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Fraher, Family Medicine colleagues funded to study shift to value-based care 

A group of UNC Family Medicine researchers, led by Erin Fraher, PhD, MPP, has been awarded a $255,000 grant from The Duke Endowment to study UNC Family Medicine’s shift to a value-based healthcare model. The project, “Producing the Evidence Needed for Hospitals to Successfully Navigate the Shift to Value,” began January 1, 2020 and will run until December 31, 2021. Read more here

Fraher presents at National Academy of Medicine's Vital Directions symposium

This past fall, the National Academy of Medicine (NAM) put together the Vital Directions for Health and Health Care Symposium, with experts on panels on health disparities, integrated care, health care data infrastructure, community engagement and health workforce. Erin Fraher, PhD, MPP spoke on the "21st Century Health Care and Science Workforces" panel along with Crystal Murillo, PhD, RN, CHSE (University of South Carolina), Peter Buerhaus, PhD, RN, FAAN (Montana State University), and Julie George, MSN, RN, FRE (North Carolina Board of Nursing). Watch the presentation here on YouTube.

Health workforce colleagues come together to write on modernizing scope of practice regulations

Directors of publicly and privately funded workforce researcher centers, Bianca Frogner, PhD, Erin Fraher, PhD, MPP, Joanne Spetz, PhD, Patricia Pittman, PhD, Jean Moore, DrPH, Angela J. Beck, PhD, MPH, David Armstrong, PhD, and Peter Buerhaus, PhD, RN, published a perspective article on scope-of-practice (SOP) regulations in the most recent issue of New England Journal of Medicine. 
Modernizing Scope-Of-Practice Regulations details the current state of national and state SOP laws and how they have failed to keep pace with health care transformation and may be, instead, hindering health care organizations from innovating care delivery. Read the full article here, and read a release from University of Washington here.
 
In the U.S., state legislators define legal scopes of practice for health professionals. Not only do these laws vary state to state, they are also not always evidence-based. In a system that is increasingly moving toward value, health systems and policy makers are increasingly recognizing these laws can hinder innovation, unnecessarily restrict access to care and raise costs without improving the quality of patient care.  Unfortunately, state laws and organizational policies are often informed by professional lobbying rather than patient interests.  “Patients, not health professions, should be at the center of the conversation on scope of practice,” says Fraher. “We should be asking, ‘what are the population’s health care needs?’ and then planning our workforce and workflows around those needs.”  
 

Latest from our blog: COVID-19, Primary Care and Infectious Disease Physicians in NC

  • The first cases of coronavirus (COVID-19) have been documented in NC. The spread has sparked concerns about public health infrastructure. Adults aged 65 and older are especially vulnerable to coronaviruses and the subsequent respiratory infections they can cause.
  • During an epidemic like this one, primary care is the entry point to testing and to referral if more intensive and specialized care is necessary. In North Carolina, primary care clinicians are unevenly distributed, with access worsening in rural areas. The populations of rural communities are older than those in urban areas.
  • Infectious disease (ID) physicians will also play a role in managing NC’s response to COVID-19. ID physicians diagnose and treat infectious diseases, consult with other physicians and develop prevention strategies to reduce transmission.
  • In 2018, 211 NC physicians reported that infectious disease was their primary area of practice. Many are associated with academic health centers and may do research or work in public health in addition to seeing patients.
  • For more information on the epidemic in NC, please see the NC’s Department of Health and Human Services coronavirus website.
To see this blog on our site, with an interactive version of the map, visit here

Recent policy brief: social work, electronic health records and workforce research

A recent policy brief from Lisa de Saxe Zerden, MSW, PhD, Erica Richman, MSW, PhD, Brianna Lombardi, MSW, and others explores how Electronic Health Records (EHR) data can be used as a workforce research tool to assess the scope, contributions and value of social work in primary care settings. They found substantial obstacles to using EHR documentation to clarify the role of social workers. Check out the full visual abstract excerpted below or read the full brief here.

Team welcomes new data analyst Tony Kane, MS

Tony has been working in data modeling, administration and analysis for over three decades. He spent half of his career at the NC Area Health Education Center, where he frequently drew on data from the North Carolina Health Professions Data System (HPDS). He considered these data sets invaluable to the outreach and impact of AHEC's various programs and services. Tony returns to the UNC community after having spent a few years in the private sector, where he worked on modern software development methods while serving as Senior Implementation Specialist for Integrify. Tony joins the team as a Research Associate and Data Analyst. 

Ricketts in the news on rural health 

Tom Ricketts, PhD was featured on NPR's "On Point" radio show discussing rural hospital closures and health care access. Catch the full show here

From our blog: how diverse is NC's obstetric workforce? 

In North Carolina, infant mortality rates are higher for non-Hispanic black babies than for non-Hispanic white babies, and this gap has persisted for nearly 20 years.  In 2018, black infants were almost two and a half times more likely to die than white infants. 

 In 2018, 21% of NC’s population identified as black or African American, compared to 13% of the state’s obstetric delivery providers. Only 4% (five) black family medicine physicians reported providing routine obstetric delivery services. Read the full blog here

Team presents at NCIOM Data Walk 

In January, our team participated in the North Carolina Institute of Medicine's (NCIOM) Healthy North Carolina 2030 Data Walk. We presented on the metric we developed, population per primary care provider in NC. It was great to talk to health department representatives from across the state - learn more about the project here.

Fraher presents to NC policy fellows on scope of practice 

North Carolina Institute of Medicine (NCIOM) hosts a yearly Legislative Health Policy Fellows Program which brings together lawmakers and health policy researchers and advocates to learn more about the health issues facing North Carolina. Fraher presented to policy fellows about scope of practice (SOP) regulations, issues and potential paths forward towards more evidence based SOP. Check out the presentation here. 

How do we define rural? 

To celebrate National Rural Health Day (November 19th)  the NC Rural Health Research Program (based at the Sheps Center), posted an informative twitter thread about how we define "rural." It's more complicated than you'd think, with multiple federal definitions using different measures of disparity and access. Our data analyst Evan Galloway, MSP joined the conversation with an alternative rural definition: rural as a measure of isolation. Check it out here on his Observable profile. 

de Zerden  featured in Modern Healthcare articles on social workers  

Lisa de Saxe Zerden, PhD, senior associate dean at the University of North Carolina at Chapel Hill School of Social Work and Carolina Health Workforce Research Center (CHWRC) researcher, was recently quoted in two Modern Healthcare articles, "Hospitals need more social workers and a way to afford them" and "Health systems hiring social workers despite reimbursement issues."

Recent scholarship 

Recent manuscripts
 Recent briefs
  •  Social Work and Electronic Health Records (EHR): A New Frontier for Health Workforce Research. Lisa de Saxe Zerden, MSW, PhD, Erica Richman, MSW, PhD, Brianna Lombardi, MSW, Kim Shoenbill, MD, PhD, Erin Fraher, PhD, MPP. Brief here, visual abstract here
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