Document text
Principal Investigator: Melanie Frances Molina
Organization: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
Fiscal Year: 2024
Award: $189,972
Funding agency: National Institute on Drug Abuse
PROJECT SUMMARY/ABSTRACT
Dr. Melanie Molina is an Assistant Clinical Professor of Emergency Medicine at the University of California,
San Francisco (UCSF) whose long-term goal is to become an independent investigator studying how to
leverage health information technology to improve care for patients experiencing social disadvantage. To
achieve this goal, she will develop critical skills in clinical informatics, human-centered design, and
implementation science by: 1) completing formal coursework in SQL and Clarity data model fundamentals,
human-centered design, and designing individual-level implementation strategies, 2) attending structured
didactics, research group meetings, journal clubs, and works-in-progress sessions, and 3) performing goal-
directed training activities in data query, retrieval, and analysis, contextual inquiry and focus group design, and
intervention implementation and pilot data collection. The research infrastructure and resources at UCSF,
including the Center for Clinical Informatics and Improvement Research and the Clinical and Translational
Science Institute, will provide Dr. Molina with all the support necessary to complete the work proposed in her
career development application. Dr. Molina has assembled an exceptional mentorship team: Dr. Laura Gottlieb
(primary mentor) is a Professor of Family and Community Medicine with expertise in social determinants of
health, Dr. Julia Adler-Milstein (co-mentor) is a Professor of Medicine and Chief of the Division of Clinical
Informatics with expertise in electronic health record (EHR) data, and Dr. Courtney Lyles (co-mentor) is a
Professor in the Department of Public Health Sciences at UC Davis with expertise in human-centered design
and implementation science methodologies.
The overarching goal of this proposal is to integrate patient social risk information into an existing EHR-
based clinical decision support (CDS) tool to facilitate ED-initiated, social risk-informed opioid use disorder
(OUD) medication treatment and ultimately improve treatment adherence and follow up. Dr. Molina will start by
extracting metadata from Epic’s reporting database capturing whether discrete social risk data were
documented and/or reviewed by ED clinicians for OUD-related ED encounters (Aim 1). Using insights from Aim
1—in addition to a human-centered design approach with semi-structured qualitative interviews of key ED staff
and patient stakeholders—she will integrate patient social risks into an existing CDS tool for OUD treatment,
creating a prototype that provides social care-enhanced OUD treatment recommendations (Aim 2). She will
then evaluate the feasibility and acceptability of the social care-enhanced CDS tool at the UCSF ED as an
intervention to increase treatment adherence and follow up using a mixed-methods, before-after approach
(Aim 3). This proposal fulfills the National Institute of Drug Abuse research priority of understanding how to
adapt existing services into more patient-centered models of care.
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epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Sampling><San Francisco><Services><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Social Workers><Structure><Survey Instrument><Surveys><Technology><Testing><Time><Training Activity><Translational Research><Translational Science><Transportation><United States><Universities><Vascular Hypertensive Disease><Vascular Hypertensive Disorder><Visit><Vulnerable Populations><Work><acceptability and feasibility><access to health care><access to healthcare><accessibility of health care><accessibility to health care><accessibility to healthcare><active followup><care for patients><care of patients><career development><caring for patients><chronic disorder><clinical center><clinical decision support><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><data base><data modeling><design><designing><diabetes><disparate effect><disparate impact><disparate result><drug/agent><electronic health care record><electronic health medical record><electronic health plan record><electronic health registry><electronic medical health record><enhanced care><evidence base><experience><family medicine><follow up><follow-up><followed up><followup><health care><health care access><health care availability><health care service access><health care service availability><health care service use><health care service utilization><health information technology><healthcare access><healthcare accessibility><healthcare availability><healthcare service access><healthcare service availability><healthcare service use><healthcare service utilization><healthcare utilization><high blood pressure><human centered design><hyperpiesia><hyperpiesis><hypertensive disease><hypertensive disorder><implementation intervention><implementation science><implementation strategy><improved><inequitable effect><inequitable impact><inequitable outcome><insight><interventional strategy><medication for opioid use disorder><meeting><meetings><meta data><model of data><model the data><modeling of the data><multidisciplinary><opiate deaths><opiate mortality><opiate use disorder><opioid deaths><opioid mortality><opioid overdose death><opioid related death><opioid use disorder><outcome disparities><outcome inequality><outcome inequity><outreach><participant recruitment><patient centered><patient oriented><pilot study><primary end point><primary endpoint><professional association><professional membership><professional society><professor><prototype><response><services research><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><skills><social><social disadvantage><social disparities><social health determinants><social inequality><social interventions><strategies for implementation><support tools><training module><translation research><translational investigation><treatment adherence><treatment compliance><trial regimen><trial treatment><unequal effect><unequal impact><unequal outcome><usability><vulnerable group><vulnerable individual><vulnerable people>