Welcome to the Hospital Medical Home Demonstration

Welcome to the Hospital Medical Home Demonstration Project
Annual Conference. You are joining representatives from 62
teaching hospitals, 160 primary care training clinics, and 118
residency programs across New York State. All of them have
committed to joining the New York State Department of Health
to transform care in outpatient clinics and train residents in
settings that provide the absolute highest quality of primary
care. Patients will benefit from care that is coordinated, teambased, evidence-based, and patient-centered, and primary care
residents will have been trained to successfully practice in the
new job description for primary care. We are here today to
celebrate our many successes as you will hear from many
presenters and see from the poster session, and to collaborate
on our next steps.
Thank you for coming,
Marietta Angelotti, MD
Associate Medical Director
Office of Quality and Patient Safety
New York State Department of Health
Foster C. Gesten, MD, FACP
Medical Director
Office of Quality and Patient Safety
New York State Department of Health
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HOSPITAL MEDICAL HOME PROJECT
ANNUAL MEETING JANUARY 23, 2014
AGENDA
9:30
CHECK-IN AND REGISTRATION BEGINS
10:00 WELCOME AND INTRODUCTIONS
MARIETTA ANGELOTTI, MD
10:05 WHY A HOSPITAL MEDICAL HOME DEMONSTRATION?
FOSTER C. GESTEN, MD, FACP
10:15 PRIME TIME FOR PRIMARY CARE
NIRAV SHAH, MD, MPH
10:30 ARE PHYSICIANS KNIGHTS, KNAVES, OR PAWNS?
IMPLICATIONS FOR GRADUATE MEDICAL EDUCATION
SACHIN JAIN, MD, MBA
11:15 COLLABORATIVE CARE IN THE HMH
LLOYD I. SEDERER, MD
11:30 LEADERSHIP PANEL: RESIDENCY, CLINIC, AND HOSPITAL LEADERSHIP FACILITATED BY FOSTER C. GESTEN, MD, FACP
NEIL S. CALMAN, MD
DAVID CLARK, MD
JON SWARTZ, MD
TOM CAMPBELL, MD
JUDY TUNG, MD, FACP
12:30 LUNCH BUFFET
POSTER SESSION: FACILITATED BY ANU ASHOK, MPH & CARLA NELSON, MBA
HMH PORTAL DEMONSTRATION PRESENTED BY JAZ-MICHAEL KING: JOIN MEMBERS OF THE WEB PORTAL
DEVELOPMENT TEAM TO EXPLORE FEATURES AND FUNCTIONS OF THE HMH REPORTING TOOL.
SPECIAL THANKS TO ST. LUKE’S-ROOSEVELT
1:30
1.
BREAK OUT SESSIONS
BEST PRACTICES IN CARE TRANSITIONS: FACILITATED BY MARY THERRIAULT, RN, MS & NICOLE HARMON, MBA HEALTHCARE ASSOCIATION OF NEW YORK STATE
CHRISTINA PAVETTO BOND, MS, FACHE
VISHALAKSHI SUNDARAM, MD
2.
BENJAMIN RUDD, MD
CARMEN TAMAYO, MD
INTEGRATING BEHAVIORAL HEALTH INTO ADULT PRIMARY CARE: NEW YORK STATE OFFICE OF MENTAL HEALTH &
THE AIMS COLLABORATIVE OF THE UNIVERSITY OF WASHINGTON
MARISA DERMAN, MD
VIRNA LITTLE, PSYD, LCSW-R, SAP
3.
PCMH FOR PEDIATRICS
EUGENE DINKEVICH, MD
BRAD OLSON, MD
HARRIS HUBERMAN, MD, MPH
4.
TYLER JAMES, MPH
ASHLEY MACON HEALD
STEPHEN BLATT, MD
NEELIMA NAYYAR-GUJRAL, RN
PCMH CURRICULA FOR RESIDENTS: FACILITATED BY PRIMARY CARE DEVELOPMENT CORPORATION
SAIMA CHAUDHRY, MD, MSHS
WILLIAM ROLLOW, MD
2:45
AFTERNOON BREAK
3:00
FACILITATORS REPORT BACK ON BREAK-OUT SESSIONS
3:45
NEXT STEPS
ALAN MITCHELL
FOSTER C. GESTEN, MD, FACP
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BEST PRACTICES ON CARE TRANSITIONS: BREAK OUT SESSION
This breakout session of the Hospital Medical Home Annual Meeting will examine how poorly planned
care transitions can result in serious health care complications and hospital readmissions. The panelists
will share their strategies for successful care transitions, including how to conduct effective medication
reconciliation, schedule timely follow-up care, and identify emerging health issues after discharge.
CHRISTINA PAVETTO BOND, MS, FACHE, ASSOCIATE, STRATEGIC INTEGRATION, ST. JOSEPH’S HOSPITAL HEALTH CENTER
BENJAMIN RUDD, MD, FAMILY MEDICINE PROGRAM, SAMARITAN MEDICAL CENTER
SHALA SUNDARAM, MD, CLINICAL FACULTY, PHELPS FAMILY MEDICINE RESIDENCY PROGRAM
CARMEN TAMAYO, MD, FAMILY MEDICINE RESIDENT, PHELPS MEMORIAL HOSPITAL CENTER
FACILITATORS:
NICOLE HARMON, MBA, PCMH CCE, DIRECTOR, PATIENT CENTERED MEDICAL HOME ADVISORY SERVICES, HEALTHCARE
ASSOCIATION OF NEW YORK STATE (HANYS)
MARY THERRIAULT, RN, MS, SENIOR DIRECTOR, QUALITY AND RESEARCH INITIATIVES, HANYS
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INTEGRATING BEHAVIORAL HEALTH INTO ADULT PRIMARY CARE- THE COLLABORATIVE CARE INITIATIVE
COLLABORATIVE CARE: AN INTRODUCTION
Individuals with common mental disorders such as depression, (which annually affects nearly 20% of the
population of U.S. Medicaid recipients), typically do not receive treatment in specialty mental health
settings licensed or operated by OMH, but in primary care settings. Past efforts to foster screening in
primary care settings and train primary care providers in the treatment of depression have not been
successful; the result: diminished ability of untreated individuals to care for themselves and adhere to
treatment plans, producing significant medical morbidity and mortality, reductions in quality of life and
increased health care costs.
To improve outcomes, OMH and DOH are engaged in an initiative to implement the Collaborative Care
approach to addressing common mental health conditions in primary care settings. Collaborative Care
programs follow the principles of measurement-based care, treatment-to-target, and stepped care, and
other aspects of the chronic illness care model proposed by Wagner and colleagues. This team approach
includes: 1) training the primary care team to screen for and treat depression using a collaborativelydeveloped, shared care plan; 2) employing care managers in the primary care setting who engage and
educate patients, provide evidence-based psychotherapeutic interventions, support medication therapy,
measure treatment outcomes at each patient contact and use the information to prompt proactive
changes in treatment until patients achieve at least a 50% reduction in symptoms or remission, teach
patients relapse prevention strategies once they are well; and, 3) weekly check-ins between the care
manager and a psychiatric consultant who proactively reviews treatment outcomes of patients
currently engaged in care, provides consultation regarding diagnosis and treatment planning, and offers
suggestions for changes in treatment when patients are not improving as expected. The Collaborative
Care approach incorporates a standardized measurement of depression (often the PHQ-9) to detect and
track the progress of depressed patients; this monitoring allows the primary care team to recognize
when treatment needs to be changed or intensified or when referral to specialty care is necessary.
