Friday, June 30, 2017                                                                                                   Volume 3. Issue 4.

The Pulse  

The Department of Community Health and Family Medicine
Quarterly Newsletter

“Without continual growth and progress, such words as improvement,
achievement, and success have no meaning.” -Benjamin Franklin

TOP STORIES

Chair's Message 
Achievements 
Three Missions: Patient Care, Education & Scholarship
CHFM Events
Faculty & Staff Spotlight
Link to 2015-2016 Annual Report
Past Grand Rounds Presentations
Past PCP Live Presentations

CHAIR'S MESSAGE

ACHIEVEMENTS

CHFM faculty and staff have been hard at work to advance the field of family medicine. In recognition of their accomplishments, the section below outlines some of the most notable achievements across the department this quarter.

2017 F. Marian Bishop Award
Dr. Peter Carek was presented the 2017 F. Marian Bishop Leadership Award at the STFM Annual Spring Conference in San Diego this May. Established in 1990 in honor of Dr. F. Marian Bishop, the Leadership Award is presented by the STFM Foundation to honor individuals who have significantly enhanced the credibility of family medicine through sustained, long-term commitment to family medicine in academic settings.

Resource Paramedic:  An Innovative Approach to Meeting the Needs of Gainesville’s Most Vulnerable Populations Award
Dr. Lisa Chacko received the Resource Paramedic: An Innovative Approach to Meeting the Needs of Gainesville’s Most Vulnerable Populations Award from UF and the City of Gainesville. Dr. Chacko was one of the seven UF- City of Gainesville research project PIs who received $312,760 in funding for their projects.  Congratulations, Dr. Chacko!

Elected to Serve on Boards and Committees
Najwa Liscombe was elected as Secretary of the national AAPC Chapter Association (AAPCCA) Executive Board and she was also elected to serve on the national AAPCCA Issues Committee.

Invitation to Serve on Committees
Dr. Jay Clugston was invited to serve on the National Collegiate Athletic Association (NCAA) Division I Autonomy Concussion Safety Protocol Review Committee and the Brain Trauma Foundation Evidence-Based Concussion Subtype Consortium Workgroup.

Invitation to Speak
Najwa Liscombe was invited to speak at the following meetings:

1. AAPC chapter meetings in Jacksonville Beach, Gainesville, and Springhill, Florida. Topics: E&M documentation guidelines, changes with FCSO and advanced coding exercises. This is designed to enhance the knowledge of physicians and coders regarding what needs to be documented for each level of service.

2. AAPC chapter meeting in Orlando, Florida this August. Topic: Radiology coding and documentation; understanding how to read referring physician orders, radiology reports, and documentation requirements for diagnostic (a.k.a. plain films) vs. ultrasounds, mammography, radiation oncology, and nuclear medicine.

University of Florida Student Health Care Center Achieves AAAHC Re-Accreditation
The University of Florida Student Health Care Center (SHCC) has achieved another three-year term of re-accreditation by the Accreditation Association for Ambulatory Health Care (AAAHC). Accreditation distinguishes this Student Health Care Center from many other outpatient facilities by providing the highest quality of care to its patients as determined by an independent, external process of evaluation. 

Status as an accredited organization means the SHCC has met nationally recognized standards for the provision of quality health care set by AAAHC. More than 6,000 ambulatory health care organizations across the United States, including approximately 250 Student Health Centers, are accredited by AAAHC. Not all ambulatory health care organizations seek accreditation; not all that undergo the rigorous on-site survey process are granted accreditation.

SHCC Director Dr. Guy Nicolette stated: “I am proud that we have accomplished continuous accreditation for 33 straight years. We are committed to providing UF students with the best quality and access to care available. We are especially proud to employ nationally recognized clinicians in sports medicine and offer premier women’s health and primary care services. Our mission is to be the preferred healthcare provider for University of Florida students and a nationally recognized leader in the collegiate health specialty.”

First accredited by another accrediting body in the mid-1980s, the SHCC made the change to AAAHC in 1999. “Going through the accreditation process is a reminder that our responsibility is to strive to continuously improve the quality of care we provide,” said Louise Okken, Quality Officer.

Organizations seeking accreditation by AAAHC undergo an extensive self-assessment and on-site survey by AAAHC expert surveyors – physicians, nurses, and administrators who are actively involved in ambulatory health care. The survey is consultative and educational, presenting best practices to help an organization improve its care and services.

The current Student Health Care Center was built in 1931 and was originally used for inpatient services only, with nurses living onsite. The SHCC provides health care to a population of about 50,000 University of Florida students. The main focus of clinical services provided is primary medical care, with a strong emphasis on continuity of care and preventive health services. Women’s health care, sports medicine, acute care and trauma, as well as allergy, immunization and travel services are also available. 

THREE MISSIONS:

PATIENT CARE, EDUCATION & SCHOLARSHIP

PATIENT CARE

WOMEN’S HEALTH ACTIVITIES:

Dr. Tanya Anim runs a gynecologic procedures clinic at UF Health Family Medicine – Main. She supervises residents and provides them with an exposure to a wide variety of services unique to the care of female patients. This clinic occurs 2-3 days each month, usually on Thursdays or Fridays.

Services provided are as follows:

• Colposcopy

• Endometrial Biopsy

• Mirena IUD Insertion

• Nexplanon Insertion and Removal

EDUCATION

MEDICAL STUDENT EDUCATION:

The STFM Conference on Medical Student Education will be held February 1 – 4, 2018, in Austin, Texas.  If CHFM’s proposals are accepted, several department faculty members will be attending and presenting. If you are interested in being part of a presentation or attending the meeting, please contact Dr. Hatch at hatch@ufl.edu. It would be great to have more faculty involved!

RESIDENCY PROGRAM:

Residency faculty and staff enjoyed attending Graduation on June 23. CHFM wishes all graduates the best as they start the next chapter in their lives.

The CHFM Residency Program is excited to report that ALL 3rd-year residents passed their board exams; the program now boasts a 100% board exam passing rate for the last 5 years!

CHFM Residency faculty and staff are eager to welcome the new resident class and hope that you can make it to the Welcome Reception on July 5 at UF Health Family Medicine – Main.

SPORTS MEDICINE FELLOWSHIP:

Drs. Thomas Starnes and Katherine Langley were busy helping to cover many baseball, softball, lacrosse and tennis games during April.  They also covered the 3-day Pepsi Florida Relays from March 30 to April 1. On April 7, Fellows Starnes and Langley stood on the Gator football sidelines for the last time during the Orange & Blue game.

Dr. Starnes and Dr. Langley, along with several sports medicine faculty and past fellows, attended the AMSSM conference, which was held May 8-12 in San Diego, California. At this national conference, Dr. Starnes presented at the podium and also displayed two poster presentations. His research oral presentation, which will also be published in the Clinical Journal of Sports Medicine, is titled Pre-participation Cardiac Screening Including Electrocardiography (ECG) and Transthoracic Echocardiography (Echo) in Men’s and Women’s NCAA Division-1 (D1) Basketball Athletes. Dr. Starnes’s research poster, Echocardiogram Values in Men’s and Women’s NCAA Division-1 (D1) Basketball, will also be published in the Clinical Journal of Sports Medicine. And he also presented a case poster: An Evolving Electrocardiogram Leading to a Diagnostic Dilemma.

Dr. Starnes pictured at the AMSSM conference
that was held on May 8-12 in San Diego, California.

Also, during the AMSSM Conference, Dr. Langley presented a case poster on Seeing Double: Diplopia in Collegiate Football Player.

