Placement: Brigham and Women’s Hospital
Mentor: David W. Bates, M.D., M.Sc. (Chief, Division of General Medicine, Brigham and Women's Hospital)
Co-Mentor: Patricia Dykes, Ph.D., M.A., R.N. (Associate Professor of Medicine, Harvard Medical School; Senior Nurse Scientist, Program Director for the Center for Nursing Excellence and the Center for Patient Safety and Research and Practice, Brigham and Women’s Hospital)
Project: Rural United States Provider Information Exchange to Coordinate Care during Transitions: The Role of HIT for Chronic Complex Conditions
Emily Gill, M.B.Ch.B., B.Med.Sci., is a 2017-18 New Zealand Harkness Fellow in Health Care Policy and Practice. She is a full-time Family Physician in two rural practices in the Bay of Plenty in New Zealand, where she focuses on the management of complex chronic conditions in high-needs populations and is an advocate for improved coordination of care through clinical governance activities. After completing her medical qualifications, Gill spent time as a rural hospital medicine trainee in New Zealand and volunteered with Doctors Without Borders (Medicins Sans Frontiers) working on two projects in West Africa. Gill’s research experience includes internships at the Australian National University’s National Centre for Population Health and the National Institutes of Health in Bethesda, Maryland, and she was the first recipient of year-long research degree in General Practice in New Zealand. She has published peer-reviewed articles on the management of diabetes in aged-care facilities and cardiovascular disease risk assessments in the community setting, and was an active member of the New Zealand Doctors-in-Training-Council (2009-2012, Deputy Chair 2010). Gill received her medical and research degrees from the University of Otago, and is a Fellow of the Royal New Zealand College of General Practice.
Project Abstract: Improving healthcare coordination for high-need, high-cost communities is a health policy priority for humanitarian and financial reasons. This population is characterized by complex medical care requiring transitions between providers, and includes rural dwellers whose rates of age-adjusted mortality, disability, and chronic disease are higher than their urban counterparts. Goals of the current United States and New Zealand healthcare strategies include improved care coordination through the use of health information technology, which may uniquely benefit rural patients. This project aims to address both countries’ strategic intentions by analyzing provider information exchange during care transitions of patients with complex chronic conditions, with a particular focus on rural primary care.
The project will include a literature review looking at interventions to improve information exchange during care transitions, and care providers will be interviewed and surveyed about their experiences of in this area, focusing on complex chronic care and rural factors. This mixed-methods analysis will provide insights to inform recommendations to address challenges facing the delivery of technologically facilitated care coordination.