Referrals to specialty mental health care are typically reduced when effective care is delivered in the
primary care setting, thereby sparing specialty mental health resources for those with the most
significant mental health conditions.
Over the past 15 years, more than 70 randomized controlled trials have established a robust evidencebase for Collaborative Care. Trials of Collaborative Care have been conducted in diverse health care
settings, including network and staff model health systems, and private and public providers; with
different financing mechanisms, including fee-for-service and capitation; different practice sizes; and
different patient populations, including both insured and uninsured/safety-net populations. Of note,
several studies have demonstrated that collaborative care programs are not only highly effective in
safety net patients and patients from ethnic minority groups but they can reduce health disparities
observed in such populations. The largest randomized controlled trial of Collaborative Care
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demonstrated that patients were more than twice as likely as those receiving usual care, even when
usual care included a co-located Master’s level provider in the primary care setting, to experience a
substantial improvement in depression symptoms over a 12 month period. They also had less physical
pain, better social and physical functioning, and better overall quality of life than patients in usual care.
Collaborative Care has been recognized as an evidence-based practice by SAMHSA’s NREPP Program
(National Registry of Evidence-based Practices)
[http://nrepp.samhsa.gov/ViewIntervention.aspx?id=301] It has also been recommended as a “best
practice” by the Surgeon General’s Report on Mental Health
(http://www.surgeongeneral.gov/library/mentalhealth/home.html), the President’s New Freedom
Commission on Mental Health (http://store.samhsa.gov/product/SMA03-3831), and a number national
organizations including the National Business Group on Health
(http://www.businessgrouphealth.org/benefitstopics/et_mentalhealth.cfm). In a recent evidence-based
practice report by AHRQ that reviewed the existing literature on approaches to Integration of Mental
Health/Substance Abuse and Primary Care (http://www.ahrq.gov/clinic/tp/mhsapctp.htm), the IMPACT
program was profiled as “the study with the strongest results.”
COLLABORATIVE CARE BREAKOUT SESSION AGENDA
Introduction to Collaborative Care: a brief overview of the model and core principles
Collaborative Care Initiative: project overview
Information Technology and Collaborative Care
Training Workforce and Engagement of Key Participants
Finance and Regulatory Issues
FACILITATORS
Lloyd Sederer, MD, Medical Director, New York State Office of Mental Health
Marisa Derman MD, MSc, New York State Office of Mental Health
Virna Little, PsyD, LCSW-r, SAP, Senior Vice President of Psychosocial Services and Community Affairs,
The Institute for Family Health
Tyler James, MPH, Program Director for New York State Collaborative Care Initiative, The Institute for
Family Health
ADDITIONAL RESOURCES
AIMS Center: http://uwaims.org
For Innovative Practices sites: http://uwaims.org/nyscci/ipg/index.html
For PCMH Grantee sites: http://uwaims.org/nyscci/pcmh/index.html
Integrated Behavioral Health Care Quality Measures: http://integrationacademy.ahrq.gov/atlas
Article of Interest: http://www.medicaid.gov/State-Resource-Center/Medicaid-State-TechnicalAssistance/Health-Homes-Technical-Assistance/Downloads/HH-IRC-Collaborative-5-13.pdf
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EVIDENCE-BASED DEPRESSION CARE PRACTICES
SETTING, STAFFING AND SUPERVISION
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Designated staff (care manager) to support depression treatment.
Care manager who participates in regularly scheduled, ongoing (e.g., weekly) caseload supervi
sion with a Psychiatrist who makes treatment
recommendations for patients who are not improving.
Consulting psychiatrist available by phone or in person for ad hoc consultation to care manager
and primary care providers.
Consulting psychiatrist available to evaluate patient and make treatment
recommendations, if needed.
PATIENT EDUCATION

Education about depression and treatment options provided to patients.
TREATMENT PLANNING AND DELIVERY
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Treatments used are consistent with evidence based treatment guidelines for depression.
Primary care provider makes or confirms diagnosis of depression, prescribes anti-depressant
Medication, educates the patient about wellness, and makes changes in treatment in
consultation with care manager and/or consulting psychiatrist if patient is not improving.
Patients receive follow-up by phone or in-person within two weeks of starting new medication
or changing medication to evaluate for adherence and side effects.
Patients receive proactive assistance with management of side effects.
Activity scheduling (behavioral activation) provided by care manager as part of treatment.
Evidence-based counseling (such as Problem-Solving Treatment) offered, either as a primary
treatment or adjunct to medication therapy.
Referral to mental health or substance abuse specialty care, if needed.
Evidence based Depression Care Practices
TRACKING TREATMENT OUTCOMES
 In-person or phone follow-up at least once every two weeks during the active phase of
treatment to monitor adherence and response to treatment.
 In-person or phone follow-up at least once a month during the maintenance
phase of treatment.
 Use of phone to reach patients who cannot make clinic appointments.Depressive symptoms
monitored at each contact with a rating scale (e.g. PHQ-9) that quantifies treatment response.
 Staff and providers use a registry or other tracking system to follow patients and ensure that
they do not fall through the cracks.
TREATMENT BASED ON OUTCOMES (STEPPED CARE)
 All treatment plans have a ‘shelf life’ of no more than 10 weeks (12 weeks for older adults).
 If the patient is not at least 50% improve at the end of the 10 weeks, the treatment plan is
changed ( increase dose, medication change, add counseling, psychiatric consultation, etc.)
RELAPSE PREVENTION
 Patients who are in remission complete a relapse prevention plan that is communicated to their
primary care provider.
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REQUIRED METRICS
CARE MANAGER FTE
NUMERATOR DEFINITION: Outpatient site staff care manager time (FTE equivalent)
dedicated to delivering depression care management in the Collaborative Care
Initiative.
DENOMINATOR DEFINITION: Place the “#1”
DEPRESSION SCREENING
NUMERATOR DEFINITION: Number of adult patients per year from the outpatient
site who received a PHQ-2 or a PHQ-9.
DENOMINATOR DEFINITION: All patients from the outpatient site.
PATIENTS DIAGNOSED WITH
DEPRESSION
NUMERATOR DEFINITION: Number of patients screened positive from the outpatient
site who were then diagnosed with depression (eliminates false positives on
screen).
DENOMINATOR DEFINITION: All patients from the outpatient site screened positive
for depression.
PATIENTS ENROLLED IN A
PHYSICAL-BEHAVIORAL
HEALTH PROGRAM
NUMERATOR DEFINITION: Number of patients from the outpatient site screening
positive for depression who enrolled in physical-behavioral health care
coordination program (Collaborative Care Initiative).
DENOMINATOR DEFINITION: All patients from the outpatient site screened positive
for depression.
ENROLLED PATIENTS WITH
PSYCHIATRIC CONSULT
NUMERATOR DEFINITION: Number of patients enrolled in the Collaborative Care
Initiative referred for psychiatric consultation
DENOMINATOR DEFINITION: All patients enrolled in the Collaborative Care Initiative.
PHQ-9 DECREASES BELOW 10
IN 16 WEEKS OR GREATER
NUMERATOR DEFINITION: Number of patients enrolled in the Collaborative Care
Initiative whose PHQ-9 went from at >10 to <10 in 16 weeks or greater.
DENOMINATOR DEFINITION: All patients enrolled in the Collaborative Care Initiative.
