Comments from Pilot Grant Recipients

What Receiving This Support Has Meant to Them

We asked funded pilot grant recipients from 2017 through 2023 to tell us what receiving the grants has meant to them and share the impact the grants had on their careers, any further related work they have done, any publications/abstracts/presentations that came out of this work, the importance of programs such as this to invigorate innovation in healthcare, and other thoughts that they felt might be inspiring for medical students, residents, fellows, faculty, and others involved in healthcare to hear.

The Institute for Primary Care Innovation Seed Grant gave me an opportunity to study a neglected field – bedside ethics – and sparked my interest in clinical research. I was able to identify and explore a question based on my clinical experiences and foster collaborations with international experts outside of my field. The experience was transformative. IPCI funding led to publications, presentations at national meetings, and further research that continues today. These seed grants are a crucial mechanism to invigorate primary care and hospital medicine investigation.

Matt McCarthy, MD
Division Chief, Hospital Medicine
Vice Chief of Inpatient Clinical Operations
Department of Medicine
NewYork-Presbyterian Queens Hospital

I loved the opportunity to collaborate with Dr. Chapman and her research team. We work in different departments (she in Ob/Gyn and the rest of the team in Pediatrics) and would not otherwise have had the opportunity to work together on the shared goal of vaccinating adolescents against HPV to prevent HPV-related cancers. This work was presented at an Ob/Gyn meeting and was just recently published in Gynecology Oncology, with all of us as co-authors. I can also share that on the ground level, I saw a 15-year-old boy who participated in this study – his mother said that she finally decided to vaccinate him, largely in part because of the information she learned from the PALS content.

P.S. I am working on a submission for this year’s grant cycle – different topic but inspired by the work we did with Dr. Chapman’s team.

Jane Chang, MD
Section Chief, Adolescent Medicine
Associate Professor of Clinical Pediatrics
Weill Cornell Medicine
Department of Pediatrics

It was a great opportunity to work with Ella and the research team on this very important project. As a primary care physician, I was glad to contribute in the development of a project that impacts a vulnerable population with such important long-term health effects. This grant provided the support (research assistants, curriculum development, technology, etc…) needed to move along at great speed and produce outcomes that will lead to further opportunities for this type of educational content. As a junior faculty member, I was pleased that this resulted in multiple abstracts, presentations and a publication.

Posters presented at Society of Gynecologic Oncology 2023 Annual Meeting on Women’s Cancer. 25th March 2023.

Publication
Webster EM, Ahsan MD, Kulkarni A, Peñate E, Beaumont S, Ma X, Wilson-Taylor M, Chang J, Ipp L, Safford MM, Cantillo E, Frey M, Holcomb K, Chapman-Davis E. Building knowledge using a novel web-based intervention to promote HPV vaccination in a diverse, low-income population. Gynecol Oncol (2023). Dec 26;181:102-109. doi: 10.1016/j.ygyno.2023.12.005

Melanie Wilson-Taylor, MD

It was a great opportunity for us to work as a multidisciplinary team and get feedback about the final innovation project that was then piloted in the clinic. We were able to include medical students and residents as well.

We had 2 poster presentations below at the Society of Gynecologic Oncology 2023 Annual Meeting.

A Patient Activated Learning System (PALS) improves human papillomavirus (HPV) vaccine-related knowledge in a diverse, Medicaid pediatric clinic. Emily Webster, Muhammad Danyal Ahsan, Amita Kulkarni, Corbyn Nchako, Xiaoyue Ma, Paul Christos, Kevin Holcomb, Melissa Frey, Evelyn Cantillo, Melanie Wilson-Taylor, Jane Chang, Lisa Ipp, Eloise Chapman-Davis

Human papillomavirus (HPV) and HPV vaccine misconceptions in a diverse, Medicaid pediatric clinic. Muhammad Danyal Ahsan, Emily Webster, Amita Kulkarni, Corbyn Nchako, Xiaoyue Ma, Paul Christos, Kevin Holcomb, Melissa Frey, Evelyn Cantillo, Melanie Wilson-Taylor, Jane Chang, Lisa Ipp, Eloise Chapman-Davis

Eloise Chapman-Davis M.D., FACOG
Associate Professor
Associate Fellowship Director
Division Director of Gynecologic Oncology
Donna Redel Clinical Scholar
Weill Cornell Medicine
Obstetrics and Gynecology

We are so grateful for the support of the award, which was instrumental to me when I was a first-year faculty member here.

The Primary Care Innovations grant generously funded our project “Risk-based Chronic Kidney Disease Care using a Population Health Registry.” The majority of chronic kidney disease (CKD) is treated in primary care settings, but it is significantly underrecognized and underdiagnosed. The IPCI grant allowed us to build a CKD registry within the electronic health record (EHR). We found substantial underutilization of evidence-based therapies, including angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARBs) and sodium-glucose cotransporter 2 inhibitors (SGLT2i). We also identified socioeconomic disparities in the use of ACEi/ARBs and SGLT2i by neighborhood-level social deprivation.