Dr. Langley pictured at the AMSSM conference
that was held on May 8-12 in San Diego, California.

From May 30 to June 3, Dr. Langley and Dr. Jocelyn Gravlee attended the ACSM Conference held in Denver, Colorado, where they co-presented Constipation in a Collegiate Hurdler.

The early part of June was very exciting for Dr. Starnes, who traveled with the UF softball team to Oklahoma for the Women’s College World Series. Sadly, the Lady Gators did not win, but this was an amazing experience for Dr. Starnes.

The department celebrated Dr. Katherine “Katie” Langley’s and Dr. Thomas “Tom” Starnes’s graduation in the Champions Club on June 24. After graduation, Dr. Langley will be moving to Spartanburg, South Carolina, where she will work as an emergency medicine physician with some local sports coverage. Dr. Starnes will be moving to Asheville, North Carolina, to begin his internal and sports medicine career.  CHFM has enjoyed their year of fellowship and wishes them the best in their future careers!

On July 1, Dr. Stephen Carek and Dr. Timothy Durkin officially join the Sports Medicine Fellowship Program for the 2017-2018 academic year. Members of the department are excited to have these fellows join their outstanding program. Dr. Carek is hailing from Carolina Healthcare Family Medicine Residency Program. Dr. Durkin is coming from private practice in Denver, Colorado. Both are eager to become Gators and participate in this program. Learn more about them by reading their bios, located below:

Stephen Carek, MD

Bio: Stephen Carek is a UF Sports Medicine fellow. A lifelong Clemson Tiger, Stephen will don a new orange in support of the Florida Gators. He was born and raised in Charleston, South Carolina, completed his undergraduate studies at Clemson University, and received his medical degree from the Medical University of South Carolina. He recently completed his Family Medicine Residency at Carolinas Medical Center in Charlotte, North Carolina, where he also served as chief resident. He is moving to Gainesville with his wife, Amanda, and 7-month-old daughter, Vivian. They are very excited about moving to Florida, with many opportunities for new adventures, meeting new people, and attending football games at The Swamp!

Timothy Durkin, DO

Bio: Timothy “Tim” Durkin is a UF Sports Medicine fellow. Prior to becoming a Gator, he practiced community emergency medicine in Colorado, where it snowed the week before he moved to Gainesville. He previously practiced emergency medicine in Albuquerque after completing emergency medicine residency at Albert Einstein Medical Center in Philadelphia. He attended medical school at Pikeville College School of Osteopathic Medicine in Kentucky. Prior to medical school, he worked as a paramedic and a project management engineer, and received his undergraduate education at Vanderbilt. He and his wife, Sharon, enjoy outdoor activities and laughing at their cats. Dr. Durkin is looking forward to rooting for an SEC team that actually wins some games.

PROGRAM  IN BIOETHICS, LAW AND MEDICAL PROFESSIONALISM: 

Education

As the 2016-2017 academic year came to a close, faculty in the BLMP program celebrated Match Day and Commencement with their medical students in the Class of 2017.

Professor Allen met with CHFM residents during a quarterly resident ethics workshop on June 7.

Over the course of the spring semester, BLMP faculty taught medical students during lectures, CLGs, and/or TBLs in the following first- and second-year courses:

• BMS 6091: Health Outcomes and Policy

• BMS 6300: Fundamentals of Microbiology and Immunology

• BMS 6631: Hematology

• BMS 6812: Introduction to Clinical Medicine II

• BMS 6814: Introduction to Clinical Medicine IV

• BMS 6816: Introduction to Cancer Biology and Clinical Oncology

• GMS 6335: Advanced Stem Cell Biology: Tissue Engineering

Faculty also interacted with students during case conferences in the following third- and fourth-year clerkships:

• MDC 7124: Family Medicine/Ambulatory Care Clerkship

• MDC 7140: Geriatrics Clerkship

• MDC 7400: Pediatrics Clerkship

• MDC 7830: Psychiatry Clerkship

Moreover, Professor Allen and Dr. Moseley directed the following fourth-year medical student elective courses:

• MDT 7100 (CM E 21): Advanced Issues in Medical Ethics and Law

• MDT 7100 (CM E 29): Financial, Business and Health Systems Aspects of Medicine

• MDT 7100 (CM E 30): Religion, Culture and Medicine

Additionally, Professor Allen led these courses for graduate students:

• GMS 6221: Ethics in Genetics

• GMS 6931: Ethical/Policy Issues in Clinical Research

Lastly, Professor Solberg led the following undergraduate student course:

• IDH 3931: Medical Ethics and Professionalism in The House of God

Service

Over the last quarter, BLMP faculty have demonstrated their commitment to the community by engaging in a series of activities aiming to increase awareness of ethical issues and promote appropriate decision-making.

BLMP faculty have volunteered to be on call, on a weekly basis, to staff the 24/7 ethics consult service at UF Health Shands Hospital. In a related capacity, faculty offered their expertise during monthly meetings of the hospital’s Ethics Committee and its Pediatric Ethics Subcommittee, contributing case analysis and recommendations for policy adoption.

Furthermore, BLMP faculty helped plan and participated in UF Health’s month-long celebration of National Healthcare Decisions Day, which ran from March through April 2017. Faculty presented a bioethicist’s perspective during panel discussions, facilitated conversations about advance directives over lunch and dinner, assisted local seniors with enacting advance directives, and they even brought their students to the “Before I Die” wall to raise awareness about end-of-life issues and the importance of advance care planning.

FACULTY DEVELOPMENT:

There is no Faculty Development session scheduled for July. The series will restart in August with a lecture on tips for precepting medical students. Just as a reminder, Faculty Development sessions are scheduled on the third Thursday of each month starting at 12:15 pm. You may attend these sessions in person at UF Health Family Medicine - Main or via Jabber by dialing 75003.

SCHOLARSHIP

 
RESEARCH:

New Studies

MEDICAL STUDENT WELLNESS CURRICULUM TO IMPROVE MEDICAL STUDENT WELL BEING

Dr. Kristy Smith is developing a wellness curriculum to improve medical student well-being and decrease depression and anxiety in medical students. Medical Student Well Being Index, GAD-7, and PHQ-9 scores will be taken on medical students every three months longitudinally throughout medical school. Interventions will include incorporating basic stress management, study skills, and resilience training to help students gain the tools they need to improve quality of life, decrease depression and anxiety, decrease dropout rates and time off, and ultimately improve academic performance. Data collection will commence with the incoming first year medical students this fall.

ASSESSMENT OF MEDICATION CHANGES DURING HOSPITAL DISCHARGES AND CORRELATION WITH RISK FOR HOSPITAL READMISSION

Eric Dietrich, PharmD, BCPS, a clinical assistant professor in the Department of Community Health and Family Medicine and a clinical assistant professor in the Department of Pharmacotherapy and Translational Research, is working on a study correlating number and type of medications during inpatient hospital stays with rate of readmission. According to CMS, approximately 1 in 5 patients are readmitted to the hospital within 30 days of discharge. 75% of these readmissions have been estimated to be preventable, which equates to a cost of $12 billion dollars per year. Medication changes during hospital stays between January 1, 2014, and November 1, 2014, will be characterized and analyzed for their correlation to rate of readmission. 

