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Facilitating Patient Understanding of Discharge Instructions: Workshop Summary (2014)

Chapter: Appendix B: Biographical Sketches of Workshop Speakers

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Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
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Appendix B


Biographical Sketches of
Workshop Speakers

John M. Byrne, D.O., is the associate chief of staff for education (ACOS/E) at the VA Loma Linda Healthcare System (VALLHCS). As a practicing general internist, Dr. Byrne has been involved with graduate medical education for the past 20 years as clinician-educator, associate program director, ACOS/E, and associate professor of medicine at Loma Linda University School of Medicine. Dr. Byrne has also served as general internal medicine section chief at VALLHCS. Currently, Dr. Byrne is also chief of the Clinical Informatics Section and the Designated Learning Officer at VALLHCS. His research interests are resident supervision, evaluation of the trainee learning environment, medical informatics, and primary care education. Dr. Byrne and his VA colleagues developed and tested the Clinical Supervision Index (CSI), a tool to quantify attending physician supervision and measure residents’ progression toward independence. Through a VA Health Services Research and Development, the CSI was tested and shown to be feasible and reliable in clinical settings at VALLHCS. With a VA Innovations grant, the CSI has been instantiated in software and has been deployed at VALLHCS through the VA electronic health record, the Computerized Patient Record System. Other areas of research include evaluating the resident learning environment through trainee perceptions and using technology to monitor resident duty hours. With another VA Innovations grant, Dr. Byrne and his colleagues have developed and tested the After-Visit Summary, a tool designed to provide patients with a summary of outpatient visits. He recently received a grant from a VA Patient Aligned Care Team Demonstration Site to test providers’ and patients’ satisfaction with the After-Visit Summary. Recently, he collaborated with the Internal Medicine Residency

Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
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and VALLHCS on an educational innovation award through the VA to develop the Primary Care Interprofessional Patient-Centered Quality Care Training curriculum for internal medicine residents, postdoctoral psychology fellows, and pharmacy residents.

Darren A. DeWalt, M.D., M.P.H., is associate professor in the division of general internal medicine at the University of North Carolina (UNC) at Chapel Hill. He is board certified in pediatrics and in internal medicine. He has been a member of the American College of Physician Foundation Programs Committee for 5 years and is incoming chair of the Programs Committee. Dr. DeWalt actively researches self-management interventions for patients with low literacy and focuses on chronic diseases such as diabetes, heart failure, chronic obstructive pulmonary disease, and asthma. His focus is on patient-physician communication and health system design to achieve better outcomes for vulnerable populations. His work in health literacy includes epidemiological studies, systematic reviews, communication tool development, and clinical trials. He is currently principal investigator on a practice-based intervention to reduce hypertension disparities, work funded by the National Heart, Lung, and Blood Institute. He is the lead author of the Agency for Healthcare Research and Quality Health Literacy Universal Precautions Toolkit.

Dr. DeWalt led the design team and is currently a national improvement advisor for the Improving Performance in Practice (IPIP) program for the boards and specialty societies of internal medicine, family medicine, and pediatrics. IPIP is a program to help practicing primary care physicians improve care systems through working in improvement networks, measuring and sharing performance data, and receiving improvement education and training. He is the principal investigator at the UNC research site for the Patient Reported Outcomes Measurement Information System (PROMIS). PROMIS is developing advanced tools for measurement of symptoms, function, and quality of life. Dr. DeWalt is interested in the use of self-report measurements among vulnerable populations, particularly those with low literacy. Dr. DeWalt is a former Robert Wood Johnson Foundation Clinical Scholar at the UNC at Chapel Hill. He completed his residency in internal medicine and pediatrics at UNC at Chapel Hill, where he also served as chief resident in internal medicine. He received his medical degree from the Vanderbilt University School of Medicine.

Benard P. Dreyer, M.D., FAAP, is professor of pediatrics and director of Developmental-Behavioral Pediatrics at New York University School of Medicine. He is co-chair of the American Academy of Pediatrics (AAP) Health Literacy Program Advisory Committee and the immediate past president of the AAP New York Chapter 3. He is a member of the AAP Council

Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
×
on Communications and Media and a liaison member of the Committee on Pediatric Research. He is also active in the Academic Pediatric Association (APA) and is presently president of the APA. Dr. Dreyer’s research group has been instrumental in documenting the improved outcomes seen in children exposed to early literacy programs such as Reach-Out-and-Read and has been in the forefront of studying ways to improve communications between providers and families with lower literacy/health literacy and limited English proficiency. He is co-editor of the book Plain Language Pediatrics: Health Literacy Strategies and Communication Resources for Common Pediatric Topics, which was recently published by the AAP. Dr. Dreyer earned his medical degree from New York University School of Medicine and completed his residency in pediatrics at Albert Einstein College of Medicine.

