Transcript welcome to clinical directors network

OVERVIEW OF
CLINICAL DIRECTORS NETWORK
CDN: Past, Present & Future
• An informal network of clinical leaders who
practice as primary care providers in
low-income and minority communities
• A clinical research and educational organization
• A means to translate clinical research into
clinical practice
CDN Corporate Structure
• 501 ( c ) (3) Tax Exempt Non-Profit Corp
• Headquarters in NYC with CEO & Staff
• Board of Directors consists of 17 volunteers
– Active Clinical Leaders practicing in LowIncome/Minority Practice Settings including
Health Centers and Health Plans in NY, NJ, PR,VI
– Physicians, Dentists, Nurses
– Elected by the CDN Membership at Annual Meeting
• Linked to a for-profit subsidiary, QPSD
Quality Professional Systems Development, Inc.
Why Clinical Networks?
• Target: Clinicians working in community, migrant,
homeless and HIV health centers
• Reduce the sense of isolation, stress, burnout
• Update clinicians in latest health improvements &
advances
• Collect & share information, skills & technical
assistance
• Introduce in the communities latest developments in
health care and business practices
Who are the Underserved?
• Poor/Low Income
• Uninsured/Underinsured/Medicaid
recipients
• Unemployed
• Women
• Children/Adolescents
• Minorities: African American,
Latino, Asian, Pacific Islander,
• Native American/Indian, Native
Hawaiian, Native Alaskan
• Migrant/Seasonal Farmworkers
• Homeless
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Drug/Alcohol Users
Rural residents
Refugees
Immigrants (Legal and Illegal)
Persons Living with HIV/AIDS
Gay, Lesbian, Bisexual and
Trans-sexuals
Prisoners/Releasees/Parolees
Mentally Impaired/Mentally Ill
Sex Workers
Disabled/Handicapped
Elderly/Frail Elderly
Source: National Association of Community Health Centers
Who are the Underserved?
National Statistics by Age and Gender
Total Users
Age
<Age 1
Pediatrics (1-11)
Adolescents (12-19)
Adults (20-64)
Geriatrics (64+)
TOTAL
% of Total
Male
Female
Number
Percent
176,676
175,324
352,000
4%
1,035,134 1,034,051 2,069,185
25%
391,053
982,206
12%
1,532,979 2,706,410 4,239,389
52%
232,515
591,153
611,121
7%
3,368,354 4,885,544 8,253,898
100%
41%
378,606
59%
Source: NY HRSA (1997)
Advantages of Participating
in Clinical Research
• Earlier access to new drugs and technologies
• Ongoing Training for Primary Care Providers
• Improved quality of care due to:
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expert protocols reviewed by experts, NIH, FDA
more frequent follow-ups
standardized assessments
ongoing quality assurance/quality improvement
external monitoring of data & patient care
feed-back to clinical sites & providers
Financial Benefits to Participants
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Low/No-cost of care to patients
Patient incentives, transportation, enablers
Payments for Provider Time
Covers costs of Visits, Tests, Medications
Improved access to equipment
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diagnostic
therapeutic
data processing
education and training
Where CDN
Conducts Research
• New York
• New Jersey
• Puerto Rico, Virgin
Islands
• Connecticut
• Florida
• Utah
• California (dental)
• Missouri
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Maine, Massachusetts
Rhode Island, Vermont
New Hampshire
Virginia, West Virginia
Maryland, Delaware
Pennsylvania, DC
Texas
Oklahoma
CDN’S RESEARCH PORTFOLIO
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HIV/AIDS
Cancer Control
Depression
Stress Management
Hypertension
Diabetes
Immunizations
Migraine/Headache
Anemia
Asthma
• NIAID HRSA NIMH
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AmFAR BMS DMP Roche
NCI AHCPR
NIDA SAMHSA
NIMH
NHLBI Pfizer
HRSA
CDC HRSA
Merck
Ortho Biotech
EPA HRSA DEP
Current CDN Research Projects
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FUNDERS:
NCI
NIMH
NHLBI
EPA HRSA
NJDEP
• HRSA CDC
PROJECT TITLE:
Prevention Care Manager
SMART/EST Women’s II
Blood Pressure Adherence
Home/Environmental
Asthma Management
Immunizations
NY Prevention Care Manager Project
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Funded by NCI
PI - Allen Dietrich, MD, Dartmouth
8 Health Centers in NYC metro area
Randomized Controlled Trial (n=1400)
To test case management strategies to
improve breast, cervical and colorectal
