Predictors of Recurrent Urinary Tract Infections and Resistant Organisms in a Primary Care Based Cohort." The study received competitive intramural funding and was selected as presidential plenary platform for PAS. Also, Patrick has been working with Dr. Keren on analysis of data on 40,000 admissions for pediatric UTI and predictors of outcomes using Pediatric Research in Inpatient Settings dataset which has been IRB approved. This project is in analysis phase and was selected as platform for PAS hospitalist session. Additionally, his paper written with Drs. Kevin Volpp and Julie Sochalski describing changes in the nurse staffing ratios in adult and pediatric settings and their policy implications was submitted to Health Affairs. Recently, Patrick accepted a position of Assistant Professor with joint appointment in Center for Heath Care Quality and Division of General Pediatrics at Cincinnati Children’s Hospital.
Reena Duseja, M.D. (Emergency Medicine) obtained her medical degree from George Washington University and completed her residency in Emergency Medicine at Boston Medical Center. Her primary interests are in the area of health policy, with a particular focus on improving emergency medicine quality of care and health outcomes and enhancing access to care and strengthening the safety net for the nation’s underserved populations. Since her application to the CSP, her interests have evolved further in the area of economic implications of health care policy. Over the past academic year, Reena took all core MSCE courses (biostatistics, epidemiology, health measurements and critical appraisal/protocol development). In addition, she took the cost-effectiveness, health policy analysis and the economics of health care classes outside of the MSCE degree curriculum, participated in the community based research to learn skills in evaluating community resources, participated in the seminar series, attended national conferences (American College of Emergency Physicians-Leadership and Advocacy Conference), and worked with a senior medical officer on a primary data collection study on quality process measures in hospitals. In addition, Reena worked with Dr. Metlay to develop a project examining unintended adverse consequences of pay for performance measures in the emergency department by comparing the quality of antibiotic treatment for patients with community acquired pneumonia with the simultaneous overuse of antibiotic treatment for patients with non-bacterial respiratory tract infections. This multi-hospital study has received IRB approval at 5 of 8 sites and data collection is beginning this summer. Reena will pursue her academic and research interests in health care economics and policy through enrollment in the Wharton School Doctoral Program in Health Care Systems.
Peter Ehrenkranz, M.D., M.P.H. (Internal Medicine) received his MD from Emory University School of Medicine and School of Public Healthcompleted the Internal Medicine Primary Care residency program at the University of Pennsylvania. His primary research interests include HIV and TB awareness and education among African immigrants to Philadelphia and international health. During the reporting period, Peter completed all core MSCE courses (biostatistics, epidemiology, health measurements and critical appraisal/protocol development). Also, in collaboration with his mentors, Drs. Metlay and Zaoutis, he developed a protocol and received competitive intramural funding for a study on "Factors Associated with Testing for HIV in Emergency Departments" to be administered in questionnaire format at a national sample of academic emergency departments coordinated by faculty at the Massachusetts General Hospital. Pending receipt of funding, and concurrently designation of exemption status by Penn’s IRB, Dr. Ehrenkranz will collect data throughout June, July, and August and will begin data analysis in August. Additionally, he is forming a project protocol for a project titled ": Delayed Medical Care after Diagnosis of HIV" under the guidance of mentors Theo Zaoutis, MD, MSCE, and Kathleen Brady, MD, MSCE at the City of Philadelphia Health Department. This study involves access to unique data resources coordinated by the Philadelphia Dept of Public Health.
Aliya Esmail, M.D.(Pediatrics) graduated from medical school at the University of Illinois in Chicago. She completed her pediatric residency and spent a year as Chief Resident in Pediatrics at the Yale New Haven Children's Hospital. Dr. Esmail’s research interests are focused on the social and psychological sequelae of obesity in children as well as contributing factors of childhood obesity that could be targeted for community or policy level interventions. In collaboration with Drs. Sara Kinsman and Nicolas Stettler, she is studying the relationship between childhood obesity and selected risk behavior participation in young adulthood using the National Longitudinal Study of Adolescent Health. She has also teamed with her collaborators and Dr. Judy Shea to develop a qualitative study, using in-depth interviewing, to better understand the knowledge, attitudes, and decision making by Philadelphia’s African-American mothers on WIC surrounding sweetened beverage consumption in their 12 to 24 month old children.