Ongoing Studies

HOW WELL DO GRADUATING MEDICAL STUDENTS RECOGNIZE KEY PHYSICAL EXAM ABNORMALITIES?
Dr. Jonathan Grant Harrell, in collaboration with Drs. Heather Harrell, Ashleigh Wright, and Carolyn Stalvey (all from UF Department of Internal Medicine), is conducting a study that intends to enroll 4th-year medical students to participate in a half-day Observed Structured Clinical Examination (OSCE) with the goal of evaluating the students’ physical examination performance based on identifying the correct abnormalities. This study is the first phase of a two-phase project. This phase involves the development of the curriculum and assessment of 4th-year students’ baseline performance on physical examination technique and recognition of abnormal findings. The Longitudinal Clinical Skills Task Force (LCSTF) will develop a longitudinal physical examination curriculum proposal following the methods proposed by Kern et al. 5 The LCSTF created a list of core abnormal physical examination findings based on a literature review, evidence of clinical usefulness, local expert opinion, and needs assessment. As another part of the needs assessment, 4th-year students’ physical examination skills will be assessed using an Observed Structured Clinical Examination (OSCE). The following are the specific aims of this study: (1) to assess 4th-year medical students’ physical examination technique; (2) to assess 4th-year medical students’ ability to identify common abnormal physical exam findings; (3) to assess 4th-year medical students’ recollection of the amount of direct observation of physical examinations after implementation of a new curriculum; and (4) to assess 4th-year medical students’ recollection of the types of abnormal physical examination findings they encountered after implementation of a new curriculum.

IMPROVING INFLUENZA VACCINATION RATES IN A FAMILY MEDICINE CENTER
Dr. John Malaty, in collaboration with Drs. Dickmann (PGY-3), Conroy (PGY-1), and Dideban (PGY-2), is conducting a study to determine if a quality improvement intervention implemented at a family medicine center has been effective in improving influenza vaccination rates. The influenza vaccination rate for patients seen by family medicine residents and faculty members in their family medical center will be determined, both before and after the intervention, and sub-group analysis involving vaccination rates for patients with specific demographic details and relevant chronic conditions will be analyzed. Data will be requested from UF Physicians Decision Support on patients seen at UF Health Family Medicine – Main clinic starting September 1, 2015 through August 31, 2016 for the pre-intervention analysis and from September 1, 2016 to August 31, 2017 for the post-intervention analysis. The data being analyzed is associated with patients who received primary and/or specialty care at UF Health Family Medicine - Main. Descriptive statistics will be used to determine the baseline influenza vaccination rate prior to the intervention, the rate of vaccination after the intervention and the rate of declines for vaccination after the intervention. The data will then be stratified to assess the rates across important demographic sub-groups. Further statistical analyses, using descriptive statistics and bivariate analyses, will be done to evaluate the prevalence of vaccination among patient subgroups with specific diagnoses which place them at high-risk for influenza-related complications per CDC guidelines.

FEO PROGRAM EVALUATION
Dr. David Quillen, in collaboration with Dr. Lisa Chacko, is conducting a retrospective 9-year program evaluation of the Faculty Enhancement Opportunities (FEO) Program at the University of Florida, including a survey of grantees and review of grant documents. The purpose of the study is to assess the degree to which University of Florida’s innovative FEO program has impacted career development of individual faculty members and departmental advancement. A comprehensive program evaluation will allow the FEO program to share its model with other institutions, quantify the degree to which promotion and career growth were served by FEO funding and seek grantee feedback for areas of future growth and improvement. The specific aims of this study are to; (1) to assess FEO grantee perspectives of the impact of FEO funding on publication, promotion, academic collaboration and contribution to departmental goals; (2) to compare original goals of FEO grants with reported outcomes; and (3) to describe and compare FEO funding across the Colleges and Departments within the University of Florida. The University of Florida’s FEO program is unique, as there is currently only one other known institution-initiated faculty enhancement award nationwide.  The other existing program is at Harvard University. This faculty enhancement program targets “vulnerable” faculty at risk of falling short of promotion and tenure goals early in their careers (prior to promotion). UF’s FEO program is innovative in its availability to faculty as soon as three years into a faculty position. This proactive approach to supporting faculty outside of traditional sabbatical or continuing education funding lines places UF’s FEO program at the forefront of innovation for faculty development nationally.

PATIENT EMPOWERED STRATEGY TO REDUCE ASTHMA MORBIDITY IN HIGHLY IMPACTED POPULATIONS (PREPARE)- VANGUARD STUDY
Dr. Ku-Lang Chang, in collaboration with Harvard University, is conducting a study measuring the impact of adding PARTICS- PARTICS-patient activated rescue therapy with Inhaled Corticosterorids (ICS) for the high-risk racial and ethnic groups of African American/Black and Hispanic/Latino patients. The PREPARE study will enroll self-identified African American/Black and Hispanic/Latino patients, the racial and ethnic groups most adversely affected by asthma. The enrolled patients will be randomized equally to the intervention (PARTICS-patient activated rescue therapy with ICS) and the usual care groups. PARTICS, the addition of ICS to each puff of SABA for rescue while continuing usual daily controller therapy was effective in a smaller very tightly controlled clinical trial; decreasing asthma exacerbations that required steroids, and asthma related ED visits or hospitalizations. Despite the added use of an ICS to rescue therapy, there was no increase in rates of oral thrush or other side effects associated with ICS use. Dr. Chang and the UF CHFM department are assisting with patient recruitment, and data collection from high-risk patients.

STANDARDIZED HOME EXERCISE PRESCRIPTION: EDUCATION OF FAMILY MEDICINE RESIDENTS
Dr. Charlie Michaudet, in collaboration with Drs. Kramer (PGY-3), Eldayrie (PGY-2), Seitchik (PGY-1), Allen (PGY-1), Gonzalez (PGY-1), and Leasure (PGY-1), is conducting a study that will evaluate the educational value of having evidence based home exercise protocols available for family medicine residents in regard to the prescription of home exercise treatment for common musculoskeletal conditions. We will be evaluating resident knowledge on home exercise prescription as well as their level of comfort in educating their patients before and after a series of didactic sessions and implementation of exercise protocols. The data will be collected in two phases with didactic lectures provided between the two phases: (1) phase I: Residents will be surveyed as to their knowledge and confidence in both diagnosing specific MSK issues and prescribing the correct home rehabilitation regimen; (2) in between phase 1 and phase 2 there will be a series of didactic lectures to educate resident on home exercise prescription and get them familiarized with the handouts; and (3) phase II: Residents will be surveyed again in May 2017 with the same multiple choice questions and Likert style confidence scales from phase 1. The specific aims of this study are to: (1) to improve resident knowledge, comfort, and efficiency in prescribing home exercise programs; and (2) to implement an evidence-based database of standardized rehabilitation programs for common musculoskeletal complaints.

EVALUATION OF ADVANCE DIRECTIVES IN AN OUTPATIENT CLINIC SETTING
Dr. Lauren Solberg, in collaboration with Drs. Ray Moseley and Bill Allen, is conducting a study to evaluate Advance Directives (ADs) in the UF Department of Community Health & Family Medicine (CHFM) in order to provide an understanding of the impact and effects of the AD educational lecture provided to clinicians to improve the quantity of CHFM patients with ADs. Between June and September 2016, the faculty members of the Program in Bioethics, Law & Medical Professionalism (BLMP), part of CHFM, delivered lectures about ADs to all of the providers and staff in each of the CHFM clinics. In total, 11 lectures were delivered; providers and staff each attended 1. The purpose of this study is to analyze data about patients with ADs on file in EPIC each month beginning 1 year prior to and 4 months after the CHFM AD lectures in order to make conclusions about the potential impact of the education. Thus, BLMP faculty will analyze data about CHFM patients with ADs on file in EPIC between June 1, 2015 and January 1, 2017. This study represents a preliminary effort to make conclusions about CHFM patients with ADs in their medical records in order to facilitate the design and implementation of future interventions to increase the number of CHFM patients with ADs on file. The specific aims of the study are to: (1) compare the number of ADs on file for CHFM patients prior to and after lectures to CHFM providers and staff about ADs; and (2) analyze demographic information about patients with ADs on file in EPIC in the specified date range in order to facilitate the design and implementation of future interventions to increase the number of CHFM patients with ADs on file in EPIC.  