Alex Federman, M.D., M.P.H., is an aging-focused health services and behavioral health researcher and associate professor of medicine at the Icahn School of Medicine at Mount Sinai. Dr. Federman obtained his bachelor of arts degree in biochemistry from the University of California, Berkeley, in 1988, his medical degree from the State University of New York, Brooklyn, in 1996, and a master of public health degree from the Harvard School of Public Health in 2001. He completed an internship and residency in primary care internal medicine at the Montefiore Medical Center of the Albert Einstein College of Medicine in 1999. He was a health services research fellow in the Department of Health Policy at Harvard Medical School from 1999 to 2001. He joined the faculty of the Mount Sinai School of Medicine in September 2002 and served as chief of the Division of General Internal Medicine there in 2011 and 2012. Dr. Federman was awarded a Robert Wood Johnson Foundation Generalist Physician Faculty Scholarship in 2004 and a Paul B. Beeson Career Development Award in Aging Research from the National Institute on Aging in 2006. His research addresses issues of chronic illness self-management with a focus on health literacy, cognition, and health-related beliefs. He leads two large National Institutes of Health (NIH)-funded cohort studies examining chronic illness self-management in older adults, as well as a Patient-Centered Outcomes Research Institute–funded randomized controlled trial of self-management support for older people with asthma. Dr. Federman also serves on the board of governors of Mount Sinai Care, the accountable care organization of the Mount Sinai Medical System. Dr. Federman provides primary care to adult patients in the Internal Medicine Associates practice in East Harlem, New York.

Alice M. Horowitz, Ph.D., R.D.H., is a research associate professor at the University of Maryland School of Public Health. Formerly she was a

Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
×

senior scientist in the Division of Population and Health Promotion Sciences at the National Institute of Dental and Craniofacial Research. She was a primary architect of the Maryland State Oral Cancer Prevention and Early Detection coalition. She initiated both state and national research on what health care providers and the public know and do about oral cancer prevention and early detection. She has initiated statewide research on what the public knows and does about preventing dental caries and their perceptions of communication skills of dental providers and on health care provider (physicians, nurse practitioners, dentists, and dental hygienists) reported use of recommended communication practices. She served as the NIH lead for the Healthy People 2010 Oral Health Chapter and worked on Healthy People and Healthy People 2000. She organized the National Institute of Dental and Craniofacial Research’s workshop on oral health literacy and co-authored the resultant findings. She has published more than 125 scientific papers and book chapters and is the recipient of numerous awards. Dr. Horowitz holds a Ph.D. in health education from the University of Maryland, College Park.

Charles Lee, M.D., is founder and president of Polyglot Systems, Inc., in Morrisville, North Carolina. Dr. Lee founded Polyglot in 2001 with a mission to develop practical, affordable multi-language technology solutions to improve health care access and reduce disparities for underserved and limited-English-proficient patient populations. He is an internal medicine physician and past National Library of Medicine fellow in medical informatics at UNC at Chapel Hill/Duke University. He has extensive experience in medical software product development as well as health literacy, user interface, and instructional design. Dr. Lee is a past recipient of the Tibbetts Award from the U.S. Small Business Administration for his work in health care and technology. Dr. Lee has received Small Business Innovation Research phase I and II grants for four separate projects through the National Institute on Minority Health and Health Disparities and the National Cancer Institute. Some areas of Dr. Lee’s multi-language research and development include (1) applications for health insurance coverage, (2) reduction of medication errors, (3) medication reconciliation and adherence intelligence, (4) discharge instructions, and (5) emergency triage.

