Health Services Researcher

Executive Summary

Clinical operations vision to ethically accomplish company goals by facilitating critical analysis of data to support knowledge management and current business strategies. Communications necessary to maximize resources and minimize errors through development or redesign of critical work processes using quality improvement principles. Facilitative nature with data-driven discussion provides consensus and focus in a team environment. Ensures timely progress updates using systematic monitoring programs across multiple areas. Influences opinion leaders and other critical business partners to support product and business strategies.

Employment

Director, Analytic Services •••••)
Alabama Quality Assurance Foundation, Birmingham. Al.
*Manager of two service products with staff of five. Service quality for the JACHO Oryx product supported •••••% client retention across 3 years.
*Statewide medicaid contract required my chair of the QI committee; with a physician champion, had no deficiencies of completed studies within a 3 year period of state audits
*Facilitated analytic support for five teams within the medicare QIO contract, including final deliverables for each request. Teams represented health care across home health, skilled nursing, inpatient and physician office settings. Focused
on pay- for-performance measures. Achieved statistcially significant improvement in the use of vaccinations in adults.
*Expert knowledge of current pharmacy treatment for congestive heart failure, pneumonia, acute myocardial infarction and surgical infection prevention (procedure-specific)
*Presented physician-specific performance reports to ••••• primary care physicians in state
*Communications and presentations to nurses, physicians, IT, academic centers and other professional organizations (CMS, AHQA, IHI, Alabama Hospital Association, Medicaid)

Director, Clinical Programs and Research (•••••)
The OATH/Health Partners of Alabama, Birmingham, Al.
*Integrated medical and pharmacy claims into disease management programs; performed program evaluations
and educated physician staff
*Developed physician-specific pharmacy report with the P&T committee
*Pharmacy interface for compliance measure development and reporting to providers (inlcuding immunization rates)
*Prepared for and passed annual State Dept of Health Insurance HEDIS audits
*Developed methods to quantify clinical and operations measures for ongoing monitoring

Manager, Medical informatics (•••••)
United HealthCare South, Birmingham, Al.
*Developed quality improvement initiatives that improved the Member Satisfaction results.
*Integrated quality performance measures into physician-specific reporting efforts which resulted in statistically significant improvement in clinical performance measures of HEDIS measures
*Worked as active member on the large group purchaser sales teams effort
*Facilitated physician focus group with medical director to develop risk adjustment methods

Director, Strategic Planning & Development (•••••)
Brookwood Medical Center, Birmingham, Al.
*Completed •••••year business plans for all service line products resulting in three approved certificate of need applications by the State of Alabama.
*Internal Liaison with consultants for ••••• months restructuring effort across all key clinical process areas
*Required six-months formal training in Deming QI methods, including advanced statistical process control concepts and facilitator techniques
*Developed and presented first surgeon and procedure-specific costs reports•••••


Health Science Officer/Clinical Trial Manager (•••••)
VA Medical Center/UAB Med Ctr/The Eye Foundation, Birmingham, Al.
*Coordinated and managed staff to conduct multiplePhase II/III clinical trials
*Ensured compliance with FDA regulations, including IRB submission process, informed consent, recruitment of eligible participants, form completion and submission


EDUCATION
B.S., Biology (•••••)
University of Alabama: Tuscaloosa, Alabama

M.P.H., Dr.P.H. (EPIDEMIOLOGY) (••••• •••••)
University of Alabama, Birmingham: Birmingham, Alabama


SKILLS
*Formal Training in Deming QI Methods, including team facilitation, process design, advanced statistical techniques
*Expert Presentation skills to Sr Level Executives, Physician/Health care provider liaison, and other entities
*Superior operations knowledge ensures high quality across all client services through efficiencies and technology
*Expert communications and technical experience with pharmacy treatment of specific diseases, disease management programs and evaluation, and feedback loops for knowledge spread and interventional strategies
••••• years research experience with SAS, SPSS, Oracle, MS Office Suite Products, report writing and interpreting results.


