Theresa Cullen

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OBJECTIVES We reviewed changes in blood glucose, blood pressure, and cholesterol levels among American Indians and Alaska Natives between 1995 and 2001 to estimate the quality of diabetes care in the Indian Health Service (IHS) health care delivery system. METHODS We conducted a cross-sectional analysis of data from the Indian Health Service Diabetes Care(More)
OBJECTIVES There are limited data regarding implementing electronic health records (EHR) in underserved settings. We evaluated the implementation of an EHR within the Indian Health Service (IHS), a federally funded health system for Native Americans. DESIGN We surveyed 223 primary care clinicians practicing at 26 IHS health centers that implemented an EHR(More)
The American Indian/Alaska Native population experiences a disproportionate burden of disease across a spectrum of conditions. While the recent National Healthcare Disparities Report highlighted differences in quality of care among racial and ethnic groups, there was only very limited information available for American Indians. The Indian Health Service(More)
BACKGROUND Although Native Americans experience substantial disparities in health outcomes, little information is available regarding healthcare delivery for this population. OBJECTIVE To analyze trends in ambulatory quality of care and physician reports of barriers to quality improvement within the Indian Health Service (IHS). DESIGN Longitudinal(More)
The Indian Health Service (IHS), a federal health system, cares for 2 million of the country's 5.2 million American Indian and Alaska Native people. This system has increasingly focused on innovative uses of health information technology and telemedicine, as well as comprehensive, locally tailored prevention and disease management programs, to promote(More)
The US Indian health system utilizes a diverse range of health information technology and innovative tools to enhance health service delivery for American Indians and Alaska Natives. This article provides an overview of efforts and experience using such tools to achieve health equity for American Indian and Alaska Native communities. Specific attention is(More)
We report a 2 10/12-yr-old girl with precocious pseudopuberty due to a feminizing adrenal carcinoma without Cushing's syndrome. The patient had marked elevation of plasma concentrations of the delta 5 adrenal steroids dehydroepiandosterone and dehydroepiandrosterone sulfate and increased levels of androstenedione, estrone, estradiol, and testosterone.(More)
OBJECTIVE Increasing use of electronic health records (EHRs) provides new opportunities for public health surveillance. During the 2009 influenza A (H1N1) virus pandemic, we developed a new EHR-based influenza-like illness (ILI) surveillance system designed to be resource sparing, rapidly scalable, and flexible. 4 weeks after the first pandemic case, ILI(More)
Authors studied the United States (U.S.) Department of Veterans Affairs' (VA) Virtual Lifetime Electronic Record (VLER) Health pilot phase relative to two attributes of data quality - the adoption of eHealth Exchange data standards, and clinical content exchanged. The VLER Health pilot was an early effort in testing implementation of eHealth Exchange(More)