Man Wai Ng, Ph.D., is chief of the Department of Dentistry at Boston Children’s Hospital and assistant professor of developmental biology (pediatric dentistry) at the Harvard School of Dental Medicine. Dr. Ng received her D.D.S. degree from the State University of New York at Stony Brook and her M.P.H. degree from the Harvard School of Public Health. She has been in full-time hospital dentistry and has served as residency director of pediatric dentistry at two children’s hospitals. She is a member of the Review

Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
×

Committee of the Commission on Dental Accreditation and the Examination Committee of the American Board of Pediatric Dentistry. She was a member of the board of trustees of the American Academy of Pediatric Dentistry and the Advisory Committee on Training in Primary Care Medicine and Dentistry of the Health Resources and Services Administration.

Michael Paasche-Orlow, M.D., M.A., M.P.H., is associate professor of medicine, Boston University School of Medicine. Dr. Paasche-Orlow is a general internist and a nationally recognized expert in the field of health literacy. Dr. Paasche-Orlow is currently a coinvestigator with five funded grants that examine health literacy, including two intervention studies evaluating simplified information technologies for behavior change among minority patients with a range of health literacy levels. Dr. Paasche-Orlow is a member of the Project RED (Re-Engineered Discharge) research team, a nationally recognized model to reengineer the process of hospital discharge to improve the safety and efficiency of transitions of care. Dr. Paasche-Orlow’s work has brought attention to the role that health literacy plays in racial and ethnic disparities, self-care for patients with chronic diseases, end-of-life decision making, and the ethics of research with human subjects. Dr. Paasche-Orlow is the associate program director for the Boston University School of Medicine’s General Internal Medicine Academic Post-Ddoctoral Fellowship Program and the associate section chief for research for the Section of General Internal Medicine in the Boston University School of Medicine’s Department of Medicine.

Ruth Parker, M.D., is a professor of medicine and public health at Emory University School of Medicine. She developed one of the first measurement tools to quantify patients’ abilities to read and understand health information—the Test of Functional Health Literacy in Adults (TOFHLA)—and co-wrote the definition of health literacy that is used by Healthy People and the NIH and in the Institute of Medicine (IOM) report Health Literacy: A Prescription to End Confusion. She is also the developer of a model of health literacy that is achieving growing recognition in the United States and internationally. Dr. Parker worked to define medication labels as an issue at the intersection of health literacy and patient safety, and she co-wrote the seminal white paper on the topic, which was presented to the IOM at a workshop on standardizing medication labels. This led to pivotal work by the U.S. Pharmacopeia, where Dr. Parker worked on an expert panel to create standards for improved medication labels. This standard has now been published by U.S. Pharmacopeia.

Dr. Parker also works with the Food and Drug Administration as a scientific expert/special government employee regarding medication labels and with the Nonprescription Drug Advisory Committee as an expert in

Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
×

consumer understanding of medication labels. Dr. Parker is also a strong advocate for health literacy and its importance to health. She has worked tirelessly with professional societies, federal and state agencies, and congressional staff to inform them about health literacy issues and to encourage them to recognize health literacy as a priority issue.

Joshua J. Seidman, Ph.D., is a consultant to the Brookings Accoutable Care Organization Learning Network, supporting physician-led accountable care organizations in using data better to manage population health. For more than 23 years, Dr. Seidman has focused on delivery system transformation through quality measurement and improvement; patient engagement; participatory medicine; and the intersection of e-health and health services research. Dr. Seidman also oversaw quality and performance improvement at Evolent Health, which supports the nation’s leading providers in their population health and care transformation efforts. He previously served as director of meaningful use for the U.S. Department of Health and Human Services, where he was responsible for the Office of the National Coordinator for Health Information Technology’s policy development around the meaningful use of electronic health records and e-quality measures. Previously, Dr. Seidman was the founding president of the Center for Information Therapy, which advanced the practice and science of using health information technology to deliver tailored information to consumers to help them make better health decisions. He has also served as director of Measure Development at the National Committee for Quality Assurance and has conducted research and analysis related to providers at the American College of Cardiology and the Advisory Board Company. Dr. Seidman earned a Ph.D. in health services research and an M.H.S. in health policy and management from Johns Hopkins Bloomberg School of Public Health and earned a B.A. in political science from Brown University. In a volunteer capacity, Dr. Seidman currently serves as president of the Society for Participatory Medicine and previously served for 5 years as president of Micah House, a transitional house for homeless women in recovery from substance abuse.