INFLUENCE OF SLEEP & PHYSICAL ACTIVITY ON CONCUSSION RECOVERY
Dr. Jay Clugston, in collaboration with Dr. Jaffee (UF Department of Neurology) and Dr. Bauer (UF Department of Clinical & Health Psychology), is working on a study measuring the impact of sleep and physical activity on concussion recovery. Sleep and physical activity play a crucial role in the maintenance and restoration of cognition, learning, and memory, and serves as a key factor in brain recovery. Sleep and physical activity may be factors that affect concussion recovery, including the days to symptom resolution, days to neurocognitive deficit resolution, and days to balance deficit resolution. Despite the high incidence of sleep and vigilance problems following concussion, few studies have used objective measures, such as actigraphy (e.g. wrist accelerometer unit), to describe sleep and wake disturbances. The purpose of this study is to determine the influence of sleep and physical activity on concussion recovery. The results of this study will help guide clinicians in determining the utility of sleep management programs and physical activity recommendations to aid recovery following concussion.

CHARACTERIZATION OF ED HIGH UTILIZERS
Dr. Peter Carek, in collaboration with Drs. Maribeth Porter and Lisa Chacko, is working on a study to characterize the patients who are frequently readmitted to the hospital. According to CMS, approximately 1 in 5 patients are readmitted to the hospital within 30 days of discharge. 75% of these readmissions have been estimated to be preventable, which equates to a cost of $12 billion dollars per year. This study’s characterization will be completed for patients that were readmitted to the ED within 30 days of a previous hospital admission. The characterization will include demographic variables, length of stay, readmissions, primary and secondary diagnoses, and medications. Subgroups from the high utilizers will be identified and further analyzed in order to develop patient-centered and population health interventions.

STFM FACULY DEVELOPMENT STUDY
Dr. Tanya Anim is working on a study to enhance development of the Family Medicine Residency Program faculty members through identification of current areas of weakness or need, and the development of a tailored faculty development series based on the needs identified. The UF Family Medicine Residency Program did not provide internal faculty development sessions until the start of this intervention. The existing faculty development program for the entire College of Medicine presents topics that often are not specific to the unique needs of the family medicine faculty. Relevant, targeted (i.e. based on identified needs) faculty development promises to dramatically improve resident and medical student education. The objectives of this study are to (1) develop and implement a tailored Faculty Development Series for the UF Department of Community Health and Family Medicine to improve the quality of teaching and (2) create a practical faculty development toolkit for programs across the nation, enabling them to tailor faculty development to the needs of their own faculty. The four-step protocol for enhancing faculty development: (1) a Research Electronic Data Capture (RED Cap) survey will be administered to faculty, residents, and clinic staff to identify areas of faculty teaching that could benefit from improvement; (2) development of a tailored faculty development series based on the needs identified in the surveys; (3) the delivery of the faculty development series utilizing a variety of presentation and teaching styles; and (4) evaluation of the impact of the faculty development series on the experience of teaching and learning. At the end of the academic year, a follow-up faculty, resident and staff survey will assess satisfaction and perceived impact of the tailored Faculty Development Series. This evaluation will specifically assess the degree to which the Faculty Development Series addresses the stated needs. Moreover, Dr. Anim and her team will assess the educational applicability and the experiential nature of the Faculty Development Series.

LOW LITERACY ASTHMA PLAN STUDY
Drs. Elvira Mercado and Kim Nguyen, in collaboration with Karen Theoktisto, DNP, ARNP, are working on a study to test the use of a low literacy asthma plan in order to improve compliance of pediatric patients regarding asthma management and reduce the number of asthma-related emergency room visits and hospital admission rates. Asthma is the most prominent chronic illness in childhood and affects an overall 9.6% of all children in the United States (Gold, et al., 2016). Text-based asthma self-management plans in a low-literacy population may not be well received and are difficult to understand. Asthma plans that utilize pictures may communicate the severity of asthma in a more understandable method, leading to better asthma control and reducing visits to the emergency room. In Alachua County, Florida, the number of emergency room visits for children age 0-17 years with asthma has increased from 293 in 2005 up to 488 in 2014, and hospitalizations have increased from 82 to 164 during the same period (Florida Public Health Tracking System, 2016). Improved health literacy approaches have been linked to improved patient outcomes but have not been well studied in childhood asthma outcomes (Yin et al., 2016).  Asthmatic children of parents with low health literacy are at risk for worse asthma-related outcomes, more severe asthma exacerbations and increased use of emergency rooms. The development of a low-literacy asthma plan can be used as part of counseling that can offer providers a framework with which to educate parents and families on specific asthma issues. Asthma affects all Americans, but the burden is especially high for children of low-income, lesser-educated and racial- and ethnic-minority populations.

INPATIENT REFERRAL ANALYSIS OF A FAMILY MEDICINE HOSPITAL SERVICE
Dr. Maribeth Porter, in collaboration with Drs. Carek, Malaty, Michaudet, Shuster, and Eldayrie (PGY-2), is conducting a study that will encompass a comprehensive analysis of referral patterns among primary care physicians within the UF Health Family Medicine inpatient service. They will gather referral data from the time period beginning on July 1, 2014, and ending on June 30, 2015. In addition, a tailored analysis of existing literature will be conducted to develop evidence-based recommendations for quality improvement in the referral process. The aim of this project is to analyze referrals within the UF Health Family Medicine inpatient service to (1) determine departmental performance in reference to national averages and (2) identify trends in the departmental consulting process for patients seen on the UF Health Family Medicine inpatient service. Based on these findings, a review of existing literature and internal policies will be conducted to identify important leverage points for improving and mitigating the cost burden of inappropriate referrals. Finally, the project aims to establish departmental policies and structures for continued monitoring of referrals.

INTERACTIVE INFORMED CONSENT STUDY
Dr. Ray Moseley and Dr. Arch G. Mainous III (CHFM and UF Department of Health Services Research, Management, and Policy), in collaboration with Dr. Christopher Harle from Indiana University (UF Department of Health Policy & Management), Dr. Janice Krieger (UF College of Journalism), and Dr. Babette Brumback (UF Department of Biostatistics), are collaborating with the goal of developing and evaluating a novel, electronic informed consent application for research involving electronic health record (EHR) data. In response to NIH RFA-OD-15-002, this study addresses research using clinical records and data, including the issues of the appropriate content and duration of informed consent and patient preferences about research use of clinical information. This study will design an electronic consent application intended to improve patients’ satisfaction with and understanding of consent for research using their EHR data. The electronic application will provide interactive functionality that creates a virtual, patient-centered discussion with patients about research that uses EHR data. Also, to correct potential misconceptions and increase informedness, the application will present trust-enhancing messages that highlight facts about research regulations, researcher training and data protections. This study will improve understanding of how to best give patients information about research that uses their health records and data. With this understanding, this study will develop a new computer application that patients can use in their doctors’ offices. This application will allow patients to learn more about clinical research and make informed choices about whether or not they want their health records and data to be used for research. This project is innovative because it will create a virtual, patient-centered discussion about research using EHR data. Moreover, this project will produce a consent application that clinicians and researchers can use as an ethically sound and practical tool for consenting patients, in a clinical setting, for research involving EHRs.