RECEIVING MEDS/THERAPY
AFTER SIX MONTHS
NUMERATOR DEFINITION: Number of patients enrolled in the Collaborative Care
Initiative still receiving medication and/or psychotherapy six (6) months after
enrollment.
DENOMINATOR DEFINITION: All patients enrolled in the Collaborative Care Initiative.
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PCMH FOR PEDIATRICS
This breakout session of the Hospital Medical Home Annual Meeting will examine how the HMH goal of
extending ambulatory training to enhance patients’ and residents’ continuity of care experience applies
in the care of pediatric patients. This session is appropriate for Pediatric and Family Medicine Residents.
The session will focus on the patient-centered medical home and organizing “wrap-around care”, on
implementing systematic developmental screening and follow-up, on providing culturally competent
care, and on providing care coordination for high risk subpopulations – in each case emphasizing the
impact on residency training. A goal of the session is for all sites to share and learn from each other.
The session will be interactive, with mini-breakout sessions focusing on 4 areas of interest (see agenda
below). A list of Mini-breakout: Questions to be addressed is also provided and participants are
encouraged to review these questions and come prepared to share their own experiences and ideas.
PEDIATRIC BREAK OUT SESSION AGENDA
1:30 – 2:00
2:00 – 2:30
2:30 – 2:45
SPEAKER PRESENTATIONS: “UPSTATE” & “DOWNSTATE” HMH IMPLEMENTATION EFFORTS IN THE
CONTINUITY CLINIC
Description of individual programs with focus on continuity resident involvement
and care integration and coordination initiatives
4 MINI BREAKOUT GROUPS FOCUSED ON APPROACHES TO CARE INTEGRATION & COORDINATION
INITIATIVES
1. Organizing care teams to ensure access, continuity and wraparound care
2. Integration of developmental screening and follow-up in the primary care
setting
3. Improved care coordination for special needs populations
4. Enhancing interpretation services & culturally competent care
RECONVENE AND PRESENT PROBLEMS/APPROACHES FROM GROUP DISCUSSIONS
MINI-BREAKOUT: QUESTIONS TO BE ADDRESSED
Each of the groups can address any number of the questions listed below:
 What are the priority care coordination & development/behavioral needs in the communities
served by your clinic?
 How do you currently provide care coordination/wrap-around care for families/children with
complex needs?
 How do you currently provide preventive interventions/guidance in the areas of behavior/child
development?
 How do you envision implementing a care coordination and/or development/behavioral initiative
at your site? What will be its main components?
 How do you currently implement developmental screening guidelines?
 How do you determine which subpopulations require care coordination?
 How do you/will you provide training to staff related to your care coordination and
development/behavioral initiative?
IMPACT ON RESIDENCY TRAINING
 How does PCMH enhance residency training?
 What barriers does PCMH add to residency training?
 What do residents learn better from PCMH than they learned before PCMH?
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SUSTAINABILITY & OUTCOMES
 How do you make it sustainable?
 How do you/will you staff it?
 How will you utilize data systems to support both day-to-day operational functions and
reporting/outcome data analysis?
 What are the outcomes you do/plan to measure to examine efficacy of your initiative?
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RESIDENCY CLINIC PCMH CURRICULA
PCMH TRAINING FOR RESIDENTS: MEDICAL HOME EDUCATION FOR THE NEXT GENERATION OF PRIMARY CARE
PRACTITIONERS
Presenters
WILLIAM ROLLOW, MD MPH
PRIMARY CARE DEVELOPMENT CORPORATION
CONSULTING MEDICAL DIRECTOR
ALAN MITCHELL
PRIMARY CARE DEVELOPMENT CORPORATION
SENIOR PROGRAM MANAGER
SAIMA CHAUDHRY, MD
HOFSTRA NORTH SHORE LIJ SCHOOL OF MEDICINE
RESIDENCY PROGRAM DIRECTOR AND VICE CHAIR OF EDUCATION
Abstract
In this session, an overview will be provided of issues relating to the training of primary care residents in
the PCMH model: residency requirements, approaches that programs have taken to training, challenges
that programs are facing, and best practices that have been identified. Panelists will discuss a training
curriculum developed for the HMH program and implemented at two hospitals, and the experience of a
large teaching center in PCMH incorporation into residency training.
Following panel presentations, there will be panel and group discussion of questions/issues including
the following:
 Some programs do not have comprehensive, systematic PCMH training. Is such training
desirable? Should PCMH simply be embedded into other training that residents are provided?
 Some programs are using systematic curricula. What are important attributes of such curricula?
 Time and logistics are significant issues in providing PCMH residency training. How have
programs dealt with these issues?
 PCMH training involves process and culture change. How can this be effectively incorporated
into a clinical training program?
 A number of programs involve residents directly in PCMH transformation, performance
assessment, and continuity of care. Some involve patients in PCMH residency training. What
experiences do you have in such best practices?
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GUEST SPEAKERS AND PANELIST BIOGRAPHIES
STEVEN D. BLATT, MD
Dr. Blatt is Professor of Pediatrics and Director, Division of General Pediatrics at Upstate Medical
University and Medical Director of University Pediatric and Adolescent Center. He holds a courtesy
faculty appointment in the College of Law at Syracuse University. Since 1991 Dr. Blatt has been the
Director of ENHANCE Services for Children in Foster Care, a multidisciplinary, comprehensive and
primary health care program for children in foster care. He has served on the Permanent Judicial
Commission on Justice for Children, chaired by Hon. Judith Kaye and the Children’s Cabinet Advisory
Board to the Governor of NY. Along with faculty from Syracuse University College of Law, Dr. Blatt codirects the Syracuse Medical-Legal Partnership that increases access to legal services for patients and
their families and is a former Assistant National Medical Director of the National Center for MedicalLegal Partnership. Dr. Blatt has collaborated with the Department of Health, the Department of Social
Services and other community agencies in improving the health care of medically underserved and atrisk children in Central New York. Dr. Blatt has participated on local, state and national advisory
committees to governmental agencies, including the American Academy of Pediatrics, the Center on
Human Policy, and the Child Welfare League of America. Dr. Blatt was an Academic Pediatric
Association National Faculty Development Scholar and a member of the Regional Advisory Committee
for Community Faculty Development at the University of Massachusetts.
NEIL S. CALMAN, MD
Dr. Calman is a Board Certified family physician who has been practicing in the Bronx and Manhattan for
the past 35 years. He is President and co-founder of the Institute for Family Health. Since 1983 Dr.
Calman has led the Institute in developing family health centers in the Bronx, Manhattan and the
Hudson Valley and in establishing health professional training in medicine, nursing, administration and
mental health. In 2012 Dr. Calman became Professor and Chair of the newly-established Department of
Family Medicine and Community Health at the Icahn School of Medicine at Mount Sinai.
Dr. Calman is a longstanding member of the New York State Council on Graduate Medical Education and
on the Board of the Community Health Care Association of New York State. He is a member of the
Executive Committee of the New York eHealth Collaborative and was appointed by the Obama
Administration as an expert in the care of vulnerable populations to HRSA’s HIT Policy Committee where
he serves on the Meaningful Use Subcommittee. Dr. Calman is also a member of the National Health IT
Collaborative for the Underserved established by the Office of Minority Health of the US Department of
Health and Human Services.