Kristen Feemster, M.D., M.P.H. (Pediatrics) graduated a joint MD/MPH program at Columbia University and completed her Pediatrics residency at the Children's Hospital of Philadelphia.. Kristen’s research interests are focused on neighborhood effects on children's health, particularly the social and environmental factors affecting patterns of infectious diseases. She is also interested in vaccine policy. Over the past academic year, Kristen completed coursework and/or requirements in all core competencies, took classes in Health Law and Policy at the Law School, Community Mapping (GIS methodology) at the School of Social Policy and Practice and engaged in a project "Can a Pediatric Primary Care Network Measure Disease in the Community" to measure whether children who seek care at the Children’s Hospital of Philadelphia primary care network reflect the sociodemographic and clinical characteristics of the pediatric population of the Philadelphia metropolitan region. Also, the neighborhood characteristics associated with the level of variation between these two populations will be measured and analyzed. This project received competitive intramural funding. She also embarked on a study "A Spatial Analysis of Late Vaccine Initiators and Perinatal Morbidity: Working towards Improved Vaccine Coverage and Perinatal Outcomes" that seeks to better understand the patterns of under-immunization amongst children under the age of 5 in the city of Philadelphia. This research study is being carried out in partnership with the Philadelphia Department of Public Health, Division of Disease Control and her Program mentors: Drs. Susmita Pati and Josh Metlay. Her most recent project is entitled "Pediatric Provider Administration of the Human Papillomavirus Vaccine to 11-12 year old Girls: Intentions and Behaviors. Using primary data collection, this study is following cohorts of providers from a pediatric primary care network and from practices participating in the Vaccines for Children program across Philadelphia. This project is also supported by intermural funding. Dr. Feemster continues to have her research activities grounded in public health. Her career goal is to pursue a joint appointment in a division of infectious diseases and a department of public health. She is also considering opportunities outside of academic medicine (e.g., with the CDC, the IOM, a public health department or a foundation working on infectious disease prevention.)
Tara Lagu, MD, MPH, RPh (Internal Medicine) graduated with MD and MPH degree from Yale and completed her residency at Brown University in General Internal Medicine. Her research interests are focused on health policy, focusing on the issues of rationing, access to care and allocation of resources. Over the reporting period, Dr. Lagu completed coursework and/or requirements in all core competencies and audited a class in cost-effectiveness analysis. As for her research, she is focusing on the role of shared responsibility for adherence on the part of both patient and provider. In collaboration with her mentor Barbara Turner, she has been working on a retrospective cohort study of low-income African American patients using visit and prescription data from the electronic medical record (EMR) for patients with hypertension in seven Philadelphia primary care practices. The objectives of this study are to identify patient and provider factors associated with prescribed antihypertensive medication initiation and adherence among primary care patients; and to examine the association of medication adherence as it relates to achievement of hypertension control goals.
Joanna Starrels, MD (Internal Medicine) received her medical degree from Jefferson Medical College and completed her residency in Internal Medicine at Columbia University Medical Center. Following residency, she returned to Philadelphia for a fellowship in the Robert Wood Johnson Clinical Scholars Program at the University of Pennsylvania. There, she received a Masters of Science degree in Health Policy Research in May 2008. In September 2008, she will be joining the faculty at Albert Einstein College of Medicine in the Bronx (Montefiore campus), as an Assistant Professor in the Division of General Internal Medicine.Dr. Starrels’ research interest is to improve the primary care management of chronic disease in relation to substance use and addiction. She has employed qualitative methods and analysis of secondary data sets to examine antibiotic use behaviors in injection drug users, national trends in drug overdose death, and potential quality measures for opioid management in primary care. Her current work focuses on helping to define best practices for the safe and effective management of patients prescribed opioid analgesics for chronic pain. Particularly, she is interested in how variation in opioid management practice, such as treatment agreements and urine drug monitoring, affects outcomes including opioid misuse, pain and function, and retention in treatment.