PAIN MANAGEMENT PROGRAM STUDY
Dr. Siegfried O. F. Schmidt, in collaboration with Lesa Gilbert, FNP-BC, Dr. George Samraj, Dr. David Feller and Dr. Ku-Lang Chang, are nearing the fourth year of the UF Pain Management Program at Main (PMPM) within the UF Family Medicine Residency Program. Through this study, researchers are continuing to monitor the care received by patients with chronic pain conditions who are being seen at the location with the goal to analyze patient data to better understand these patients’ experiences and understand how their treatment and diagnoses changed after being referred to this program. Alongside the patient care aspect, the research team intends to evaluate resident education and knowledge gained from their one-month rotation with PMPM.

OTIC BAROTRAUMA STUDY
Dr. Susan Millan and her research team at the UF Health Wound Care and Hyperbaric Center at Magnolia Parke have begun their project to evaluate the causes of barotrauma during hyperbaric oxygen therapy (HBOT) and what treatments can be used to prevent otic barotrauma (OB). They have begun by analyzing historical data from 2/1/2014 through 12/31/2015, and specifically otic barotrauma adverse events that have occurred at the UF Health Wound Care and Hyperbaric Center. They plan to analyze diagnoses, depth of treatments, chamber operators, number of treatments received, gender, day of week and TEED otic barotrauma scores. The aim of this project is to determine whether there are significant factors that affect otic barotrauma while patients are undergoing hyperbaric oxygen therapy. The results of this study will help aid clinicians to not only assist in decreasing the number of OB adverse events in HBOT, but it may also inform scuba divers with comorbidities of otic barotrauma. Available literature does not address comorbidities on the incidence of otic barotrauma in HBOT or of pre-hyperbaric oxygen therapy evaluation and treatment by Otolaryngology.

HEARTMATH STUDY
The research team led by Dr. Frank Orlando and Dr. Maria Elisa Lupi launched the HeartMath study in both the Haile Plantation and Hampton Oaks clinics with a total of 18 healthcare providers (physicians, nurse practitioners, physician assistants, and nurses) being monitored throughout the duration of the 12-week study. HeartMath uses biofeedback to teach the recipient emotional self-regulation techniques that can benefit them both immediately and over a sustained period of time. EmWave Pro is a HeartMath product that helps one achieve coherence through various standardized, interactive mindfulness techniques, such as guided meditations focusing on positive emotions, breathing, and imagery. The HeartMath emWave Pro uses an ear sensor that measures the user's pulse. The sensor uses a minute amount of infrared light to measure the speed of blood flow in the ear. The sensor sends this signal to the emWave Pro USB module where the inter-beat interval is calculated in milliseconds and then heart rate variability is plotted. This study will help determine whether using the HeartMath’s biofeedback system with emWave Pro daily mindfulness practice is a practical way to (1) improve job satisfaction and performance of physicians, advance practice clinicians, and nurses; (2) improve patient satisfaction; and (3) positively impact resting blood pressure and heart rate when comparing baseline to follow-up measures. Currently, this study is in the data analysis phase and will apply for a grant funding the implementation of a wellness curriculum for the CHFM residents.

COMPARE STUDY
Eric Dietrich, PharmD, BCPS, a Clinical Assistant Professor in the Department of Community Health and Family Medicine and a Clinical Assistant Professor in the Department of Pharmacotherapy and Translational Research, in collaboration with Dr. David Feller and Dr. Peter Carek, has been working on a study aiming to identify and compare factors that patients and providers pinpoint as reasons for their hospital readmission. Hospital readmissions have been a recurring and costly problem for the healthcare system. Identifying key underlying problems could help drive a viable solution to this problem. This study seeks to find common underlying causes for hospital readmissions by obtaining the patient’s perspective, in addition to the healthcare provider’s perspective, on the possible causes for the patient’s return to the hospital within 30 days or less of their previous discharge. The study will collect data via two separate interviews conducted by research staff that ask the patient and the provider (separately) to identify potential reasons for readmission. The results will then be analyzed to determine the main reasons that cause patients to have hospital readmissions and whether there is a discrepancy in what patients perceive and what providers perceive to be the cause. Currently, data collection and analysis are complete, and the manuscript is being circulated for review within the department.

POPULATION HEALTH STUDY
Dr. Lisa Chacko is working on a project looking to identify barriers and best practices for implementing population health curriculums within primary care residency programs. The research team will conduct in-depth interviews with Family Medicine Residency Program Directors (PDs) in Florida. The interviews will explore Program Directors’ perceptions of ACGME milestones, the utility of EMRs, the role of leadership, the need for faculty development and resident buy-in. The data collected from Program Director responses will be coded and analyzed to identify recurrent themes across interviews. The specific aim of the project is to identify barriers to incorporating population health curriculums into residency training as means to identify opportunities for supporting curriculum development and sharing of best practices. The results of this study will help aid clinicians to reveal barriers to curriculum development and implementation, as well as opportunities to support Program Directors in ongoing curriculum design. Next steps might include submission to the Council of Academic Family Medicine Educational Research Alliance (CERA) Survey, or the development of a population health learning network for primary care residencies to foster sharing of best practices regionally.

QUALITY:
Highlights for CHFM quality projects for the past quarter:

Readmission Trends in Family Medicine – The CHFM Readmission Rate continues to remain high compared to national standards. Patients attributed each week to family medicine for readmissions have ranged from a low of three to a high of 14. The past few weeks have shown a downward movement thanks to the work of the inpatient faculty, residents, ancillary staff and clinic staff.  Outpatient health coaches have started to participate in the weekly Readmission Meeting with the impatient staff increasing communication and understanding of patient needs. 

Patients Frequently Readmitted to the Hospital: How do They Compare to Other Hospitalized Patients and Do They Change over Time was accepted for presentation at the 2017 STFM Conference on Practice Improvement.  This study looked at patients satisfied into yearly cohorts over a three year time period who had been readmitted to the hospital three or more times.  These patients were compared to patients who had been readmitted one to two times and admitted to the hospital over the same time periods. Demographics, number of problems on the problem list, number of medications and presence of substance or chronic pain were compared between cohorts.  Presenters: Dr. Peter Carek, Dr. Maribeth Porter, Dr. David Quillen, Dr. Lisa Chacko, Kim Lynch, Lauren Bielick.

ED Utilization – The Eastside ED Utilization project is mid-cycle with the current cohort of high utilizers, patients who have been seen 6 or more times in the ED in the previous year, being compared to the overall Eastside population that utilizes the ED.  The overall trend is that high utilizers are going to the ED less frequently now than they did at the start of the current cycle.  This cycle will end September 7. 

RN-Health Coach Intervention to Decrease ED Use in a Cohort of Frequent ED Users  was accepted for presentation at the 2017 STFM Conference on Practice Improvement.  This study is presenting the results of the pilot cohort with the Eastside Health Coach.  Presenters: Dr. Lisa Chacko, Dr. Peter Carek, Dr. Elvira Mercado, Rethea Felder, Lauren Bielick, Kim Lynch.

POSTERS:

International

Wokhlu A, Gong Y, Cooper-DeHoff RM, Smith SM, Handberg EM, Pepine CJ. Relationship between diastolic blood pressure and all-cause mortality with lower systolic blood pressure among hypertensive coronary artery disease patients: Long-term follow-up of the US cohort of the International Verapamil-SR-Trandolapril Study (INVEST). Poster presented at: The American College of Cardiology (ACC) 2017 Annual Scientific Session & Expo; March 17-19, 2017; Washington DC.