Dr. Calman is the recipient of many national awards for his work in Public Health including the Robert
Wood Johnson Foundation's Community Health Leadership Award, the American Academy of Family
Physicians' Public Health Award, the Pew Charitable Trusts' Primary Care Achievement Award and the
Physician Advocacy Award from the Institute on Medicine as a Profession. In September of 1999, Dr.
Calman became the project director of a multi-year grant from the Centers for Disease Control, to work
towards eliminating racial and ethnic differences in health outcomes in the Bronx. His published essay
Out of the Shadows (Health Affairs, Jan/Feb 2000) details his experiences in dealing with racism in the
care of his patients. Making Health Equality a Reality: The Bronx Takes Action (Health Affairs, Mar/Apr
2005) describes the community based legislative action that has evolved from this grassroots effort to
address institutional racism in medical care. Separate and Unequal Care in New York City. (Journal of
Health Care Law & Policy 2006) reports on the Institute’s investigation of discrimination in NYC
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hospitals. Dr. Calman’s work has been featured in chapters in three books, one on the history of family
medicine (Caring for America, Stannard), one on not-for-profit leadership in healthcare (To Give Their
Gifts, Couto) and one on primary care in America (Big Doctoring in America, Mullan).
In 2002, the Institute became one of the first community health center networks in the country to
implement a fully integrated electronic medical record and practice management system (Epic),
improving both preventive and chronic care treatment outcomes throughout its centers. In recognition
of this achievement, Dr. Calman received the prestigious 2006 Physician’s Information Technology
Leadership Award, presented by the Healthcare Information and Management Systems Society (HIMSS).
In 2008 the Institute received the HIMSS Davies Award in Public Health in recognition of its
development of public health functionality into its EHR. In 2008 the New York Times recognized the
Institute with its Non-profit Excellence Award in the Use of Technology and Focus on Mission. In 2011
the Institute initiated a project with the National Library of Medicine to hyperlink diagnoses, medication
names and test names to the NLM Medline Plus database which is available free in the public domain.
This project received the HRSA Innovation of the Year Award in 2011 and this free functionality is
available to EHR users across the country. This year, the Institute received the Organization of the Year
award from the e-Health Initiative which lauded the organization for innovations that are shared openly
with other health care providers.
The Institute for Family Health is a federally qualified community health center network, founded in
1983, dedicated to providing primary health services to medically underserved populations. It operates
18 full-time health centers in the Bronx, Manhattan and the Mid-Hudson Valley, including two schoolbased health centers, and eight part-time centers that care for people who are homeless. The
organization serves nearly 100,000 patients who make 425,000 visits each year.
In 2009, the Institute achieved Level 3 certification for all of its sites as a primary care medical home
from the National Committee on Quality Assurance.
The Institute operates more than 50 grant funded programs, several of which support the goals of
eliminating health disparities and providing access to quality health care to all, regardless of ability to
pay. For ten years, it has been a leader of a program designed to eliminate racial and ethnic disparities in
health outcomes funded by the Centers for Disease Control and the National Institutes of Health, and
was recently named a National Center of Excellence in the Elimination of Disparities.
The Institute also operates three residency training programs in family medicine designed to train
providers to serve the underserved, including two in Manhattan, focused on urban communities, and
one in Kingston, NY, focused on rural communities.
The Institute is a founding member of Family Health ACO, LLC along with Hudson River Community
Health and Open Door Family Medical Centers – a Medicare Shared Savings Plan that began on January
1st of 2014.
THOMAS L. CAMPBELL, MD
Thomas L. Campbell, M.D. is the William Rocktaschel Professor and Chair of Family Medicine at the
University of Rochester School of Medicine and Dentistry and Associate Director of the University’s
Center for Primary Care. He is the Board Chair and Past President of the Association of Departments of
Family Medicine and serves on the core committee examining the Future of Family Medicine, a national
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project sponsored by the seven Family Medicine organizations. He has written extensively on the
influence of the family on health and the role of mental health in primary care. His NIMH monograph,
Family’s Impact on Health, has been an influential review of the research in this area. Other books, he
has co-authored include: Families and Health with William Doherty, Ph.D. and Family-oriented Primary
Care (second edition) with Susan McDaniel, Ph.D., Alan Lorenz MD and Jeri Hepworth, PhD. He coedited (with Susan McDaniel) , Families, Systems & Health: The Journal of Collaborative Family
Healthcare.
SAMIA CHAUDHRY, MD, MSHS
Dr. Chaudhry currently serves as Residency Program Director and Vice Chair of Education at the Hofstra
North Shore LIJ School of Medicine. She graduated from New York University School of Medicine and
completed her internal medicine residency at UCLA Medical Center in California. Her interests in medical
education led her to pursue a fellowship with the Robert Wood Johnson Clinical Scholars Program also
at UCLA where she obtained her Masters of Science in Health Services. As program director, Dr.
Chaudhry was responsible for the 2010 successful merger of the North Shore and LIJ Internal Medicine
Residency Programs, now with approximately 135 house staff. Her residents work in an NCQA level 3
PCMH. She serves as the vice chair of the APDIM Survey Committee, Councilor for the American College
of Physicians NY Chapter, and future president for the APDIM NY Special Interest Group. She was
recently nominated to the New York State Council on Graduate Medical Education (COGME).
DAVID A. CLARK, MD
Dr. Clark is Professor and Chairman of Pediatrics at Albany Medical Center. He continues to practice
clinical neonatology and inpatient general pediatrics. He is a graduate of the State University of New
York, Upstate Medical Center in Syracuse. He completed pediatric residency training at the University
of North Carolina at Chapel Hill and Neonatology Fellowship training at Rainbow Babies and Children’s
Hospital (Cleveland) and SUNY Upstate Medical Center (Syracuse).
He has been an advocate for children, the primary care medical home, and community and subspecialty
pediatricians for over 35 years, including 10 years in New Orleans. Since returning to New York State in
1998, he has been directly involved with many efforts of AAP District II with the various branches of
New York State government. These include newborn and metabolic screening, the use of medications in
schools, regionalization of perinatal care and child passenger safety. He is a member of the AAP
Committee on Federal Government Affairs as the Chair of the Advocacy Committee of the Association of
Medical School Pediatric Department Chairs.
He has extensive experience in working with children with disabilities and special needs. He is the
author and editor of 5 books, 3 which deal with children with disabilities, early intervention and
continuation of care with special education. He is the author of over 100 peer reviewed articles, over
150 abstracts, and numerous invited chapters. He is a member of the American Academy of Pediatrics,
the Society of Pediatric Research, the American Pediatric Society, and the Association of Medical School
Pediatric Department Chairs.
He and his wife Darlene have three daughters and six grandchildren.
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EUGENE DINKEVICH, MD
Dr. Dinkevich is an associate professor of clinical pediatrics in the Department of Pediatrics at SUNY
Downstate Medical Center and the Director of Downstate’s Pediatric Ambulatory Services. He is the
Director of Downstate’s HMH pediatric Patient Centered Medical Home program. An area of interest is
childhood obesity including feeding practices and other factors which shape excessive weight gain, and
primary care approaches to help children achieve and maintain normal weight and healthy lifestyles. Dr.
Dinkevich is the director of the Downstart Healthy Lifestyles center at SUNY Downstate, which uses a
team approach to evaluate children and institute healthy lifestyle, dietary and fitness interventions.
FOSTER C. GESTEN, MD, FACP
Foster Gesten is the Medical Director for the Office of Quality & Patient Safety in the New York State
Department of Health. Dr. Gesten provides clinical direction and leadership for a team of professionals
engaged in quality oversight, performance measurement and clinical improvement within health plans
and public insurance programs in New York.
