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DoM Quality Recognition Program Honorees

Faculty and staff in the department of medicine (DoM) are committed to ensuring that our patients receive the highest quality of care, which is effective, equitable, and patient centered. As part of this goal, we place a high priority on quality improvement metrics that enhance the patient experience  and create a positive collaborative culture of excellence at UCLA Health. Within the department, our quality recognition leadership team has implemented the DoM Quality Recognition Program to recognize 25 high performing and improving primary care physicians and 10 clinics who are leaders in best practices within the scope of health maintenance and preventive care. I am pleased to honor and celebrate these quality leaders who achieved this recognition by addressing clinical quality gaps and providing exceptional patient care. We are proud to have them represent the department of medicine. As a department, we strive to remain on the forefront of quality improvement as we meaningfully incentivize our physicians to achieve these important goals.

DoM Residents in the UCLA Health Resident Informaticist Program

One strategy for improving quality within our practice is to leverage the electronic health record to improve processes and the patient experience at UCLA Health. The UCLA Health Resident Informaticist Program provides clinical trainees a year-long training experience that teaches how information technology can impact safety, quality, and efficiency of care. Each year, a cohort of trainees collaborate with mentors and the Department of Information Technology at UCLA Health to leverage the electronic health record to improve the delivery or management of care. We recently highlighted the 2023 graduates of the program. Today, I am pleased to introduce you to the incoming 2023-2024 cohort of DoM residents and fellows taking part in this valuable training program.

DoM Faculty Shine at AcademyHealth

Each year, AcademyHealth hosts an annual research meeting where stakeholders from health, health care and policy convene to discuss the latest findings and research on how health systems work, what they cost, and how we can improve them. This year, faculty from our division of general internal medicine and health services research gathered in Seattle, Washington to participate in and lead discussions. Nearly 30 presentations were led by DoM GIMHSR faculty. I am pleased to share that Carlos Oronce, MD, MPH, MSc was awarded the best presentation at AcademyHealth. Over 1,000 abstracts were submitted, 21 of these abstracts were top-rated, and eight were invited to present at the conference. Dr. Oronce’s esteemed presentation discussed the following:

"In the public health literature, there’s an appealing hypothesis that the United States experiences worse health outcomes and higher health care spending compared to other industrialized countries because we underinvest in social services (policies related to safety net programs, housing, public transit, infrastructure). The US is very large, however, and a large portion of social spending is under the discretion of local governments. Our study examined part of this hypothesis, focusing on variation in local social services spending and its relationship with how low-income vulnerable older adults utilize primary care and acute care services.

We merged claims data of Medicare beneficiaries who were enrolled in Medicaid from 2016 to 2018, with government finance data from the U.S. Census Bureau. We conducted a cross-sectional analysis and controlled for confounding variables that might be correlated with how much governments decide to spend on social services and the utilization of care for older adults (such as the number of primary care physicians in a community). We found that low-income older adults living in counties in the top quintile of spending on welfare, housing, and infrastructure services (utilities, building inspections, etc.) had significantly higher rates of annual primary care visits, compared to low-income older adults in the lowest quintile of spending. We also observed that those living in the top quintile counties for housing and public transit spending had significantly lower rates of preventable hospitalizations, a finding driven by lower rates of acute condition preventable hospitalizations (e.g. UTI, pneumonia). In absolute terms, our findings were clinically significant, translating to about 1 more primary care visit per person per year and about 18-20 lower hospitalizations per 1,000 older adults per year. 

This work suggests that governmental decisions on investing in social services may result in lower barriers to accessing primary care for vulnerable patients and prevent more costly hospitalizations."