National

Clugston JR, Kontos AP, Houck ZM (g), Asken BM (g), Boone JK, Hoffman NL, Chrisman SPD, Buckley TA, Schmidt JD, Kaminski TW, Collins MW, Ortega JD.  Relationship between the King-Devick Test (KDT) and commonly used concussion tests. Poster presented at: 2017 American Medical Society for Sports Medicine 26th Annual Meeting; May 11, 2017; San Diego, CA.  Invited Oral Poster Presentation.

Hoyes B, Costain J, Szereszewski J, Gilbert L, Samraj G, Schmidt S. Evaluating diagnostic accuracy of patients with chronic pain in a family medicine residency program. Poster presented at: The 50th STFM Annual Spring Conference; May 5, 2017; San Diego, CA.

Langley KJ (f), Balch K, Clugston JR. Seeing double: Diplopia in collegiate football player. Poster presented at: 2017 American Medical Society for Sports Medicine 26th Annual Meeting; May 12, 2017; San Diego, CA. Invited Poster Presentation.

Malaty J, Michaudet C, Anim T. Teaching procedural workshops: Efficacy of using simulation, multiple modalities, and open answer approach. Poster presented at: The 50th STFM Annual Spring Conference; May 5-9, 2017; San Diego, CA.

Starnes TA (f), Clugston JR.  An evolving electrocardiogram leading to a diagnostic dilemma. Poster presented at: 2017 American Medical Society for Sports Medicine 26th Annual Meeting; May 11, 2017; San Diego, CA.

Starnes TA (f), Reifsteck F, Clugston JR, Harmon KG, Dillon MC, Edenfield KM. Echocardiogram values in men’s and women’s NCAA Division-1 (D1) basketball. Poster presented at: 2017 American Medical Society for Sports Medicine 26th Annual Meeting; May 11, 2017; San Diego, CA. Invited Oral Poster Presentation.

Szereszewski J, Costain J, Gilbert L, Hoyes B, Rahmanian K, Samraj G, Schmidt S. Does an integrated chronic pain management program reduce narcotic use? Poster presented at: The 50th STFM Annual Spring Conference; May 5, 2017; San Diego, CA.

Local/Regional

Agana DF, Crooke H, Chacko L, Porter M, Striley C, Carek P. Characteristics of UF Health Family Medicine frequently readmitted to the hospital in 2016. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Amratia P, Millar J, Psychas P, Abuaku B, Ahorlu C, Koram K, Oppong S, Valle D. Using a Bayesian geostatistical model to understand local-scale heterogeneity of malaria risk: The example of Bunkpurugu-Yunyoo District in Northern Ghana. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Carek P, Porter M, Agana DF, Bielick L, Chacko L, Lynch K, Yang Y. Patients frequently readmitted to the hospital: Do the members of the high utilizer group change over time? Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Chacko L, Bielick L, Felder R, Mercado E, Carek P, Lynch K. Reducing ED utilization: An RN-health coach intervention. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Clugston J, Kontos A, Houck Z, Asken B, Boone J, Hoffman N, Chrisman S, Buckley T, Schmidt J, Kaminski T, Collins M, Ortega J. Relationship between the King-Devick test and commonly used concussion tests. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Costain J, Kramer D, Eldayrie G, Woody K, Gonzalez F, Allen G, Porter M, Michaudet C. Addressing and coding nicotine dependence in a family medicine residency clinic. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Cowart K, Sando K. Evaluation of outpatient fluoroquinolone prescribing for acute uncomplicated cystitis across a multi-site academic family medicine practice. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Dickmann S, Driscoll D, Conroy L, Park S, Dideban B, Dorsey N, Malaty J. Improving influenza vaccination rates using a team-based approach. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Hatch R, Rabazza C, Rubin D, Nall R. Do faculty evaluate continuity students differently than block students? Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Hoyes B, Costain J, Szereszewski J, Rahmanian K, Gilbert-Wright L, Samraj G, Schmidt S. Evaluating diagnostic accuracy in patients with chronic pain in a family medicine residency program. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Hwant A, Dave C, Smith S, Malaty J, Michaudet C, Anim T. Use of medications that potentially interfere with blood pressure control among patients with resistant hypertension on ≥4 antihypertensive drugs. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Jo A, Mainous A. Utility of body mass index and body fat as an indicator of abnormal blood glucose: The informational value of body fat. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Konopack J, Cowart K, Westwood G, Harrell G, Sando K. Physician-pharmacist collaborative care in a rural family medicine clinic: A step towards team-based primary care. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Kramer D, Zaremski J. When history taking saves a life. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Langley K (f), Balch K, Clugston J. Seeing double: Diplopia in a collegiate football player. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Malaty J, Michaudet C, Anim T. Teaching procedural workshops: Efficacy of using simulation, multiple modalities, and open answer approach. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Millar J, Amratia P, Psychas P, Abuaku B, Ahorlu C, Koram K, Oppong S, Valle D. Identifying malaria risk factors in a hyperendemic setting using Bayesian model selection. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Porter M, Hagan H, Yang Y, Seehusen D, Carek P. Burnout and resiliency among family medicine program directors. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Porter M, Agana DF, Harrell G, Klassen R, Hatch R, Carek P. Primary care tracks in medical schools. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Porter M, Michaudet C, Yang Y, Lynch K, Carek P. Inpatient consults on a family medicine teaching service. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Samuels S, Jo A, Mainous A, Madsen Beau De Rochars M, Gonzales M, Keys H, Blount S, Noland G. Diabetes among residents living in Bateyes in the Dominican Republic: A hidden epidemic in a middle-income country. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Solberg LB, Carter C, Solberg LM. Geriatric care boot camp series: Interprofessional education for health care professionals. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Starnes T (f), Clugston J. An evolving electrocardiogram leading to a diagnostic dilemma. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Starnes T (f), Reifsteck  F, Clugston J, Harmon K, Dillon M, Edenfield K. Echocardiogram values in men’s and women’s NCAA Division-1 (D1) basketball. Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

Szereszewski J, Costain J, Hoyes B, Rahmanian K, Gilbert-Wright L, Samraj G, Schmidt S. Does an integrated chronic pain management program reduce narcotic use? Poster presented at: CHFM Second Annual Research Day; June 1, 2017; Gainesville, FL.

PRESENTATIONS:

International

Deininger KM, Hirsch JD, Graveline SA, Feist A, Smith SM, Reich JA, LaFleur J, Ambardekar AV, Lindenfeld J, Aquilante CL. Relationship between patient-perceived treatment burden and medication adherence in heart transplant patients. Presented at: International Society for Heart & Lung Transplantation (ISHLT) 2017 Annual Meeting and Scientific Sessions; April 5-8, 2017; San Diego, CA. 

National

Asken B (g), Houck Z (g), Bauer R, McCrae M, Clugston J. Effect of playing through concussion on recovery in collegiate athletes. Presented at:  NCAA-DoD Concussion Awareness Research & Education (CARE) Consortium Investigators Meeting; June 13, 2017; Rosemont, IL. Invited.

Clugston J.  Concussion prevention and management. Presented at: On Common Ground, A Team Approach to Sports Medicine Conference; June 1, 2017; University of Michigan, Ann Arbor, MI. Invited.

Clugston J.  Concussion sideline evaluation – SMART Workshop. Presented at: 2017 American Medical Society for Sports Medicine 26th Annual Meeting; May 12, 2017; San Diego, CA. Invited.