Major initiatives include the development of statewide public reporting systems for commercial,
Medicaid, and Child Health managed care programs on quality, access, and satisfaction, medical home
demonstrations, provider based quality measurement and improvement, and patient safety. His
interests include population health, health service research, and quality improvement projects directed
at prevention services and chronic care.
Dr. Gesten is a member of the Committee on Performance Measurement (CPM) at the National
Committee for Quality Assurance (NCQA), and a member of the Measure Application Partnership
Coordinating Committee of the National Quality Forum (NQF).
Dr. Gesten was trained in general internal medicine at Brown University
NEELIMA NAYYAR-GUJRAL, RN
Ms. Nayyar-Gujral is the Nurse Coordinator for SUNY Downstate’s Division of Child Development. She
coordinates the Division’s developmental clinics as well as the Behavior & Development resident
training module. Ms. Nayyar-Gujral has extensive experience in pediatric primary care nursing, and has
certificate training in patient care coordination. She currently serves as a Developmental Care Manager
in Downstate’s ambulatory pediatric clinic. Ms. Nayyar-Gujral is also one of the few New York
developmental providers who conducts ADOS evaluations in Urdu.
HARRIS S. HUBERMAN, MD, MPH
Dr. Huberman is a developmental pediatrician and the director of the SUNY Downstate Division of Child
Development. He leads the Behavior & Development module of the Downstate’s pediatric residency
program and is Co-Director of the Human Development course for medical students. Dr. Huberman has
a background in pediatric primary care, and has served as the Medical Director of a .330 community
health center in the Bronx. He also served as the Medical Director of the NYC Infant Child Health
Assessment Program, at the time the Part H Child Find component of the NYC Early Intervention
program which used public health approaches to identify and serve children at-risk for developmental
delay. Areas of interest include public health and its intersection with child development, preventive
15
parenting programs to improve developmental outcomes for children living in poverty, autism spectrum
disorder and international health.
ALAN MITCHELL
Alan has 15 years of experience in the technology and non-profit sectors, and has been working with
PCDC since 2008 to enhance the performance of primary care practices, particularly in medically
underserved areas. Alan currently serves as a project manager on several large-scale projects. Through
this work, Alan collaborates closely with hospitals and ambulatory practices to improve quality,
implement health information technology, and achieve Patient Centered Medical Home recognition. In
addition, he leads PCDC’s role as a Regional Extension Center implementation agent, focusing on
Meaningful Use. Alan’s expertise also includes strategic planning and change management. He is an
NCQA-certified PCMH Content Expert and was educated at the College of William and Mary in Virginia.
BRADLEY OLSON, MD
Dr. Olson is an Associate Professor of Pediatrics at SUNY Upstate Medical University where he serves as
an Associate Program Director for Resident Education responsible for curriculum design &
development. Aside from his interests in medical education, his clinical area of focus includes Pediatric
International Health. He is the director of the Pediatric Global Health Clinic at SUNY Upstate Medical
University where he cares for a large pediatric refugee population. In the last several years his area of
focus has concentrated on medical education and curriculum development. He has worked with the
School of Education from Syracuse University in the development of a novel online core curriculum for
pediatric resident education. Most recently he has collaborated with the faculty from UCSF medical
center to create a comprehensive shared online curriculum for pediatric resident education.
SACHIN JAIN, MD, MBA
Dedicated to harnessing the power of data, technology, medical science and collaboration to improve
patient health, Sachin Jain, M.D., M.B.A., is chief medical information and innovation officer (CMIIO) at
Merck. His charge includes developing strategies and global partnerships to leverage health data to
improve patient health. Dr. Jain’s work emphasizes understanding of real-world patient experiences and
outcomes and applying that knowledge to appropriate use of medications, medication adherence, and
advancing medical discovery.
16
Medicine is at the core of his efforts, and in addition to his role as CMIIO at Merck, Dr. Jain continues to
serve as an attending hospitalist physician at the Boston VA-Boston Medical Center, and is a lecturer in
healthcare policy at Harvard Medical School.
Prior to joining Merck, Dr. Jain was senior advisor to the administrator of the Centers for Medicare and
Medicaid Services (CMS), where he helped launch the Center for Medicare and Medicaid Innovation,
briefly serving as its acting deputy director for policy and programs. He also served as special assistant to
the National Coordinator for Health Information Technology at the Office of the National Coordinator
for Health Information Technology (ONC), supporting the agency’s implementation of the HITECH
Provisions of the Recovery Act, which provide incentives for physicians and hospitals to become
meaningful users of health information technology.
An advocate for faster translation of healthcare delivery research into practice, Dr. Jain has been drawn
to the transformational relationship between a patient and caregiver, and ensuring patients’ access to
both medicines and to caring, comprehensive treatment. To that end, Dr. Jain is a founder of several
non-profit healthcare ventures including the Homeless Health Clinic at the Harvard Square Homeless
Shelter; the Harvard Bone Marrow Initiative; and ImproveHealthCare.org. He also co-edited the book,
“The Soul of a Doctor,” which has been translated into Chinese.
With expertise in the impact of reimbursement and access on patient health, Dr. Jain worked previously
at WellPoint, McKinsey & Co, and the Institute for Healthcare Improvement, and served as an expert
consultant to the World Health Organization. He has authored more than 50 publications on healthcare
delivery innovation and healthcare reform in journals such as the New England Journal of Medicine,
JAMA, and Health Affairs, and is co-editor-in-chief and co-founder of Health Care: The Journal of Delivery
Science and Innovation.
Dr. Jain graduated magna cum laude from Harvard College with a B.A. in government, and continued on
to earn his M.D. from Harvard Medical School and M.B.A. from Harvard Business School. While
completing his medical residency at Brigham and Women’s Hospital, he maintained a faculty
appointment at the Harvard Business School and remains affiliated as a senior institute associate at the
school’s Institute for Strategy and Competitiveness.
WILLIAM ROLLOW, MD
Dr. Rollow is Assistant Professor in Family Medicine and Director of Clinical Services at the Center for
Integrative Medicine at the University of Maryland. Board-certified in family medicine, in integrative
medicine, and with a master’s degree in public health, he has an extensive background in primary care
practice transformation, quality improvement, healthcare technology, medical management, managed
care, federal government programs, and administration, having developed and led the Emblem Health
Medical Home High Value Network Project, directed the CMS group with responsibility for the Medicare
Quality Improvement Organization and End Stage Renal Disease Networks programs, provided
technology-based strategic and analytic consulting services at IBM, and held senior medical director
positions at BlueCross BlueShield of Illinois and at Anchor HMO. Dr. Rollow seeks to promote
transformation: in the lives of individuals through clinical care, in organizations through delivery system
redesign resulting in improvements in outcomes and cost, and in communities through policy and
practice that support health and wholeness.
17
LLOYD I. SEDERER, MD
LLOYD I. SEDERER, M.D., is Medical Director of the New York State Office of Mental Health (OMH), the
nation's largest state mental health system. As New York's “chief psychiatrist”, he provides medical
leadership for a $3.5 billion per year mental health system which annually serves over 700,000 people
and includes 24 hospitals, 90 clinics, two research institutes, and community services throughout a state
of ~ 19 million people.
Dr. Sederer is an Adjunct Professor at the Columbia/Mailman School of Public Health.
