“We know that a lot of clinical research occurs in academic health centers,” says Allison Cole, M.D., MPH, assistant professor in the Department of Family Medicine, “but most patient care occurs in community-based settings.”
A fruitful partnership that brings academia and the community together: that’s the rationale behind the WWAMI Region Practice & Research Network (WPRN). “Doing more research in real-world settings helps, ensure the research is applicable to real-world patients,” says Cole.
The WPRN, supported by the Institute of Translational Health Sciences and the Department of Family Medicine, consists of nearly 50 primarycare clinics in Washington, Wyoming, Alaska, Montana and Idaho, and its goals are twofold: to make sure the best healthcare is available in communities across the region and nation and to understand what’s important to patients and healthcare providers.
A real-world study of cell phone use
Amy Bauer, M.D., M.S., UW assistant professor in the Department of Psychiatry and Behavioral Sciences, recently conducted a study with the WPRN. She wanted to determine how and if patients used cell phones to access health information, and she surveyed 918 patients from WPRN clinics in four states. Here are her answers to our questions.
Why partner with the WPRN?
The WPRN serves a large region, including many rural and underserved areas. It was important to work with clinics outside Seattle to better understand broad patterns of use. Also, most treatment for mental disorders, here and abroad, takes place in primary-care clinics.
What were the study’s big takeaways?
Fifty-five percent of the patients we surveyed owned smart phones, and 70 percent of those patients use mobile health tools like WebMD. Despite concerns about a digital divide, we found that smartphone ownership and mobile health tools use were comparable regardless of race/ethnicity, health literacy, chronic diseases or depression.
Did anything surprise you?
Few patients felt it was important that their primary-care provider know that they used mobile health tools. Less than 10 percent reported that their provider had recommended one. We also found that disease-specific tools (e.g., for managing diabetes or depression) were rarely cited by patients as their favorite.
How are you distributing your findings?
We presented initial findings at the WPRN annual meeting in March 2014, and my next step is to discuss data and impressions with each clinic involved in the study. We also presented findings at two medical conferences, and we have a manuscript being published soon in the Journal of the American Board of Family Medicine.
What did the findings suggest?
That people are willing to use mobile apps to find health information, but that we need to maximize the technology’s potential to help manage chronic diseases, including depression and anxiety. I hope this research encourages providers, patients, researchers and technology developers to collaborate.
WALT HOLLOW, M.D. ’75
AN ELDER, A LEADER, AN ALUMNUS
A calming presence, a great teacher, always willing to help students. That’s how Hailey Wilson, M.D. ’14, now a family medicine resident, describes Walter Hollow, M.D. ’75, the first Native American to graduate from the UW School of Medicine.
“I first heard about Dr. Hollow when he was medical director at the Nez Perce Nimiipuu Health Center in northern Idaho,” Wilson recalls. “After I graduated from Boise State, he hired me as a patient educator, then urged me to apply to medical school. He’s been a wonderful mentor.”
To honor Hollow’s efforts to improve healthcare for Native Americans and to mentor students locally and nationally, the Washington Academy of Family Physicians (WAFP) honored Hollow with a 2014 Family Medicine Educator of the Year Award. The award also celebrates Hollow’s efforts to establish innovative education programs for Native healthcare professionals, notes Leo Morales, M.D. ’90, Ph.D., FACP, director of the School’s Center for Health Equity, Diversity and Inclusion (CEDI). “Dr. Hollow continues to be an ally and supporter of our efforts to recruit Native students and to address the health needs of Native people in our region,” Morales says.
Hollow was active on the Seattle Indian Health Board (SIHB) and UW Medicine’s clinical faculty, establishing family medicine residency rotations for physicians who wanted to work in Indian health. While with the School’s Office of Multicultural Affairs (now CEDI), he obtained a federal grant to create the Native American Center of Excellence, serving as director for 10 years.
“Dr. Hollow emphasized that traditional medicine is a vital partner to Western healthcare for Native patients,” says Terry Maresca, M.D., a UW Medicine clinical faculty member who works with the SIHB and the Puyallup Tribal Authority. “He put the UW School of Medicine on the map nationally as a magnet for Native students.”
Hollow also created UW Medicine’s Indian Health Pathway, an important curricular innovation that allows students of all backgrounds to learn how to work more effectively with Native patients. More than 75 medical students have received pathway certificates, and Hollow still serves as a preceptor.
“Indian health status is the lowest of any American minority group. Pneumonia, homicide, suicide, diabetes and chronic liver disease are the top five causes of mortality,” says Hollow. “The pathway curriculum teaches strategies for treating these problems and helps future physicians prepare for working successfully in Indian country.”
Walt Hollow, M.D. ’75, is admired for leading in a traditional way: with humility and grace, strength and compassion. He’s shown here discussing a patient’s chest X-ray with Brooke Parker, M.D. (off camera), a first-year family medicine resident.
A Force for Good
JAMIE L. GARCIA, M.D. ’99
A high-school dropout, a professional musician, a UW School of Medicine graduate and an advocate for the poor. That was Jamie Lynn Garcia, M.D. ’99, the founder of the Pomona Community Health Center in Pomona, Calif. Her patients knew her as Dr. Jamie.
Garcia left a musical career in her late twenties to attend UCLA, where she earned a degree in philosophy and ethics. After pursuing a medical degree at the UW School of Medicine, she decided to practice family medicine and began a residency at Pomona Valley Hospital Medical Center (PVHMC) in 2000. Low-income patients, she saw, were using the emergency room to get care for chronic conditions. Garcia was moved to do something about it.
First, Garcia partnered with PVHMC and the Los Angeles County Department of Public Health to create a small free clinic for homeless people, the uninsured and the under-insured. Then she set her sights on another goal: transforming that clinic into a larger, better equipped center that could help more people. Seed funding was awarded in April 2010. Unfortunately, Garcia was diagnosed with aggressive ovarian cancer five months later.
Garcia died in July 2012, the same month the new Pomona Community Health Center opened, but her spirit lives on in the bricks and mortar. “It’s a beautiful facility and a little light in an impoverished community,” says interim CEO Carmen Angulo. ”We treat everyone the same way, with dignity.”
Today, Pomona has two sites and a staff of about 23 people, and the patient population has doubled over the past year. Angulo estimates that the center will serve about 3,000 people, predominantly Latino, in 2014. Other advances: Pomona can now treat children, in addition to adults. And, thanks to government and foundation funding, staff will soon install an electronic medical records system.
“Dr. Jamie was a force,” says Angulo. “The mission that she founded in her heart — her legacy — will continue because our staff have that same passion and commitment to this community.”