Avniel Shetreat-Klein, M.D., Ph.D., is associate medical information officer at the Mount Sinai Medical Center, a 1,300-bed, Davies-award-winning academic medical center. Dr. Shetreat-Klein is board certified in physical medicine and rehabilitation as well as in clinical informatics. In addition to an active clinical practice specializing in the rehabilitation of individuals with spinal cord injury, he leads a team of clinicians who provide clinical input into decisions affecting the information systems at the medical center, focusing heavily on the use of the electronic medical record and associated systems to drive quality, safety, and regulatory initiatives.

Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
×

Rachel Solotaroff, M.D., M.C.R., is medical director at Portland, Oregon’s Central City Concern, an agency whose mission is to provide comprehensive solutions to ending homelessness and achieving self-sufficiency. She works as a general internist at Central City Concern’s Old Town Clinic, a designated Healthcare for the Homeless program. In the past 8 years, Dr. Solotaroff has also overseen the transformation of the Old Town Clinic into a patient-centered primary care home, with an emphasis on providing integrated care for individuals with complex social, medical, and behavioral health conditions, including chronic pain, addiction, trauma, and homelessness. In the current environment of health care transformation, Dr. Solotaroff devotes most of her nonclinical time to co-creating an integrated and seamless continuum of care for vulnerable individuals at Central City Concern and within the Portland community.

Mark V. Williams, M.D., FACP, M.H.M., is director of the Center for Health Services Research and professor and vice-chair of the Department of Internal Medicine at the University of Kentucky. Dr. Williams graduated from Emory University School of Medicine and completed a residency in internal medicine at Massachusetts General Hospital. He also completed a Faculty Development Fellowship in General Medicine at UNC at Chapel Hill, the Woodruff Leadership Academy at Emory, the Program in Palliative Care Education and Practice at Harvard, the Advance Training Program in Health Care Delivery Improvement sponsored by Intermountain Healthcare’s Institute for Health Care Delivery Research, and the Business for Scientists Program at the Kellogg School of Management at Northwestern University.

Dr. Williams established the first hospitalist program at a public hospital in 1998 and built two of the largest academic hospitalist programs in the United States at Emory University (1998–2007) and Northwestern University (2007–2013). A past president of the Society of Hospital Medicine (SHM) and the founding editor of the Journal of Hospital Medicine, Dr. Williams actively promotes the role of hospitalists as leaders in the delivery of health care to hospitalized patients. He has been quoted in the New York Times, the Wall Street Journal, and Consumer Reports. He also serves as principal investigator for SHM’s Project BOOST (Better Outcomes by Optimizing Safe Transitions). With grant funding from the John A. Hartford Foundation, BlueCross BlueShield of Illinois, and other foundations, Project BOOST has been disseminated to more than 180 hospitals across the United States. Dr. Williams has more than 100 peer-reviewed publications, including work in such journals as the Journal of the American Medical Association, the New England Journal of Medicine, and the Annals of Internal Medicine. His research focuses on quality improvement, care transitions, teamwork, and the role of health literacy in the delivery of health care.

Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
×

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Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
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Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
×
Page 54
Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
×
Page 55
Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
×
Page 56
Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
×
Page 57
Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
×
Page 58
Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
×
Page 59
Suggested Citation:"Appendix B: Biographical Sketches of Workshop Speakers." Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18834.
×
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 Facilitating Patient Understanding of Discharge Instructions: Workshop Summary
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The Roundtable on Health Literacy brings together leaders from academia, industry, government, foundations, and associations and representatives of patient and consumer interests who work to improve health literacy. To achieve its mission, the roundtable discusses challenges facing health literacy practice and research and identifies approaches to promote health literacy through mechanisms and partnerships in both the public and private sectors.

To explore the aspects of health literacy that impact the ability of patients to understand and follow discharge instructions and to learn from examples of how discharge instructions can be written to improve patient understanding of-and hence compliance with-discharge instructions, the Roundtable on Health Literacy held a public workshop. The workshop featured presentations and discussions that examined the implications of health literacy for discharge instructions for both ambulatory and inpatient facilities. Facilitating Patient Understanding of Discharge Instructions summarizes the presentations and discussions of the workshop. This report gives an overview of the impact of discharge instructions on outcomes, and discusses the specifics of inpatient discharge summaries and outpatient after-visit summaries. The report also contains case studies illustrating different approaches to improving discharge instructions.

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