These findings inspired multiple quality improvement projects, including building a CKD dashboard and best practice alert (BPA). We will be testing the CKD BPA in a controlled trial to assess its impact on guideline-directed medical therapy for CKD. Research during the IPCI funding period also served as preliminary data for a grant awarded through the Dalio Center for Health Justice. We have also submitted extramural funding applications to the National Institutes of Health and private foundations.

As early career faculty members, the IPCI grant was instrumental in fostering our research careers. It also led to rich, ongoing nephrology-primary care collaborations as well as mentorship opportunities for internal medicine residents. Fostering innovative research in primary care through the IPCI program is crucial to transform the backbone of our healthcare delivery system and better serve our patients.

Sri Lekha Tummalapalli

I’ve had the opportunity to mentor two trainees on IPCI seed grants. From my standpoint as a cardiologist, these grants have facilitated a stronger bond between subspecialty care (cardiology in this case) and primary care from a scientific and professional standpoint. It has been great to include trainees on grants like this because it demonstrates the value and importance of ensuring a strong relationship between sub-specialists and primary care to maximize outcomes for patients, especially older adults with multiple chronic conditions including heart failure which require coordination between multiple physicians. Best care and practices of an aging population that frequently contends with multiple chronic conditions and impairments in multiple health domains will continue to depend on close collaboration across multiple disciplines—I am grateful that IPCI recognizes this, and supports scientific activities that explicitly examines best models of collaboration, and also explicitly incorporates investigators from multiple disciplines to help achieve this.

Parag Goyal, MD

Clinical demand for the resident-based Geriatrics consult/education module created with the IPCI grant has increased significantly, and the residents do seem to have a good experience when they do it.

Perhaps the biggest thing to come from our project so far is the idea of using the program as an opportunity to obtain additional resources from the hospital’s Ambulatory Care Network leadership, and there are other faculty in our group who want to get involved as well, specifically targeting polypharmacy.

Brian Eiss, MD
Director, Ambulatory Care Clerkship
Assistant Professor of Medicine
Division of General Internal Medicine
Division of Geriatrics and Palliative Medicine
Department of Medicine
Weill Cornell Medicine

I’m very grateful for the funding I received from the Primary Care Innovation Program. The grant supported me and several other division members to collectively develop and pilot an education-based intervention for home health aides caring for adults with heart failure. This study was an integral step towards an overall body of work that led to a clinical trial, now funded by the NIH. Not only did our team publish our findings and present them at national conferences, but our community partners saw high value from the work, and it is now the basis of an evidence-based intervention being used in practice. I could not thank the program and the foundation more!

Publications
Leung PB, Silva AF, Cho J, Kaur H, Lee A, Escamilla Y, Wiggins F, Safford MM, Kern LM, Shalev A, Sterling MR. Eliciting the educational priorities of home care workers caring for adults with heart failure. Gerontol Geriatr Educ. 2022 Apr-Jun;43(2):239-249. doi: 10.1080/02701960.2020.1793760. Epub 2020 Jul 15. PMID: 32666906; PMCID: PMC7855568.

Sterling MR, Cho J, Leung PB, Silva AF, Ringel J, Wiggins F, Herring N, Powell A, Toro O, Lee A, Loughman J, Obodai M, Poon A, Goyal P, Kern LM, Safford MM. Development and Piloting of a Community-Partnered Heart Failure Training Course for Home Health Care Workers. Circ Cardiovasc Qual Outcomes. 2022 Nov;15(11):e009150. doi: 10.1161/CIRCOUTCOMES.122.009150. Epub 2022 Nov 15. PMID: 36378772; PMCID: PMC9674373.

Madeline R. Sterling, MD, MPH, MS, FAHA
(primary care physician and health services researcher, DGIM)
Associate Professor of Medicine
Weill Cornell Medicine
Director, Initiative on Home Care Work, Cornell University
Weill Cornell Medicine
Division of General Internal Medicine

The Primary Care Innovation seed grant enabled us to successfully launch a novel facilitator-in-training program for group peer mentoring (GPM). We are the first GPM facilitator training program to our knowledge in academic medicine. We are currently training our second cohort of facilitators, who undergo rigorous preparation, skills practice, observation, coaching, and 360-degree evaluations.

The seed grant allowed us to perform rigorous mixed methods program evaluation to generate pilot data and gain momentum, with transformative effect. Over 100 faculty at WCM have been involved in Group Peer Mentoring since receiving this support, and we have been able to garner additional intramural and extramural support. We have also been able to contribute to meaningful outcomes for WCM faculty. At WCM, we captured significant gains in faculty participants in GPM feeling connected to a supportive WCM community, identifying their values and strengths, formulating and achieving career and personal goals, and confidence in becoming leaders in academic medicine. GPM also significantly improved wellbeing measures, including self-efficacy in succeeding at work without sacrificing personal or family commitments, and in aligning professional activities and personal values.