BIBLIOGRAPHY:

•••••, W.; Alexander, W.; Cassells, R.: Demographic Characteristics of Men with Urethritis (Abstract). Presnted at the First Sexually Transmitted Diseases World Congress, San Juan, Puerto Rico, November, •••••

Haddox, J.; Pfister, R.; •••••, W.; In vitro Incubation of PMN: Studies of Inhibitory and Stimulatory Compounds (Abstract). Presented at the Association of Research in Vision and Ophthalmology Meeting, Sarasota, Florida, May, •••••

Pfister, R.; Haddox, J.; •••••, W.; Dodson, R.: Polymorphonuclear Leucocytic Inhibition by Citrate, Other Metal Chelators, and Triflouroperazine: Evidence to Support Binding Protein Involvement. Invest. Ophthal and Visual Science, Vol. •••••, pps •••••, •••••

•••••, W.: Determinants of Managed Care Member Satisfaction and Initiatives for Improvement (Abstract and Presentation). The Robert Sherrill, MD, Quality Symposium, Birmingham, Al. •••••

•••••, W.: Use of Quality Improvement Techniques for Enhancing Performance of HEDIS Clinical Measurements (Abstract and Presentation). The Robert Sherrill, MD Quality Symposium, Birmingham, Al. •••••

•••••, W.: Defining the Clinical Performance Measures for the 7th Scope of Work Among The Quality Improvement Organizations (Presentation at Plenary Session). The Robert Sherrill, MD Quality Symposium, Birmingham, Al. •••••

•••••, W,: Defining How Hospitals Will Use The Quality-Net Exchange to Transmit Data Into The QIO Clinical Warehouse (Presentation). The Robert Sherrill, MD Quality Symposium, Birmingham, Al. •••••

•••••, W.; Sansom, M.; Grayson, M.: Using Statistical Control Charts to Determine Interventional Strategies for Improvement Among Hospital Performance Measures (Abstract and Presentation). The Tri-Regional AHQA Conference, St. Petersburg, Fl. •••••

Ahmed, A.; Grayson, M.; •••••, W.: Systolic Heart Failure, Chronic Kidney Disease, African Americans and ACE Inhibitors/ARB Use (Abstract and Presentation). Centers for Medicare and Medicaid Services Quality Net Conference, •••••

Ahmed, A.; •••••, W.: Predictors of Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Use in Patients with Systolic Heart Failure. (being submitted)

Ahmed, A., •••••, W.: Angiotensin Receptor Blockers, Angiotensin-Converting Enzyme Inhibitors, and Reduction of Mortality in Elderly Heart Failure Patients with Chronic Kidney Disease. (in-progress)



OTHER MEMBERSHIPS/TECHNICAL SUPPORT
Member, Technical Expert Panel for NCQAs Health Outcomes Survey (HOS). Started as managed care data user of the survey results in •••••, requested by Chris Haffer, CMS Director, to be TEP Member, since •••••

Participating Senior Manager, in preparation and receiving the Malcolm Baldridge Award, among small businesses, from the Alabama Productivity Center at the University of Alabama. My focus was on performance measurement monitoring across key processes.

Expert User, Consumer Assessment of Health Plans Survey (CAHPS). Attended most recent users meeting in Baltimore, Md (Nov •••••). Have experience applying results to improvement activities among managed care organizations. Expanded applications of this satisfaction survey will include acute care settings (for JCAHO/CMS performance of hospitals) and ambulatory settings (CMS/physician offices).

Expert in Quality Improvement, with formal training and applications in Quality Improvement techniques using the Deming Methodology, including facilitation and team development. Six months intensive review through the Executive Learning Group. Included process design/redesign, flow charting, and advanced statistical applications. Used extensively for over ••••• years.


REFERENCES

Bob Sutton, M.D.
Medical Director
(•••••) •••••, cell
(•••••) •••••, work

Cathy Munn
Co-Worker and Friend
(•••••) •••••, work
(•••••) •••••, home

Mike Robinson,
Technical Co-Worker
(•••••) •••••, cell

Jack Mooresmith, JD
Burr and Forman, LLP
Healthcare Law Specialist
(•••••) •••••

Lynn Cummings, RN
Brookwood Medical Center
Director, Patient Ambassador
•••••, work