Clugston JR, Chrisman SPD, Houck ZM (g), Asken BM (g), Boone JK, Kontos AP, Buckley TA, Schmidt JD, Kaminski TW, Collins MW, Ortega JD.  King-Devick Test time varies by testing modality. Presented at: 2017 American Medical Society for Sports Medicine 26th Annual Meeting; May 12, 2017; San Diego, CA. Invited Podium Presentation.

Costain J, Szereszewski J, Hoyes B, Gilbert L, Rahmanian K, Samraj G, Schmidt S. Does a multidisciplinary chronic pain management program improve residency education? Roundtable presentation and discussion at: The 50th STFM Annual Spring Conference; May 5, 2017; San Diego, CA.

Langley KJ (f), Gravlee JR. Constipation in a collegiate hurdler. Presented at: 2017 American College of Sports Medicine 64th Annual Meeting; June 3, 2017; Denver, CO. Invited Oral Case Presentation.

Malaty J, Michaudet C.  Procedural training in family medicine residency: Curriculum implementation and assessing competency. Presented at: The 50th STFM Annual Spring Conference; May 5-9, 2017; San Diego, CA.

Schmidt S, Hagan H, Chang KL, Costain J, Gilbert L, Rahmanian K, Samraj G. Does implementing chronic pain management in a family medicine residency program reduce health care costs? Presented at: The 50th STFM Annual Spring Conference; May 5, 2017; San Diego, CA.

Schmidt S, Hagan H, Gilbert L, Chang KL, Costain J, Rahmanian K, Samraj G.  Multidisciplinary chronic pain management program in a family medicine residency improving patient care and resident education: 3-year experience. Presented at: The 50th STFM Annual Spring Conference; May 5, 2017; San Diego, CA.

Starnes TA (f), Reifsteck F, Clugston JR, Harmon KG, Dillon MC, Edenfield KM. Pre-participation cardiac screening including electrocardiography (ECG) and transthoracic echocardiography (Echo) in men’s and women’s NCAA Division-1 (D1) basketball athletes. Presented at: 2017 American Medical Society for Sports Medicine 26th Annual Meeting; May 10, 2017; San Diego, CA. Invited Podium Presentation.

Theoktisto K. Primary care guidelines for the care of gender non-conforming children. Presented at: The 38th National Conference on Pediatric Health Care, National Association of Pediatric Nurse Practitioners; March 15-16, 2017; Denver, CO.

Local/Regional

Ware M, Feller D, Hall K. Measurement-based care: What, why, and how. Presented at: The Florida Academy of Family Practitioners Spring Conference; April 22, 2017; Orlando, FL.

PUBLICATIONS:

Agana DG. Re: Primary care patients' willingness to participate in comprehensive weight loss programs: From WWAMI region Practice and Research Network. J Am Board Fam Med. 2017; 30(2):264.

Carek PJ, Anim T, Conry C, Cullison S, Kozekowski S, Ostergaard D, Potts S, Pugno P. Residency training in family medicine: A history of innovation and program support. Fam Med. 2017;49(4): 275-81.

Carter CS, Solberg LB, Solberg LM. Applying theories of adult learning in developing online programs in Gerontology. Journal of Adult and Continuing Education. 2017; In press.

Baldonado A, Hawk O, Ormiston T, Nelson, D. Transitional care management in the outpatient setting. BMJ Qual Improv Reports. 2017;6: doi:10.1136/bmjquality.u212974.w5206.

Hwang AY, Dietrich E, Pepine CJ, Smith SM. Resistant hypertension: Mechanisms and treatment. Curr Hypertens Rep. 2017;19(7):56.

Bowman MA, Lucan SC, Rosenthal TC, Mainous AG, James PA. Family medicine research in the United States. Fam Med. 2017;49(4):289-295.

Deininger KM, Hirsch JD, Graveline SA, Feist A, Smith SM, Reich JA, LaFleur J, Ambardekar AV, Lindenfeld J, Aquilante CL. Relationship between patient-perceived treatment burden and medication adherence in heart transplant patients. J Heart Lung Transplant. 2017;36(4):S152.

Eichner RE, Schnebel B, Anderson S, Clugston JR, Hale H, Michaudet C, Small JM. Acute lumbar paraspinal myonecrosis in football players with sickle cell trait. Medicine & Science in Sports and Exercise. 2017 April;49(4):627-632. PMID: 27875493.

Harle CA, Marlow NM, Schmidt SOF, Shuster JJ, Listhaus A, Fillingim RB, Hurley RW. The effect of ehr‐integrated patient reported outcomes on satisfaction with chronic pain care. Am J Manag Care. 2016 Dec 01;22(12):e403-e408.

Hwang AY, Dietrich E, Pepine CJ, Smith SM. Resistant hypertension: Mechanisms and treatment. Curr Hypertens Rep. 2017;19(7):56.

Hwang AY, Smith SM, Gums JG. Adrenal Gland Disorders. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017.

Hwang AY, Smith SM, Gums JG. Cushing Syndrome. In: Schwinghammer TL, Koehler JM, Borchert JS, Park S, Slain DS, eds. Pharmacotherapy Casebook: A Patient-Focused Approach. 10th ed. New York, NY: McGraw-Hill; 2017.

Schmidt S. Metatarsalgia. In: Ebell MH, Ferenchick G, Smith M, Barry H, Slawson D, Shaughnessy A, Forsch R, Li S, Wilkes M, Usatine R, eds. “Essential Evidence Plus (EE+),” Hoboken, NJ: John Wiley and Sons. In Press pending, Update June 2017. URL: ttp:/www.essentialevidenceplus.com.

Smith SM, Pepine CJ. Hypertension in Ischemic Heart Disease. In: Bakris GL, Sorentino M. Hypertension: A Companion to Braunwald’s Heart Disease. 3rd ed. 2017;288-297.

Tsai T, Kroehl ME, Smith SM, Thompson AM, Dai IY, Trinkley KE. Efficacy and safety of twice- vs once-daily dosing of lisinopril for hypertension. J Clin Hypertens. 2017;doi: 10.1111/jch.13011.

Wokhlu A, Gong Y, Cooper-DeHoff RM, Smith SM, Handberg EM, Pepine CJ. Relationship between diastolic blood pressure and all-cause mortality with lower systolic blood pressure among hypertensive coronary artery disease patients: Long-term follow-up of the US cohort of the International Verapamil-SR-Trandolapril Study (INVEST). J Am Coll Cardiol. 2017;69(11):1685.

CHFM EVENTS

UPCOMING EVENTS

YOUR SHOE SIZE X 2 FUNDRAISING CAMPAIGN – NOW THROUGH AUGUST 18, 2017
In conjunction with UF Health’s Raising Hope at Work Campaign, CHFM’s fundraising campaign is “Your Shoe Size x 2” for your donation amount. The campaign continues through August 18 and this year, employees have the choice of contributing to the following four fund options:

1. Patient Technology and Experience: Enhancing facilities and technology for patients and families. 

2. Facility Improvements to Women’s and Children’s Areas:  Future facility improvements for women’s and children’s services at UF Health.

3. Arts in Medicine Fund: Transforming the hospital experience for patients, visitors, caregivers and staff through the arts. 

4. Dean’s Preeminence Scholarship Fund: Lending critical support to students and investing in the education of tomorrow’s health care leaders. 

You can help make an impact in the field of family medicine by giving to one of the three Family Medicine fund options below:

1. Cary R. Barber, M.D. Scholarship for Providers Depression Awareness and Suicide Prevention Fund: As medical school expenses in this country continue to rise at a rapid pace, your commitment to medical education will leave a lasting legacy for future generations. Your gift to scholarship helps the best students obtain the world-class education they need and deserve. The Cary Barber scholarship supports a medical student interested in family medicine, depression and suicide prevention.

