Calkins Fellowship Supports Innovative Diabetes Care Project

The clinical assistant professor of medicine received the $1,500 award May 18 during the 2013 GME Scholarly Exchange of Spring Clinical Day at the Hyatt Regency Buffalo.

Incorporating quality improvement methodologies, “this initiative has the potential to change how care for chronic medical conditions is delivered at the Hertel-Elmwood Internal Medicine Center,” says Diaz Del Carpio.

Affiliated with the University at Buffalo’s Department of Medicine, the Kaleida Health center where Diaz Del Carpio practices serves mostly low-income Buffalo residents.

Twelve patients with uncontrolled Type 2 diabetes are expected to participate in the study.

Over a year, they will attend monthly four-hour group sessions that cover self-management education, nutrition and physical activity, as well as a private consultation.

The diverse care team includes a doctor, nurse, diabetes educator and dietitian.

The overall goal is to improve access and quality of diabetes care to underserved patients in Buffalo, says Diaz Del Carpio.

“We want to benefit our community by translating basic and clinical research (pure science) into actual care, measured by quality and access (applied science).”

Effective, comprehensive disease management is key to improving the quality of life of those with diabetes while reducing acute and long-term complications, notes Diaz Del Carpio.

He lists a litany of issues doctors should address for diabetes patients: screening and treatment for coronary artery disease, nephropathy and neuropathy; nutrition counseling; foot care; smoking cessation; immunizations; disease management concerns; and socioeconomic barriers such as health literacy, medication costs, depression and lack of transportation.

“Obviously, typical 15-minute visits are insufficient to accomplish all these tasks,” says Diaz Del Carpio.

Therefore, “many chronic disease patients look for additional health services in urgent care and emergency rooms settings,” he notes.

The selection committee was impressed with Dr. Diaz Del Carpio’s study design as well as his commitment to community-based primary care, says Roseanne C. Berger, MD, senior associate dean for graduate medical education, who appointed the committee.

“The project has the potential to improve outcomes at reduced cost for a common medical condition that is a major cause of devastating complications, including blindness, stroke, kidney failure and heart attacks,” she says.

As a primary care physician, Diaz Del Carpio specializes in treating prevalent chronic diseases.

He also is the medical director of quality improvement and patient safety at UBMD Internal Medicine.

His dual roles allow him to “take care of the individual as well as impact the community as a whole,” he says.

“I truly enjoy the rewards and challenges of implementing process change in health care, especially in primary care settings,” he adds.

Interested in redesigning and improving patient experiences, Diaz Del Carpio says he focuses on creating innovative ways for vulnerable chronic disease patients to access care and improve their health.

He completed his combined residency in internal medicine and social and preventive medicine, as well as his master’s degree in public health, from UB.

He also was trained in quality improvement at both UB’s Center for Industrial Effectiveness and the Quality and Safety Educators Academy, co-sponsored by the Society of Hospital Medicine.

Diaz Del Carpio’s project offers a model that could help the rapidly-growing diabetes population as well as many more patients with chronic conditions.

According to the New York State Department of Health, diabetes has reached epidemic proportions, affecting one of 12 adults statewide.

Since 1994, the number of New Yorkers with diabetes has more than doubled, and that number will likely double again by 2050.

“Our alternative approach would also benefit patients with other prevalent chronic medical diseases, while increasing the satisfaction and productivity of medical providers,” Diaz Del Carpio adds.

He is collaborating with two associate professors in the Division of General Internal Medicine—Scott Stewart, MD, and Richard Schifeling, MD—and Laurene Tumiel-Berhalter, PhD, associate professor of family medicine, who directs the Primary Care Research Institute.

Surveys, focus groups and chart reviews will help evaluate the study’s effectiveness.

Results will be presented during the 2014 GME Scholarly Exchange at Spring Clinical Day.

This annual interdisciplinary research forum is a major initiative of UB’s Office of Graduate Medical Education, working in partnership with the UB Medical Alumni Association.

The Calkins fellowship supports UB medical school residents or junior faculty members engaged in community-based research or quality improvement projects.

Priority is given to proposals that address the health care needs of the poor and medically disadvantaged.

The award was established by Evan Calkins, MD, former director of medicine at Meyer Memorial Hospital, now Erie County Medical Center.

A witness to clear and unmet medical needs among Buffalo’s urban poor, Calkins advocates using the talents and resources of medical institutions to improve access to and quality of care in the community.

As Diaz Del Carpio says, “Health care does not happen in my office or in a hospital—it happens in our community.”

The award may support, for example, projects that enhance patient self-management or address one or more phases of the “plan-do-study-act” quality-improvement cycle.