cancer early detection services for women
SMART/EST Women’s Project II
• Funded by NIMH
• PIs - Stephen Weiss, PhD MPH- U Miami
& Jonathan N. Tobin, PhD - CDN
• 12 Health Centers in NYC,NJ, Miami
• Randomized Controlled Trial (n=450)
• To test cognitive behavioral stress
management training and health education
to reduce distress and improve medication
adherence for adult women with HIV/AIDS
Antihypertensive & Lipid Lowering to
Prevent Heart Attack Trial (ALLHAT)
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Funded by NHLBI
PI - Jonathan N. Tobin, PhD - CDN
3 Health Centers in NY & NJ [Nationally: 623 sites]
Randomized Controlled Trial (n=126) [42,450 pts]
To compare 4 classes of blood pressure drugs
against each other without a placebo to improve
blood pressure control, lipids and outcome for hirisk hypertensive adults
Improving Blood Pressure Medication
Adherence and BP Control
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Funded by NHLBI
PI - William Gerin, PhD - Mt Sinai
12 Health Centers in NYC & upstate
Randomized Controlled Trial (n=450)
To test home blood pressure monitoring and
telephone nurse case management to improve
medication adherence and blood pressure control
for poorly controlled hypertensive adults
Improving Home/Environmental
Asthma Management
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Funded by EPA, HRSA Reg II, NJ DEP
PI - Jonathan N. Tobin, PhD - CDN
12 Health Centers in NY,NJ,PR,VI,PA,MO
Randomized Controlled Trial (n=250)
To test home visits and telephone nurse case
management for health education and support to
improve asthma control for pediatric asthmatics
Improving Immunization Rates
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Funded by HRSA & CDC
PI - Jonathan N. Tobin, PhD - CDN
20+ Health Centers in NY,NJ
CQI/Observational Studies (n=18,050)
To test assessment and feedback of immunization
rates, individualized Technical Assistance, Office
Systems Development and Follow-up Support on
Immunization Completion Rates (4-3-1-3-3)
STUDY LINK
• Funded by Title I Ryan White CARE Act
• HIV/AIDS Research Coordinators Network
• Database of all enrolling HIV/AIDS clinical
research in NYC
• Warmline/Single phone number for access to
information and referrals to research studies
• Marketing clinical research to clinicians, case
managers, AIDS service organizations
CDN’s Educational Activities
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Annual Clinical Leadership Conference
Information Management for Clinical Leaders
Community Health Center Rounds
Dental Quality Assurance Peer Review
Customized Training & Office Systems Consultation
eCME: Video-teleconferences & Webcasts
http://CDN.horizonlive./com
ON-SITE AND ON-LINE
Community Health Center Rounds
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Detection of HIV/AIDS & Oral Cavity Cancer
Cancer Control, Early Detection & Prevention
Screening for Colo-rectal Cancer in Primary Care
Reducing Perinatal Transmission of HIV/AIDS
Detection of Depression in Primary Care
Quality Improvement in Immunizations
Detection & Prevention of Domestic Violence
Basics in Fundraising & Grant Writing
Internet Access: How to Surf & Search the Web
CDN’s Educational Activities
• eCME: Video-teleconferences & Webcasts
http://CDN.horizonlive./com
• Bringing the latest in clinical and management
information and technology to Health Center Clinicians
both On-site and On-line
– Live at Health Centers
– Live Webcasts
– Archived Webcasts available 24 x 7
Long-term Goal:
Clinical Research to Set
Standards for Clinical Practice
To recruit every practice,
every provider and every
patient
to participate
in at least one clinical trial
CDN’S FUTURE DIRECTIONS
• Develop & Market Products to strengthen links
between Patient Care, Education, Training, Research
and Business Practices
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Electronic Medical Publishing
Distance Education/Web-based Training
Electronic Medical Records
Clinical Decision Support Tools
• Patient Recruitment/Medical Marketing
• Industry-sponsored Clinical Trials
CLINICAL DIRECTORS NETWORK
Jonathan N. Tobin, PhD
President/CEO
CDN
Clinical Directors Network, Inc.
54 West 39th Street - 11th Floor
New York City NY 10018 USA
Tel (212) 382-06-99 ext 34
Fax (212) 382-06-69
Email: [email protected]
Web Site: www.CDNetwork.org