Previously, Dr. Sederer served as the Executive Deputy Commissioner for Mental Hygiene Services in
NYC, the City’s “chief psychiatrist”. He also has been Medical Director and Executive Vice President of
McLean Hospital in Belmont, MA, a Harvard teaching hospital, and Director of the Division of Clinical
Services for the American Psychiatric Association.
In 2013, Dr. Sederer was given the Irma Bland Award for Excellence in Teaching Residents by the
American Psychiatric Association, which in 2009 recognized him as the Psychiatric Administrator of the
Year. He also has been awarded a Scholar-in-Residence grant by the Rockefeller Foundation and an
Exemplary Psychiatrist award from the National Alliance on Mental Illness. He has published seven
books for professional audiences and two books for lay audiences, as well as over 350 articles in medical
journals and non-medical publications like TheAtlantic.com, The New York Times/The International
Herald Tribune, The Wall Street Journal, The Washington Post.com, Commonweal Magazine, and
Psychology Today. He is Medical Editor for Mental Health for the Huffington Post/AOL, where over 150
of his posts and videos have appeared. He recently became Mental Health Advisor for upwave , Turner
Broadcasting’s new multi-media platform for health and wellness.
His new book, The Family Guide to Mental Health Care (Foreword by Glenn Close), is for families of
people with mental illness. His even newer book, co-authored with Jay Neugeboren and Michael
Friedman, is The Diagnostic Manual of Mishegas (The DMOM), a parody on the DSM.
Dr. Sederer’s website is www.askdrlloyd.com.
18
NIRAV R. SHAH, MD, MPH
Dr. Nirav R. Shah is the 15th Commissioner of the New York State Department of Health. A native of
Buffalo, he graduated with honors from Harvard College, and has an M.D. and M.P.H. in medicine and
chronic disease epidemiology from Yale University. He is board certified in internal medicine and is an
elected member of the Institute of Medicine (IOM) of the National Academy of Sciences.
Before becoming Commissioner, he was Attending Physician at Bellevue Hospital Center in Manhattan,
Associate Investigator at the Geisinger Center for Health Research in central Pennsylvania, and Assistant
Professor of Medicine in the Section of Value and Comparative Effectiveness at NYU Langone Medical
Center. His interests as a researcher include using large-scale clinical laboratories and electronic health
records to improve the effectiveness and efficiency of care. He is a nationally recognized thought leader
in patient safety and quality, health information technology, and the strategies required to transition to
lower-cost, patient-centered health care for the 21st century.
As commissioner, Dr. Shah heads one of the world's leading public health agencies with an annual
budget of more than $58 billion. The Department regulates more than 200 hospitals and hundreds of
other health care facilities, administers the state's public health insurance programs for over 5 million
New Yorkers, oversees more than 80,000 NY state licensed doctors, administers the state health benefit
exchange, runs a premier biomedical laboratory, and supports public health and prevention initiatives.
During Dr. Shah’s tenure, the Department led the transformation of the state’s Medicaid program,
which resulted in more than $4 billion in savings in just the first year while improving population health
and quality of care. The Department also spearheaded the creation of a health benefit exchange that
will give 1.1 million New Yorkers health insurance coverage; and drafted an evidence-based Prevention
Agenda for improving the health of all New Yorkers.
JONATHAN SWARTZ, MD
Jonathan Swartz MD, MBA is a Regional Medical Director for Montefiore Medical Group, where he
oversees a network of 11 primary care practices performing 450,000 visits annually. He has had a clinical
practice and leadership roles in underserved New York area communities for over 25 years in the areas
of practice management, residency education, and managed care. At Montefiore Jon championed
Diabetes improvement efforts in the Medical Group over the past decade, culminating recently in a
Bridges to Excellence Award for 122 Medical Group physicians. He recently led the Patient Centered
Medical Home Pilot program at two Montefiore Medical Practices, and is now working with other MMG
leadership to extend PCMH transformation across the Medical Group.
19
Jon completed Medical School at the University of Connecticut School of Medicine and residency at
Montefiore Medical Center. He is Board Certified in Family Medicine and holds a Masters in Business
Administration from the Physician Executive MBA Program of the University of Tennessee. He has
worked as a clinician and leader for New York City Health and Hospitals Corporation, St. Joseph’s
Medical Center in Yonkers, NY, and The Institute for Urban Family Health. Jon was the founding Medical
Director of The Bronx Health Plan (now Affinity Health Plan) and returned to Montefiore in 2000 as the
Vice Chair of the Department of Family Medicine before taking on his current MMG role in 2006.
JUDY TUNG, MD
Dr. Judy Tung is an Associate Professor of Clinical Medicine at the Weil Cornell Medical College/ New
York Presbyterian Hospital. She obtained her M.D. at the Albert Einstein College of Medicine and
completed her Internal Medicine Residency at the University of California, San Francisco. She completed
a chief residency at Bellevue Hospital/ New York University prior to joining the faculty at Cornell. Dr.
Tung was the Director of the Primary Care Residency training program and an Associate Program
Director of the Internal Medicine Residency training program at New York Presbyterian Hospital for
seven years. She is currently the Director of the Weill Cornell Internal Medicine Associates (WCIMA), a
blended faculty resident practice certified as a level 3 Patient Centered Medical Home. She is also the
Interim Chief of the Division of General Internal Medicine. Dr. Tung is a respected educator who has
presented nationally on various aspects of outpatient medicine and resident education, including
transitions of care, ambulatory practice teams and year end panel handoffs.
20
POSTER SESSION - FACILITATED BY ANU ASHOK, MPH & CARLA NELSON, MBA - GREATER NEW YORK HOSPITAL
ASSOCIATION
1.
Improvements in Quality and Care Coordination: A Demonstration-Wide Look at HMH Outcomes
Kate Bliss, MSW, Research Scientist – NYS Department of Health
2.
A Combined Quality Improvement and PCMH Curriculum – Improving Practice and Engaging Residents
Amanda S. Carmel, MD, Fred N. Pelzman, MD, and Judy Tung, MD – Weill Cornell Medical College
3.
Implementing Best Practices in Pediatric Sepsis: Use of Simulation and House Staff-Driven Education
ML Quintos-Alagheband, MD, and Arsenia Asuncion, MD – Winthrop University Hospital
4.
Development of a Multidisciplinary Pediatric Home Visiting Program in an Underserved Community
Joseph Truglio, MD, MPH – Mount Sinai Medical Center
5.
Improving Resident Continuity in a PCMH
Jacqueline Weber and Ulka Kothari, MD – Winthrop University Hospital
6.
Rapid Cycling: Implementing a Resident-Driven Quality Improvement Project in the Outpatient Setting
Tamara Goldberg, MD, Michael Wiener, MD, and Claudia Levine, MD – St. Luke’s Roosevelt Hospital
7.
Improving Continuity of Care in a Teaching Community Hospital
Guiseppe Annunziata,MD – St. Barnabas Hospital
8.
From Inpatient to Outpatient – Easing the Transition for Our Patients
Jessica Glaser, PCMH Coordinator – Kaleida Health
9.
