Shana Steinbeck and Christopher Streib

Investigators to test ideas for improving healthcare delivery

Two University of Minnesota and M Health Fairview investigators will receive support to test their ideas for enhancing healthcare delivery, such as improving patient outcomes, decreasing the burden on the healthcare system, and reducing costs.

Support comes from the Spring 2022 RapidEval call for proposals from the Center for Learning Health System Sciences (CLHSS), and in partnership with the Clinical and Translational Science Institute. This round of selected investigators receive mentorship, research design expertise, and support for project management, implementation, dissemination, and statistical analyses. M Health Fairview projects receive data and technology support.

Proposals were selected on the basis of potential impact on an important issue with high likelihood of scalability, theoretical and scientific basis, rapid (data collection <6 months) timeframe, and measurable and testable outcomes. Projects will commence later this summer, and the next call for proposals is anticipated in fall 2022.

Shana Steinbeck
Shana Steinbeck, PharmD, BCPS, Clinical Pharmacy Manager, Residency Program Director, M Health Fairview, Woodwinds Health Campus

Shana Steinbeck, PharmD, BCPS

Project: Improving utilization of medication therapy management services for patients with economic instability

The inpatient pharmacist assesses all patient admission medication histories, inpatient medications, and discharge medications for indication, effectiveness, safety, and convenience.

Currently, a medication therapy management (MTM) referral is placed for M Health Fairview patients with certain high-risk disease states and/or polypharmacy based on an Epic formula. Research has shown the benefit of MTM pharmacist inclusion on care teams through alleviating chronic disease risk factors and monitoring patients for clinical care needs. 

Unfortunately, there are currently no pharmacist assessment questions nor an Epic formula that can identify patients with potential economic instability who would benefit from MTM care. The inclusion of social determinants of health, such as economic stability, can directly impact a patient's ability to afford their medications, and, therefore, maintain adherence and reduce disease progression.

This proposal aims to identify patients with potential economic instability and refer them to MTM services. The hypothesis is that the inclusion of patients who may not be able to afford their medications in the MTM referral process will ultimately reduce medication non-adherence, which will impact patient morbidity and health care utilization in the long-term.

Christopher Streib
Christopher Streib, MD, Associate Professor, Department of Neurology; Vascular Neurology Fellowship Director, University of Minnesota; Cerebrovascular Director, M Health Fairview

Christopher Streib, MD

Project: Expanding specialist telestroke care for all hospitalized M Health Fairview stroke patients

Stroke is the fifth leading cause of death and number one cause of long-term disability in the United States. For patients presenting to the hospital with acute ischemic stroke, urgent diagnostic stroke evaluation and immediate initiation of targeted secondary stroke prevention is essential. 

However, due to a severe shortage of stroke neurologists, timely specialist stroke care is often unavailable. This is problematic because fragmented and inconsistent stroke care reinforces known racial and geographic healthcare disparities.

It is our intent to utilize telemedicine ("telestroke") to facilitate urgent stroke specialist care for all hospitalized M Health Fairview stroke patients regardless of geographic location.

We aim to test the impact of this care model on multiple relevant stroke care outcomes, including the percent of acute ischemic stroke patients who receive an urgent telemedicine stroke, recurrent stroke rate, and readmission rate among other outcomes.