A Message from the Executive Director of the Meyers Primary Care Institute

Jerry H. Gurwitz, MD Executive Director

Over the past decade, we have witnessed an impressive expansion of the agenda of the Meyers Primary Care Institute, as faculty from varied disciplines have come together to address the most important health-related issues concerning our community, region, and our nation. In support of this mission, the Institute has benefited from its membership in the HMO Research Network and involvement in federally-funded, national initiatives including the Cancer Research Network and the HMO Research Network Center for Education and Research on Therapeutics.

The Meyers Primary Care Institute research agenda has focused on

Patient Safety: Institute researchers are studying ways to reduce the risk of medication-related injuries. The Institute is collaborating with investigators at Brigham and Women’s Hospital in a federally-funded Center of Excellence on Patient Safety, and with a national consortium of health maintenance organizations, to examine better strategies to encourage safe medication use across all patient populations. We are also participating in groundbreaking efforts to implement computerized interventions to improve medication safety in the long-term care setting.

Children: Faculty are examining ways to improve how primary care physicians and specialists can work collaboratively to provide the safest and highest quality care to children who suffer with chronic illnesses.

Cancer: Investigators are working with a consortium of investigators from health plans across the country on new initiatives that are examining cancer prevention, early detection, treatment and surveillance.

Disparities in healthcare: The underlying reasons for persistent racial and ethnic disparities in medical care are being investigated by Institute researchers.

Heart Disease: Cardiovascular disease is one of the leading causes of hospitalization, disability, and death in the United States. Faculty members are involved in majory population-based studies examining the prevalence and treatment of these very common and deadly conditions.

Pregnancy: A national study of medication prescribing during pregnancy funded by the Agency of Healthcare Research and Quality is being led by MPCI investigators with the goal of improving the safety of medication use in this very special patient population.

Arthritis: Millions of Americans suffer from pain and disability due to arthritis. MPCI faculty are working to develop innovative strategies to provide medical care to patients affected by this highly prevalent condition.

Physician-Patient Communication: Institute researchers are examining how optimal communication between physicians and patients affects patients' tendencies toward forgiving their doctors following a medical error.

Hypertension and diabetes:  Controlling high blood pressure and managing diabetes remain major challenges in the care of many patients. Investigators have examined the factors that make it especially challenging to treat hypertension and diabetes in the primary care setting.

Health Policy:  Medicare Part D, the drug benefit for Medicare beneficiaries, is the largest expansion to the Medicare program since its inception in 1965. Investigators are examining the financial and clinical implications of Part D for older adults.

Education

In the educational arena, MPCI continues to be extremely active in establishing new educational initiatives directed toward the needs of medical students, residents, and practicing physicians.

The Institute has developed and implemented a curriculum focused on evidence-based medical practice that provides the skills to critically appraise the published scientific literature, and effectively apply this information in the clinical practice setting. The Institute is collaborating with the University of Massachusetts Medical School Office of Graduate Medical Education to develop a core curriculum on evidence-based medicine for residents across all training programs in Central Massachusetts.

The Institute has coordinated a successful training program for medical and family practice residents, as well as nurse practitioner trainees, focused on a team approach to the care of the frail elderly. This effort has been successful due to the strong support of the staff of the Fallon Elder Service Plan and has been funded through a grant to the University of Massachusetts Medical School from the Macy Foundation.

The Institute has successfully coordinated annual educational programs on managed care for University of Massachusetts Medical School students since 1996. These programs focus on preparing students for clinical training and practice in an ever changing healthcare environment.

In a joint effort with the Massachusetts Medical Society, the Institute has completed educational modules on managed care and evidence-based medicine that are available on-line and in CD-ROM format for the benefit of physicians in-training, practicing physicians, and medical educators.

The Institute has directed needed attention toward selected focus areas for medical students and physician trainees by coordinating an annual Geriatric Teaching Day at the medical school and a Health and Human Rights Student Interest Group.

Grants and Activities

To foster primary care research by local investigators, the Institute has awarded nearly $450,000 to fund numerous modest-scale collaborative research projects relevant to health services, epidemiologic, and public health issues. Topics that have been explored with this funding include the care of patients with asthma in the managed care setting, sexually transmitted disease in adolescent women, prevention of child obesity, and the relation between ethnicity and medication adherence in the elderly.

The Institute is proud to be a member of the HMO Research Network, an organization of health plan-based research programs whose mission is to use our collective scientific capabilities to integrate research and practice for the improvement of health and healthcare among diverse populations. Members of the Network hold to the belief that health plans play a crucial role as laboratories for the conduct of health services, epidemiological, and clinical research. The Institute and its sponsors served as the host for the 12th Annual HMO Research Network Conference.

The Institute’s faculty continue to publish in the world’s leading medical journals including the New England Journal of Medicine, and the Journal of the American Medical Association. Furthermore, the Institute’s faculty have been featured in numerous stories relating to their work in the media including USA Today, the Wall Street Journal, the Los Angeles Times, the Boston Globe, the Boston Herald, the Toronto Star, and the Worcester Telegram & Gazette.

In summary, The Meyers Primary Care Institute bridges the interests of three very remarkable institutions- the University of Massachusetts Medical School, a national leader in the education of primary care physicians, the Fallon Healthcare System, one of the preeminent managed care systems in the country, and the Fallon Clinic, a nationally-recognized, multi-specialty medical group. The Institute symbolizes a very strong commitment of these organizations to promoting high quality primary care in Central Massachusetts and beyond. The faculty and staff of the Meyers Primary Care Institute will continue to build on the strengths of our sponsors to help ensure that our research and educational efforts are translated into practice for the benefit of our communities.