The DoM’s Global Reach: Tannaz Moin, MD, MBA and Taiwan Ministry of Health  Affairs Discuss Diabetes Prevention Research and System-Wide Initiatives

Our department boasts world-renowned leaders in diabetes prevention research and system-wide initiatives. As a testament to the global reach of DoM faculty, the Taiwan Ministry of Health Affairs and the Taiwanese Association of Clinical Diabetes traveled to UCLA on June 15-16th to meet with Tannaz Moin, MD, MBA, MHSH and colleagues to inform implementation of diabetes care programs across primary care networks in Taiwan. Dr. Moin hosted a two-day diabetes prevention research meeting for leaders from Taiwan, which included presentations from UCLA leaders, faculty, research teams, the Centers for Disease Control and Prevention (CDC) Division of Diabetes Translation, and the University of California Diabetes Prevention Program Coordinating Center, which Dr. Moin co-directs with Associate Vice Provost Dr. Wendy Slusser. The meeting also included visits to the UCLA Teaching Kitchen and a session with active participation from internal medicine residents and faculty to learn more about healthcare in Taiwan. Other DOM faculty participants included Dr. Carol Mangione, Dr. O. Kenrik Duru, Dr. Sam Skootsky, and Dr. Neveen Al-Farra. Enjoy a few pictures from the meeting below. 

David Goodman-Meza, MD, MAS Presents to Mexico’s Senate About Treatment for Fentanyl Use Disorder and Potential Opportunities in the Country

David Goodman-Meza, MD, MAS from the division of infectious diseases, was recently invited to present in the Mexican Senate on his work related to fentanyl and opioids in Mexico. It was a full circle moment for David. He is originally from Mexico, studied Medicine in Tijuana, and one of his first manuscripts as a fellow at UCLA was alerting on the possibility of an opioid epidemic in Mexico published in America Journal of Public Health. Since then, he has published several manuscripts on the presence of fentanyl in Mexico, the need for an overdose prevention space, the impact of an overdose reversal program and the penetration of fentanyl in Northern Mexico, the qualitative experiences of women using fentanyl and their behavior change to fentanyl testing, and a policy agenda on how to address opioid use in Mexico. His body of work has been published in leading public health and addiction journals like Lancet, Lancet Public Health, Lancet Americas, Drug and Alcohol Dependence, Harm Reduction, and International Journal of Drug Policy. In the Mexican Senate, he gave a passionate speech on the need for evidence-based medications and interventions to treat people with opioid and fentanyl use disorder and to use a low barrier approach to engage people with this disease. He noted that currently there are no medications available to treat opioid use disorder in Mexico. This after the government closure of the only manufacturer of methadone in the country leading to a public health crisis and increases in overdoses. 

Coincidentally the next day, David was quoted in the LA Times related to a story around fentanyl overdose in Mexico which contradicts the official narrative in Mexico that fentanyl is not used and overdoses do not occur due to the drug.

Mexico says it doesn't have a fentanyl problem. New data reveal a hidden epidemic

Data compiled by a medical examiner in northern Mexico reveal that fentanyl use is far more common there than the country's leaders have claimed.

Read the Article >

Douglas Ruiz Carbal Appointed Director of Education in the Department of Medicine

Please join me in congratulating Douglas Ruiz Carbajal who has been appointed the director of education in the DoM. Doug succeeds Libby Shin, who previously served in this role. Douglas joined the internal medicine residency program education team in 2014 and served as the program coordinator. He has extensive experience overseeing program operations which includes complex scheduling logistics across the multitude of training locations, program accreditation, and office administration management.

He was recently appointed chair of the Association of Program Directors in Internal Medicine/Program Administrator Advisory Council, which represents and advocates for program administrators within the national organization, while promoting collaboration and professional development within the administrator community. He was a member of the AAIM Learner Handoff Standards Task Force from 2021-2022 that resulted in the development of an Individualized Learner Plan to ease the transition of students from Undergraduate Medical Education to Graduate Medical Education.

Doug has a deep passion for promoting the development and success of others. On behalf of the department, I wish him well as he assumes this leadership position which will continue to position us as a premiere training program. Welcome on board!

DoM Wellness Townhalls 

Throughout the month of August and September, we will be hosting five regional town halls to discuss the department's wellness initiatives. I encourage you to attend a regional meeting and share your thoughts about wellness within the DoM. Get full details and make sure to RSVP by Monday, July 24th by visiting HERE.  

Dale

P.S.

The visit with my granddaughter ended this weekend. Even though she insisted on me trying her shades, we agreed that she would keep them in the end. Missing her already and planning the next visit!

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