In addition to giving Department of Medicine Grand Rounds, and receiving interest from other departments, we are discovering national interest in our work, with invited talks about our work from other academic health centers. We have manuscripts in preparation for submission and a workshop on facilitation skills training in May at the NEGEA meeting. In short, this seed grant has catalyzed our academic careers by transforming us from educators to impactful innovators and scholars, and allowed us to give back through meaningful impact on the lives and careers of other faculty.

Kimberly Bloom-Feshbach

I received a pilot grant for Internal Medicine that funded preliminary work on developing and pilot testing videos on advance care planning (ACP) within the Patient Activated Learning System (PALS). That project allowed me to collect pilot data from a racially and ethnically diverse population of patients with advanced cancer for feedback, development, and pilot testing. That preliminary work bolstered my current line of research in the area of digital interventions and video-based communication interventions. This supported project has proven invaluable to obtaining later grants in similar lines of work from the NIH (R21s, R01, and SBIR R44s). I highly recommend this grant mechanism, especially if you are looking to grow or innovate an area in your own program of research.

Megan Shen

The IPCI grant was fundamental in providing funding for a seminal study quantifying salt consumption and its relationship with elevated blood pressure in Haiti. Haiti, like many low-income countries, faces an epidemiologic transition from infectious diseases to chronic diseases contributing to the largest cause of adult morbidity and mortality. In Haiti, hypertension is the leading modifiable risk factor. Our earlier work had found age-adjusted hypertensive prevalence was 29% and occurs earlier in Haitians age 18-30 as compared to Black Americans. What we did not know is why?

We had several hypotheses and a leading one was high salt consumption based on extreme poverty, food practices, and cultural uses.

Salt is a tricky thing to measure. Self-report is known to be inaccurate and yet to measure it in the urine is difficult and cumbersome. We worked with experts at the Weill Cornell Hypertension Center to use a new method called spot urine sodium quantification. A medical student, Adrienne Clermont, took the lead as her AOC (Area of Concentration) project and with IPCI funding. She collected urine samples from approximately 3000 participants and then measured sodium using flame photometry. The results were impressive. Indeed, salt use was high: > 95% of Haitians tested use greater than the WHO recommended amount. Moreover, increased salt use among young Haitians was associated with increased blood pressure.

The IPCI is a unique grant that provides real-time funding for nimble projects that are game changers for primary care. In our case, this work has led to multiple NIH projects.

Margaret McNairy, MD

I am extremely honored to be an IPCI grant recipient in FY 2022-2023. Up to that point my analytic portfolio involved research on older adults with chronic conditions, but I had always had a desire to work on research related to children’s health. This grant gave me the opportunity to get a foothold into that new area of research. One advantage of the IPCI grant mechanism is that it is open to both faculty and aspiring non-faculty members, and this was my ticket to getting to explore my new area of interest. Since receipt of the grant, I have built relationships with the Department of Pediatrics at Weill Cornell and New York State Medicaid (the primary provider of health coverage for low-income children in NY State) and am working on several new projects related to health equity and behavioral health in children. None of this would have been possible without the grant.

Mangala Rajan, MBA

I am a physician who spends most of my time working clinically with patients who have been traditionally excluded from medical research, namely pregnant people. In my work, I frequently have the experience of making a clinical observation that I think is really important in caring for these patients, but never gets the opportunity to be studied more rigorously. The Primary Care and Hospital Medicine Innovations Pilot Grant allowed me, in collaboration with my physician-scientist colleagues, to describe these clinical experiences in such a way that they can be visible and meaningful to the larger medical community. Through this work, we have been able to document complex relationships between the physical and psychological experiences of pregnancy that we hope will inform future research, clinical care, and policymaking.

Alison Hermann, M.D.
Associate Professor in Clinical Psychiatry
Weill Cornell Medicine
Clinical Director, Weill Cornell Medicine Women’s Mental Health Program
Clinical Director, Weill Cornell Psychiatry Specialty Center
Weill Cornell Medicine I NewYork-Presbyterian
Weill Cornell Psychiatry Specialty Center

The IPCI grant was instrumental in helping us explore the relationship between positive care (i.e. “placebo”) effects and point of care ultrasound (POCUS). The funding it provided was crucial to allow us to set up a qualitative exploratory project to better understand the aspects of the intervention so it could be optimized and tested for effectiveness in the future. It funded two students to learn qualitative research methods, coding with NVivo, to present this research at Cornell and at the 2023 national SGIM conference, and to ultimately publish a paper in an open-access, peer-reviewed journal. The pilot data and publication generated will go a long way to bolstering our applications as we seek external funding for further implementing this intervention.

Publication
Point-of-care ultrasound (POCUS): Assessing patient satisfaction and socioemotional benefits in the hospital setting

David Scales, MD