JoAnn M. Sperl-Hillen

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PURPOSE We wanted to test whether improvements in care quality were correlated with changes in the Chronic Care Model (CCM) in a large medical group that attempted to implement the CCM. METHODS The leaders of 17 primary care clinics in this medical group completed the Assessing Chronic Illness Care (ACIC) survey measure of CCM implementation before and(More)
Clinical inertia is defined as lack of treatment intensification in a patient not at evidence-based goals for care. Clinical inertia is a major factor that contributes to inadequate chronic disease care in patients with diabetes mellitus, hypertension, dyslipidemias, depression, coronary heart disease, and other conditions. Recent work suggests that(More)
OBJECTIVE To assess two physician learning interventions designed to improve safety and quality of diabetes care delivered by primary care physicians (PCPs). RESEARCH DESIGN AND METHODS This group randomized clinical trial included 57 consenting PCPs and their 2,020 eligible adult patients with diabetes. Physicians were randomized to no intervention(More)
OBJECTIVE To assess the reversibility of the elevation of serum creatinine levels in patients with diabetes after 5 years of continuous on-trial fenofibrate therapy. RESEARCH DESIGN AND METHODS An on-drug/off-drug ancillary study to the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Lipid Trial to investigate posttrial changes in serum(More)
OBJECTIVE To assess whether providing customized clinical information to patients and physicians improves safety or quality of diabetes care. RESEARCH DESIGN AND METHODS Study subjects included 123 primary care physicians and 3,703 eligible adult diabetic patients with elevated A1C or LDL cholesterol, who were randomly assigned to receive customized(More)
OBJECTIVE To compare the effect of intensive versus standard glycemic control strategies on health-related quality of life (HRQL) in a substudy of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. RESEARCH DESIGN AND METHODS A randomly selected subsample of 2,053 ACCORD participants enrolled in the HRQL substudy was assessed at(More)
Development of data mining technologies to predict treatment errors in populations of patients represents a major advance in patient safety research. In the work presented here, we create a simulation test environment using characteristic models of physician decision strategies and simulated populations of patients with type 2 diabetes, employ a specific(More)
Objectives: Diabetes-related medical errors in outpatient practice are common and costly. This study attempts to accurately identify, classify, and interpret patterns of diabetes-related medical errors in primary care settings using diagnostic, laboratory, and pharmacy data. Methods: Automated diagnostic, laboratory, and pharmacy data were used to evaluate(More)
INTRODUCTION The study analyzes the effect of an advanced access program on quality of diabetes care. METHODS We conducted this study in a medical group of 240,000 members served by 17 primary care clinics. Seven thousand adult patients older than 18 years of age with diabetes were identified from administrative databases. Two aspects of advanced access -(More)