FY23 Annual Report: Frontline Primary Care Panel
Frontline Primary Care Panel Helps Fine Tune Research Studies
By: Michael Keating
Johns Hopkins physician and faculty member Elham Hatef developed a tool that informs physicians and advanced practice providers when their patients live with social conditions that could harm their health, such as food insecurity, residential instability or transportation issues. The care team would then be asked to assess the social needs of their patients and provide different services to address those needs, including making referrals to support patients.
She received NIH funding and approvals to implement the tool in selected clinics and assess its adoption and effectiveness from the Johns Hopkins Community Physicians (JHCP) research and projects committees and the Johns Hopkins Medicine Institutional Review Board. Before she started her study, Hatef was invited to meet with the new Frontline Primary Care Panel within JHCP to ensure her tool was properly implemented in the clinical and digital workflows in the primary care setting.
The group of panelists proposed important insight on how to effectively implement the tool in the clinic to ensure its success in real-world clinical care.
“As a result of feedback from the panel, we adjusted the process in terms of who would be the primary user of our tool, shifting it from the physicians and clinicians to social workers and care managers,” says Hatef, a preventive medicine-public health physician, clinical informatician and associate professor in the Johns Hopkins Division of General Internal Medicine in the Department of Medicine.
“Also, comments about how we should communicate with the patients and make the research study more patient-friendly, and at a level that the patients can connect with, were very valuable,” she says.
Setting Up Researchers for Success
Researchers from the Johns Hopkins University schools of medicine and nursing are increasingly looking to conduct large studies within JHCP’s 40-plus primary care clinics. If implemented successfully, innovations from these studies can improve care, workflows, clinical outcomes, patient satisfaction and health equity. Engagement with research could also help reduce provider burnout, as many providers want to be part of the academic mission at Johns Hopkins, says JHCP research program manager Sarah Rubin.
Launched by JHCP in January 2023, the Frontline Primary Care Panel aims to inform and facilitate that research while guarding against adding new tasks for providers, says physician Wendy Bennett, a general internal medicine physician at Johns Hopkins and research director for JHCP.
“The panel worked closely with Dr. Hatef to develop a process to take this out of the hands of our busy clinicians and shift it to social workers through Hopkins Community Connection,” says Rubin. “She asked a lot of questions about how we currently screen for social determinants of health and how this can be implemented into our clinics and workflow. So, the suggestions produced changes in their protocol to reduce burden from the research study for providers.”
The panel of 14 members (see current member list below) includes physicians, nurse practitioners, medical directors, clinical supervisors and support staff from throughout Maryland. Honorariums for the panelists, who meet quarterly on their own time to review large, multiyear, multimillion dollar study requests, are funded by the researchers.
The researchers, who often are not practicing clinicians, get valuable real-world feedback on how JHCP clinics and the electronic health records operate to help improve the design of their studies before they even begin. The panelists get to participate in the research mission of the organization in ways that were previously unavailable.
“People come to work at Johns Hopkins because they want to be involved in all that Hopkins does,” says Bennett. “They want to touch upon the scholarly mission in some way. We are trying to build an opportunity for our people to find joy in their work and to be part of something that could positively impact patient care.”
So far, the panel has reviewed three research projects.
One study, conducted by Yvonne Commodore-Mensah, a cardiovascular nurse epidemiologist, helps community health workers teach patients at risk for high blood pressure how to monitor themselves using a new screening app on their phones. “Originally, her team wanted to interface the results from the app into the electronic health record, to support clinical decision-making,” says Rubin. “We had a lot of discussion about how to get information to the providers without it being onerous or even missed. And without adding what we call ‘pajama time,’ which is when they go home at the end of the day and they go back to work essentially to finish their documentation.”
Commodore-Mensah says the opportunity to present the LINKED-BP Program to a panel of experts was tremendously helpful because it allowed them to tailor the approach to the unique JHCP context. “Since the project involves different health systems in the Maryland area, it was critical to receive input from clinicians and staff members at the practice to support the implementation and the sustainability of the program,” she says.
Rubin and Bennett emphasized that the panel’s role is as a collaborator, not a gatekeeper. “This is not about putting a hand up and creating a barrier, but really about having that dialogue to say your project is very important, your topic is very important, and we want to think about how to make sure this works, given all the challenges in a very busy primary care setting,” says Bennett.
“At the end of the day, we need to make sure their project is not troublesome to our providers or practices, but also that it’s meaningful because it’s implemented in a real-world setting. We want to make sure there’s front-line input at every stage of a research project that is touching our practices, our patients and our providers.”
Hatef sees this new opportunity for researchers to work with the panel as a win-win.
“I would tell other researchers that getting the providers’ feedback early on during the design of a project is really valuable before everything is finalized — or even before they have started,” says Hatef. “They can then incorporate that knowledge into the process in their work, earlier rather than later, so that it is more efficient and will have a bigger impact.”
If you are interested in having your study reviewed by the committee, please submit a completed REDCap form via this website.
Frontline Primary Care Panel Members (at the time of writing)
- Catherine Parrish, physician – pediatrics, Canton Crossing
- Naaz Hussain, office medical director, Frederick
- Ariana Martin, physician – family practice, Odenton
- Sajida Chaudry, office medical director, Odenton
- Denisse Mueller, office medical director, East Baltimore Medical Center
- Vivienne Rose, office medical director, East Baltimore Medical Center
- Valerie Streeb, nurse practitioner, Bowie
- Jill Crank, nurse practitioner, Remington
- Sarah Crislip, practice administrator, Dundalk
- Lauren Liberatore, clinical supervisor, White Marsh
- Helen Kim, clinical supervisor, McLean
- Natarsha Robinson, medical assistant–Sibley
- Sergio Henao Molina, bilingual medical assistant, Glen Burnie
- Tré Corbin, medical office assistant, Canton Crossing