Reducing Hospital Admissions Among Pediatric Asthma Patients
Steven Gelman, MD, Debbie Cleveland, NP, Kathy Garrett-Syzmanski and Pramod Narula, MD – New York Methodist
Hospital
10. Specialty Care Referrals in a Pediatric PCMH
Robyn Rosenblum, MD, Theresa Lang, and Laurie Gordon, MD – The New York Hospital Medical Center of Queens
11. Integration of a PCMH Rotation into the Family Medicine Curriculum
Andreas Cohrssen, MD – Beth Israel Medical Center
12. Transitions in Care – Targeting High Risk Patients Across the Continuum of Care
Jason Hyde, AVP Community Case Management – Lutheran Medical Center & Family Health Centers
13. Quality Improvement: Is Rapid Plan-Do-Study-Act Cycle feasible in a Residency Ambulatory Setting?
Yar Pye, MD, Juana Hernandez, MD, and Concetta Rizzo, RN – Lutheran Medical Center & Family Health Centers
14. Evaluating the Effectiveness of a Coordination of Care Program in a Resident Run Clinic
Joanne Gottridge, MD – North Shore Long Island Jewish School of Medicine
15. No Referrals Left Behind: Improving Specialty Care Coordination
TingTing Wong, MD, Sabiha Friedrich, MD, Khalid Amin, MD, Parag Mehta, MD, and Christina Santos – New York
Methodist Hospital
16. Steps to Transition
Tiffany Bacchus, FNP, Sabiha Friedrich, MD, Khalid Amin, MD, and Parag Mehta, MD – New York Methodist Hospital
21
POSTER SESSION - FACILITATED BY ANU ASHOK, MPH & CARLA NELSON, MBA - GREATER NEW YORK HOSPITAL
ASSOCIATION (CONTINUED)
17. Learners Participation in PCMH Implementation
Sonia Velez, MD, JD, Michelle Vaca, MD, Laurie Sullivan, PhD, and Maryam Salehpour, MD – St. Joseph’s Medical Center
18. The Role of the PCMH Nurse in Facilitating Team Based Care in a Family Medicine Residency Practice
Teresa Semalulu, MPH, Merdith Snyder, CHES, MPH, and Angela Bosinski, PhD – University of Buffalo Primary Care
Research Institute
19. Reducing Readmissions Through the Creation of an Interdisciplinary, High-Risk Patient Working Group
Janina Morrison, MD, MPH, Inga Bell, RN, Carol Lau, FPN, Joanna White, RN, Marta Rico, MD – Montefiore Medical Center
20. Multidisciplinary Development of an Institutional Sepsis Program
Davis Tompkins, MD – Lutheran Medical Centered & Family Health Centers
21. Teaching Clinic Redesign: A Collaborative Effort to Improve Care Coordination and Resident Learning
Anu Ashok, Senior Director Graduate Medical Education – Greater NY Hospital Association
nd
22. Preparing Residents for Future Practice by Implementing a Quality Curriculum in the 2 Year of Residency
Using Longitudinal Rotation
Mathew J. Devine, DO – University of Rochester Medical Center
23. Resident Quality Improvement – Increasing Continuity of Care in a Pediatric Primary Care Setting
Melanie Wilson-Taylor, MD – NY Presbyterian Hospital
24. The Post-Hospital Discharge Clinic in the Transition of Care From the Hospital to the Outpatient Setting
Jonna O. Mercado, MD, Oleyumisi Ariyibi, MD, Archie Bella, MD, Ranjita Pallavi, MD, Ethan Jacobi, Nora V. Bergasa, MD –
Metropolitan Hospital Center
25. Engaging Residents in Analyzing System Errors in a PCMH
Jennifer Rockfeld, MD, Kendrick Lopez, MD, and Barbara Porter, MD, MPH – NYU School of Medicine & Bellevue Hospital
26. Internal Medicine Residents Attitudes About a Change in Training Schedules That Gives Emphasis to Primary
Care
Anastasia Asanov, MD, Susan Grossman, MD, Say Salomon, MD, Yanely Pineiro-Puebla, MD, and Thierry Mallet, MD –
Woodhull Medical Center
27. The July Problem: Hand-off of Graduating Residents’ Continuity Clinic Panels
Barbara Porter, MD, and Jennifer Rockfeld, MD – Bellevue Hospital
28. Poor Competency in Screening Practices May Explain Lower Than Expected Depression Rates in Inner City
Catchment Clinics
Gutnick, DN, and Landolt J – Bellevue Hospital
29. Building an Engaged and Skilled Work-force for Collaborative Care Implementation in a Public Hospital
System
Marianne Howard-Siewers, Damara Gutnick, Elizabeth Lagone, David Stevens, Mary-Ann Etiebet, and Gary Belkin – NYC
HHC Hospitals
30. Integrating House Staff into the Ambulatory Quality Improvement Infrastructure/What’s Your QI IQ?
Resident Physicians as Quality Improvement Leaders
David Eshak, MD – Jacobi Medical Center
22
HOSPITALS AND RESIDENCIES PARTICIPATING IN THE HOSPITAL MEDICAL HOME DEMONSTRATION
ALBANY MEDICAL CENTER HOSPITAL
INTERNAL MEDICINE
ALBANY MEDICAL CENTER HOSPITAL
INTERNAL MEDICINE-PEDIATRICS
ALBANY MEDICAL CENTER HOSPITAL
PEDIATRICS
BELLEVUE HOSPITAL CENTER
INTERNAL MEDICINE
BELLEVUE HOSPITAL CENTER
PEDIATRICS
BETH ISRAEL MEDICAL CENTER - PETRIE CAMPUS
INTERNAL MEDICINE
BETH ISRAEL MEDICAL CENTER - PETRIE CAMPUS
FAMILY MEDICINE
BRONX-LEBANON HOSPITAL CENTER
INTERNAL MEDICINE
BRONX-LEBANON HOSPITAL CENTER
FAMILY MEDICINE
BRONX-LEBANON HOSPITAL CENTER
PEDIATRICS
BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER
BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER
FAMILY MEDICINE
FAMILY MEDICINE
BROOKLYN HOSPITAL CENTER - DOWNTOWN CAMPUS
INTERNAL MEDICINE
BROOKLYN HOSPITAL CENTER - DOWNTOWN CAMPUS
INTERNAL MEDICINE
BROOKLYN HOSPITAL CENTER - DOWNTOWN CAMPUS
INTERNAL MEDICINE
