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and Women's Hospital
Grant Title: Improving
Care for Acute Respiratory Infections
Grant Number: K08 HS014563
Total Award: $669,600
Project Description: This project had four main
- To develop the Acute Respiratory Infection (ARI) Smart Set Form,
which will standardize documentation of care and give providers easy access to
clinical information, on-line decision support, and patient education
- To perform a randomized controlled trial (RCT) of the ARI Smart
Set Form to assess its effectiveness in decreasing antibiotic prescribing in
primary care practices.
- To connect the ARI Smart Set Form with a national
disease surveillance program, the National Bioterrorism Syndromic Surveillance
Demonstration Project, to provide an automated, bi-directional link between the
personal and public health systems.
- To perform an RCT of providing clinicians
with point-of-care, real-time data about the prevalence of influenza and other
respiratory illnesses in an individual patient's neighborhood through the ARI
Smart Set Form.
Career Goals: Dr. Linder is an Assistant Professor of Medicine at the Harvard Medical School. He received his MD from Northwestern University Medical School and did his residency in Primary Care Internal Medicine at the University of California, San Francisco (UCSF). He then went on to earn his MPH from Harvard School of Public Health.
Progress to Date: This grant has been completed. The ARI Smart Form was not associated with a decreased antibiotic prescribing rate but it was only used in 6% of 11,954 visits. For the ARI Quality Dashboard RCT, patients made 18,754 ARI visits and there was no difference in the antibiotic prescribing rate between intervention and control practices.
Future Plans: The grantee will continue his academic research focusing on improving care for ARIs and, more broadly, improving the quality of primary care in the United States.
Highlights and Specific Accomplishments:
Provisional Medical Staff, Faulkner Hospital, Boston, MA.
Associate Physician, Brigham and
Women's Health, Boston, MA.
Excellence in Teaching Award, Harvard Medical School and Harvard School of Dental Medicine, Class of 2006.
K-Generated Publications (selected):
Linder JA, Bates DW, Platt R. Antivirals and antibiotics for
influenza in the United States, 1995-2002. Pharmacoepidemiol Drug Safety 2005.
Linder JA, Huang ES, Steinman MA, et al. Fluoroquinolone
prescribing in the United States: 1995 to 2002. American Journal of Medicine 2005. 118(3):259-68.
Linder JA, Ma J, Bates DW, et al. Electronic health record use
and the quality of ambulatory care in the United States. Archives of Internal Medicine
2007. July 9:1400-05.
Linder JA, Schnipper JL, Tsurikova R, et al. Barriers to
electronic health record use during patient visits. AMIA Annual Symposium Proceedings 2006. pp.499-503.
Linder JA, Bates DW, Williams DH, et al. Acute infections in
primary care: Accuracy of electronic diagnoses and electronic antibiotic
prescribing. Journal of the American Medical Informatics Association 2006.
Linder JA, Bates DW, Lee GM, Finkelstein JA. Antibiotic
treatment of children with sore throat. Journal of the American Medical Association 2005. 294(18):2315-22.
Linder JA, Chan JC, Bates DW. Appropriateness of antiviral
prescribing for influenza in primary care: A retrospective analysis. Journal of Clinical Pharmacy and Therapeutics 2006. 31:245-52.
Farwell WR, Linder JA,
Jha AK. Trends in prostate-specific antigen testing from 1995 through 2004.
Archives of Internal Medicine 2007. 167(22):2497-502.
Linder JA, Kaleba EO, Kmetik KS. Using electronic health records to measure physician performance for acute conditions in primary care: Empirical evaluation of the community acquired pneumonia clinical quality measure set. Medical Care 2009. 47(2):208-16.
Linder JA, Rigotti NA, Schneider LI, et al. An electronic health record-based intervention to improve tobacco treatment in primary care: A cluster randomized controlled trial. Archives of Internal Medicine 2009. 169(8):781-87.
Linder JA, Schnipper JL, Tsurikova R, et al. Documentation-based clinical decision support to improve antibiotic prescribing for acute respiratory infections in primary care: A cluster randomized controlled trial. Inform Primary Care 2010. 17(10):231-40.
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