2. David & Pearl Braddock Endowment for Underserved Patients Fund: This fund supports improving patient care for underserved populations at the UF Health Family Medicine clinics on the east side of Gainesville. 

3. Community Health and Family Medicine Education and Development Fund: This fund supports educational and developmental expenses for residents, students and faculty. 

***If you choose to donate to a Family Medicine fund, the best way to donate is to complete a paper pledge card and write the fund option you wish to give to, and then complete the payroll deduction section on the pledge card.*** 

You can send those cards directly to the UF Health Development Office through campus mail, PO Box 100386, or drop them off at the UF Health Development Office in the 1329 Building, Suite 3150.

Mail: PO Box 100386
Fax: 352.265.7954
Email: raisinghopeatwork@med.ufl.edu

If you choose to submit directly to the UF Health Development Office, please let Emilee Rice know your donation amount. For anonymous donations, just submit a slip of paper with the donation amount and place it in Emilee/Sheila’s mailbox in the CHFM Administrative Office Copy Room.

WELCOME RECEPTION – NEW DATE - JULY 5, 2017
All CHFM faculty, residents, administrative staff, ACU managers, and clinic staff are cordially invited to join in after work on Wednesday, July 5, from 5:30 p.m. to 7:30 p.m., in the resident lounge at Family Medicine – Main to welcome new faculty and the incoming resident class of 2020.

GRAND ROUNDS – AUGUST 1, 2017
Presenter:        TBD
Title:                 TBD
Location:          UF Health Family Medicine - Main, Room #2135 or via Jabber by dialing 75001
Time:                12:15 p.m. - 1:15 p.m.

STATE OF THE DEPARTMENT – SEPTEMBER 29, 2017
The State of the Department address has been scheduled for September 29 at the Hilton University of Florida Conference Center. Watch for the invitation to be sent out shortly.

MIND, BODY, AND SOLE 5K – NOVEMBER 11, 2017
This is the fourth year of the Mind, Body, and Sole 5K and all profits from this race will go to the Carey R. Barber, M.D. Scholarship for Providers Depression Awareness and Suicide Prevention fund, providing funding for medical students who are interested in helping this cause. This race is sponsored by the American Medical Student Association (AMSA), and Awareness Wellness Ambassadors Reaching Everyone (AWARE). Come join us in this fun event and help support this great cause!

Race Date and Time
Saturday, November 11, 2017, at 8:30 a.m.

Event Information
Check In: 7 a.m.
Start Time: 8 a.m.
Awards Ceremony: 9:15 a.m.

Location
UF Commuter Lot on Gale Lemerand Drive
Gainesville, FL 32608

Early Registration Fee until November 10, 2017, at 9 a.m.

• UF Students: $15

• Non-UF Students and Faculty and General Public: $25

• Children (18 and under): $10

Late Registration Fee after 9 a.m. on November 10

• UF Students: $20

• Non-UF Students and Faculty: $30

• Children (18 and under): $15

Registration
Register online at www.ITSYourRace.com
An additional processing fee will be charged by ITSYour Race.com for online registration. Online registration closes Friday, November 10, 2017, at 9 a.m. For Mail-in registrations, please make checks payable to UF Foundation or UFF and mail to 3800 Sandy Shores Drive, Jacksonville, FL 32277. Sorry, no refunds will be provided.

Course
The “Infamous UF Boot”

Post-Race Celebration
Join attendees after the race for a runner’s banquet with refreshments!
Gift certificates for food, shirts and items are up for bid.

PAST EVENT HIGHLIGHTS

CHFM RESEARCH DAY – JUNE 1, 2017
CHFM held its second annual Research Day on Thursday, June 1, 2017, with twenty-five scholarly posters on display. The event was held at the Champions Club at Ben Hill Griffin Stadium and was well attended by CHFM faculty, residents, fellows, students and Dean Michael Good. Numerous faculty, residents and fellows participated and shared their scholarly work from the past year. Dr. Carek and the Research & Quality Improvement Committee are looking forward to planning next year’s Research Day; a date will be announced in the coming weeks.

SUMMER PICNIC – JUNE 3, 2017
On Saturday, June 3, CHFM celebrated its 3rd annual summer picnic and it was a great success! The event took place at beautiful Poe Springs, located in the nearby city of High Springs in Alachua County. Attendees enjoyed Mojo Hogtown BBQ in the quaint Poe Springs Lodge, which was very comfortable on a hot June day. Fortunately, the weather cooperated so that attendees could enjoy the natural springs and play outside. Dr. Carek was very pleased to have so many members of the extended CHFM family attend this year and enjoy food, fun, and fellowship. He looks forward to another pleasant experience with everyone at next year’s summer picnic, already scheduled for Saturday, June 2, 2018.

FACULTY & STAFF SPOTLIGHT

Mindy Halbrook
ACU Manager for UF Health Family Medicine – Main

Mindy Halbrook currently serves as the ACU Manager for UF Health Family Medicine – Main. She is originally from Mechanicsville, Virginia. After meeting her husband, who was born and raised in Alachua, she moved there for love 15 years ago. Mindy has worked for CHFM for 14 years. She started at Haile Plantation doing checkout and then was promoted to manager. She transferred to 4th Avenue (now Main Street) when the previous manager retired after 35 years of service.

“I truly enjoy the family atmosphere we create for patients, staff and physicians. I truly enjoy being around people (coworkers and patients). I love to help and see a positive outcome from that. My husband and I have 5 children (23, 18, 11, 9, 8). It’s a crazy roller coaster of FUN!! We enjoy church, many sports (watching or playing) and anything that involves being on the water.”  

LINK TO 2015-2016 ANNUAL REPORT

The 2015-2016 Annual Report has been published and added to the CHFM webpage. Here is the link to the report: 2015-16 Annual Report

GRAND ROUNDS PRESENTATIONS

In case you missed any of the latest sessions:

June 6, 2017
Jessica Gonzalez, PharmD
Working Together to Reduce e-Prescribing Errors
June 2017 Grand Rounds Presentation - Mediasite

May 2, 2017
Anzeela M. Schentrup, PharmD, PhD, BCPS
The Road to Leadership in Academic Family Medicine: Challenges and Reward
May 2017 Grand Rounds Presentation - Mediasite

April 4, 2017
Jeannette South-Paul, MD
The Road to Leadership in Academic Family Medicine: Challenges and Reward
April 2017 Grand Rounds Presentation - Mediasite

March 14, 2017
Shireen Madani Sims, MD
Coaching for Resilience to Foster Wellness in Faculty and Learners
March 2017 Grand Rounds Presentation - Mediasite

February 7, 2017
Brian Berryman
COM Faculty Benefits and Retirement
February 2017 Grand Rounds Presentation - Mediasite

January 2017
Cancelled

PCP LIVE PRESENTATIONS

PCP Live sessions have been cancelled. The last session was held in November 2016.

In case you missed any of the latest sessions:

PCP Live #33
November 16, 2016
Ki Park, MD
Cardiovascular Risk Stratification in Women- Where are we in 2016?
November 2016 PCP Live Presentation - Mediasite

PCP Live #32
October 19, 2016
Alice Rhoton-Vlasak, MD
Oncofertility and Infertility – What is the Difference and Why does it Matter?
October 2016 PCP Live Presentation - Mediasite

PCP Live #31
September 21, 2016
Siddhartha A. Wayangankar, MD, MPH
Demystifying the Screening and Diagnosis of Peripheral Arterial Disease
September 2016 PCP Live Presentation - Mediasite

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