BROOKLYN HOSPITAL CENTER - DOWNTOWN CAMPUS
FAMILY MEDICINE
BROOKLYN HOSPITAL CENTER - DOWNTOWN CAMPUS
FAMILY MEDICINE
BROOKLYN HOSPITAL CENTER - DOWNTOWN CAMPUS
PEDIATRICS
CITY HOSPITAL CENTER AT ELMHURST
INTERNAL MEDICINE
CITY HOSPITAL CENTER AT ELMHURST
PEDIATRICS
CONEY ISLAND HOSPITAL
INTERNAL MEDICINE
CONEY ISLAND HOSPITAL
PEDIATRICS
ELLIS HOSPITAL
FAMILY MEDICINE
ERIE COUNTY MEDICAL CENTER
INTERNAL MEDICINE
ERIE COUNTY MEDICAL CENTER
FAMILY MEDICINE
FLUSHING HOSPITAL MEDICAL CENTER
INTERNAL MEDICINE
FLUSHING HOSPITAL MEDICAL CENTER
PEDIATRICS
GLEN COVE HOSPITAL
FAMILY MEDICINE
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
FAMILY MEDICINE
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
PEDIATRICS
HARLEM HOSPITAL CENTER
INTERNAL MEDICINE
HARLEM HOSPITAL CENTER
PEDIATRICS
HIGHLAND HOSPITAL
FAMILY MEDICINE
INTERFAITH MEDICAL CENTER
INTERNAL MEDICINE
JACOBI MEDICAL CENTER
INTERNAL MEDICINE
JACOBI MEDICAL CENTER
PEDIATRICS
JAMAICA HOSPITAL MEDICAL CENTER
FAMILY MEDICINE
JAMAICA HOSPITAL MEDICAL CENTER
INTERNAL MEDICINE
KALEIDA HEALTH - BUFFALO GENERAL MEDICAL CENTER
FAMILY MEDICINE
KALEIDA HEALTH - BUFFALO GENERAL MEDICAL CENTER
INTERNAL MEDICINE
KALEIDA HEALTH - MILLARD FILLMORE SUBURBAN HOSPITAL
FAMILY MEDICINE
23
KALEIDA HEALTH - WOMEN AND CHILDREN’S HOSPITAL OF BUFFALO
PEDIATRICS
KALEIDA HEALTH - WOMEN AND CHILDREN’S HOSPITAL OF BUFFALO
INTERNAL MEDICINE-PEDIATRICS
KINGS COUNTY HOSPITAL CENTER
INTERNAL MEDICINE
KINGS COUNTY HOSPITAL CENTER
PEDIATRICS
KINGS COUNTY HOSPITAL CENTER
FAMILY MEDICINE
KINGSBROOK JEWISH MEDICAL CENTER
INTERNAL MEDICINE
KINGSTON HOSPITAL
FAMILY MEDICINE
KINGSTON HOSPITAL/INSTITUTE FOR FAMILY HEALTH
FAMILY MEDICINE
LINCOLN MEDICAL &AMP; MENTAL HEALTH CENTER
INTERNAL MEDICINE
LINCOLN MEDICAL &AMP; MENTAL HEALTH CENTER
PEDIATRICS
LONG BEACH MEDICAL CENTER
FAMILY MEDICINE
LUTHERAN MEDICAL CENTER
FAMILY MEDICINE
LUTHERAN MEDICAL CENTER
INTERNAL MEDICINE
MAIMONIDES MEDICAL CENTER
INTERNAL MEDICINE
MERCY HOSPITAL OF BUFFALO
INTERNAL MEDICINE
METROPOLITAN HOSPITAL CENTER
INTERNAL MEDICINE
METROPOLITAN HOSPITAL CENTER
PEDIATRICS
MONTEFIORE MEDICAL CENTER
FAMILY MEDICINE
MONTEFIORE MEDICAL CENTER
INTERNAL MEDICINE
MONTEFIORE MEDICAL CENTER
PEDIATRICS
MOUNT VERNON HOSPITAL
INTERNAL MEDICINE
NASSAU UNIVERSITY MEDICAL CENTER
PEDIATRICS
NASSAU UNIVERSITY MEDICAL CENTER
INTERNAL MEDICINE
NASSAU UNIVERSITY MEDICAL CENTER
PEDIATRICS
NEW YORK METHODIST HOSPITAL
INTERNAL MEDICINE
NEW YORK METHODIST HOSPITAL
PEDIATRICS
NIAGARA FALLS MEMORIAL MEDICAL CENTER
FAMILY MEDICINE
NORTH CENTRAL BRONX HOSPITAL
INTERNAL MEDICINE
NORTH SHORE UNIVERSITY HOSPITAL
INTERNAL MEDICINE
PECONIC BAY MEDICAL CENTER
FAMILY MEDICINE
PHELPS MEMORIAL HOSPITAL ASSOCIATION
FAMILY MEDICINE
QUEENS HOSPITAL CENTER
INTERNAL MEDICINE
RICHMOND UNIVERSITY MEDICAL CENTER
INTERNAL MEDICINE
RICHMOND UNIVERSITY MEDICAL CENTER
PEDIATRICS
ROCHESTER GENERAL HOSPITAL
INTERNAL MEDICINE
ROCHESTER GENERAL HOSPITAL
PEDIATRICS
SAMARITAN MEDICAL CENTER
INTERNAL MEDICINE
SAMARITAN MEDICAL CENTER
FAMILY MEDICINE
SISTERS OF CHARITY HOSPITAL
INTERNAL MEDICINE
SISTERS OF CHARITY HOSPITAL
FAMILY MEDICINE
SOUND SHORE MEDICAL CENTER OF WESTCHESTER
INTERNAL MEDICINE
SOUND SHORE MEDICAL CENTER OF WESTCHESTER
PEDIATRICS
SOUTH NASSAU COMMUNITIES HOSPITAL
FAMILY MEDICINE
24
ST BARNABAS HOSPITAL
INTERNAL MEDICINE
ST BARNABAS HOSPITAL
FAMILY MEDICINE
ST BARNABAS HOSPITAL
PEDIATRICS
ST JOSEPH’S HOSPITAL HEALTH CENTER
FAMILY MEDICINE
ST. JOSEPH’S MEDICAL CENTER
FAMILY MEDICINE
ST. LUKE’S- ROOSEVELT HOSPITAL CENTER
INTERNAL MEDICINE
STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
INTERNAL MEDICINE
STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
FAMILY MEDICINE
STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
PEDIATRICS
STONY BROOK UNIVERSITY HOSPITAL
FAMILY MEDICINE
STONY BROOK UNIVERSITY HOSPITAL
PEDIATRICS
STONY BROOK UNIVERSITY HOSPITAL
INTERNAL MEDICINE-PEDIATRICS
STONY BROOK UNIVERSITY HOSPITAL
INTERNAL MEDICINE
STRONG MEMORIAL HOSPITAL
INTERNAL MEDICINE
STRONG MEMORIAL HOSPITAL
STRONG MEMORIAL HOSPITAL
PEDIATRICS
INTERNAL MEDICINE-PEDIATRICS
THE MOUNT SINAI MEDICAL CENTER
INTERNAL MEDICINE
THE MOUNT SINAI MEDICAL CENTER
PEDIATRICS
THE MOUNT SINAI MEDICAL CENTER
FAMILY MEDICINE
THE NEW YORK AND PRESBYTERIAN HOSPITAL
INTERNAL MEDICINE
THE NEW YORK AND PRESBYTERIAN HOSPITAL
FAMILY MEDICINE
THE NEW YORK AND PRESBYTERIAN HOSPITAL
PEDIATRICS
THE NEW YORK AND PRESBYTERIAN HOSPITAL
INTERNAL MEDICINE
THE NEW YORK AND PRESBYTERIAN HOSPITAL
PEDIATRICS
THE NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS
INTERNAL MEDICINE
THE NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS
PEDIATRICS
UNITY HOSPITAL
INTERNAL MEDICINE
UNIVERSITY HOSPITAL SUNY HEALTH SCIENCE CENTER
PEDIATRICS
UNIVERSITY HOSPITAL SUNY HEALTH SCIENCE CENTER
PEDIATRICS
WESTCHESTER MEDICAL CENTER
INTERNAL MEDICINE
WESTCHESTER MEDICAL CENTER
PEDIATRICS
WINTHROP-UNIVERSITY HOSPITAL
PEDIATRICS
WOODHULL MEDICAL &AMP; MENTAL HEALTH CENTER
INTERNAL MEDICINE
WOODHULL MEDICAL &AMP; MENTAL HEALTH CENTER
PEDIATRICS
WYCKOFF HEIGHTS MEDICAL CENTER
INTERNAL MEDICINE
WYCKOFF HEIGHTS MEDICAL CENTER
PEDIATRICS
25