General Internal Medicine and Primary Care Research

Our main areas of research focus on the use of computerized systems to improve the quality and safety of patient care, assessment of quality of care, and access to care, particularly among the poor and uninsured.  Drs. Francis Cook, John Orav, Garrett Fitzmaurice, and Stuart Lipsitz, leaders in clinical epidemiology and biostatistics work with many division members and also play key roles in the Clinical Effectiveness Program. 

The division has maintained a strong research profile that has grown considerably under Dr. Bates; this growth has more than doubled over the past couple of years. Furthermore, affiliated members have an additional several million dollars in awarded research funds. In just the past year-and-one-half, 89 grant applications were submitted (including continuation applications), 53 were awarded and 31 are pending.

Regarding computerized systems, the division interacts closely with and shares many faculty with Partners Information Systems, especially the Clinical Systems Research and Development Group, directed by Dr. Blackford Middleton and co-directed by both division members.  Drs. David Bates, Tejal Gandhi, Eric Poon, Rainu Kaushal, and Jeffrey Rothschild all work primarily in this area.  The division, with Dr. Bates as Principle Investigator, has just completed a 5-year, $5 million award from the Agency for Healthcare Research and Quality (AHRQ) to support development of a national Center of Excellence in Patient Safety, one of only three such awards.  To continue our mission as a Center for Patient Safety Excellence we have submitted a 4-year, $4-million application to AHRQ to fund a Center for Education and Research on Therapeutics in the area of Health Information Technology (HIT). An additional $2 million in research applications, also focused on HIT, are being prepared for submission for the next federal funding period.

In the quality and access areas, Drs. Arnold Epstein, John Ayanian, Nancy Keating, Jennifer Haas, Judy Ann Bigby, Thomas Sequist and Eric Schneider have all made major contributions.  For example, they have demonstrated differences in the care received by minorities, women and the poor across a variety of domains that cannot be fully explained by clinical factors.

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