Current Research Topics:
- HIV – Being the largest overall healthcare provider in the United States, the Veterans Affairs (VA) health care system is also the largest provider of HIV care in the US. The VA cared for about 17,000 patients with HIV in fiscal year 1999, providing approximately one million outpatient visits and 170,000 days of hospital care. HIV testing continues to be a high priority for the VA, especially given that patients with certain HIV risk factors, (e.g., intravenous drug abuse, homelessness) are overrepresented among VA patients. However, many at-risk VA patients are not tested for HIV. Previous studies showed that only 30-50% of VA patients with documented risk factors have undergone HIV testing. As a consequence, many HIV-positive patients are diagnosed later in the disease course than is optimal. The objectives of my research are to develop methods using system sciences as an innovative approach to assess the organizational cost in the implementation of an expanded HIV testing program, and the long-term goals to extend the new knowledge into more efficient and effective implementation strategies in comparative studies of the VA healthcare system (with electronic medical records) and other non-VA systems. As the new era of the implementation of universal health care reform, there is much to learn from a VA-healthcare system and to adopt new and fresh of delivery of health care and preventive care for the population in general.
- HCV – Research has shown that by the year 2020 there will be an increasing number of patients with hepatitis C (HCV) worldwide, and currently, the Veterans Affairs Healthcare system, being the largest medical care provider to HCV patients, is estimated to identify and treat more patients in the next decade. Computer models can simulate the system effects of introducing new medications by incorporating estimates of drug prices, rates of treatment with the new drugs, possible increases in patients treated, and other key parameters. Patient and provider preferences about how to balance short- and long-term benefits and risks of therapies are not known, and will be important to the cost impacts of new drug combinations to the VA. The objectives of my research are to evaluate the patient and provider’s preferences of new HCV drug regimen, and then, using quantitative preferences, to model how the introduction of powerful protease-based HCV therapies will influence treatment patterns. The long-term outcomes of my research are 1) analyses of patients’ and providers’ preferences for new therapeutic approaches, and 2) cost-benefit analyses of using new HCV drug regimens from a patient and providers’ perspectives. The new knowledge will be critical to help inform VA decision makers at different levels in tailoring programmatic responses aimed at improved delivery of care and patient outcomes with HCV.
- Mental Health – Even though medication can prolong patients with HIV, hepatitis and chronic diseases, patients are often experience stress and have difficult managing stress which can decrease immune responses and affect quality of life. Collaborating with UC San Diego, we are evaluating the cost-effectiveness analysis of new cognitive behavior therapy, meditation, and stress reduction programs compared to traditional pharmacological management. These stress reduction programs have success in stress reduction in patients and medical providers.
- Genetic Testing- Population-based genetic testing in infants for metabolic disorder and genetic diseases before the manifestation of symptoms can improve survival and save lives. Using mathematical models to evaluate the cost and benefits of implementing a population-based newborn screening program are important to guide policy recommendation and allocation of resources. Since the publication of the methods (Chan and Puck, 2005), the states of Wisconsin and Massachusetts adopted the assay to screen for babies for severe combined immunodeficiency (SCID). In our research group, we plan to develop models to balance the benefits and harms of expanding genetic screening and the impact of new screening recommendations on the delivery of child health services.
Current Lab Members (present):
- Michelle Vickery – a graduate student in Master of Public Health (concentration in International Health) at Boston University working on research paper on pharmacogenomics. Michelle was also a teaching assistant for Dr. Kee Chan’s course HS320 Genomics in Public Health in Spring Semester 2012.
- Emily Petro – MPH graduate in Community Health Sciences working on research projects on HIV and women’s health.
- Michael Esang, MD – a graduate student in Master in Public Health in International Health working on cost-effectiveness analysis of stress reduction mantram therapy in patients with HIV.
- Heidi Yang – a graduate student in Master in Public Health Epidemiology working on budget impact of routine HIV testing.
Past Lab Members:
- Amy Dippolito (2012) – MPH student working on HIV testing outreach in homelessness shelters in Massachusetts area.
- Leilani Hernandez (2010-2012) – MPH graduate, current position – data analyst at Harvard Pilgrims.
- Wei Huang (2010-2012) – PhD candidate at Boston University
- Nicole Germino (2010-2012) – MPH graduate, current position – analyst at Thomas Reuters.
- Matt Hanlon (2009-2010) – MPH graduate, current position – analyst at genomic health care center.
- Erika Langer (2009-2011)- MS graduate, current position – PhD candidate at University of California, San Francisco .
- Elizabeth Cho (2009-2011) – BS graduate, current position – studying for Graduate School in Biology.
- Yi-Fang Lee (2008-2009)- MPH graduate, current position – health care analyst at Taiwan Health care center.
- Steven Lin (2008) – MPH graduate, current position – medical student at Boston University