Untitled Document

Bill Lafferty, M.D., Merl & Muriel Hicklin/Missouri Endowed Chair in Medicine, and Shauna Roberts, M.D., ’84, professor of medicine, are collaborating on a new model for chronic disease treatment and management.

Endowed chair brings chronic disease
care, research to School of Medicine

By Hannah Crippen

Primary care aims to treat the whole patient, not simply certain symptoms or diseases at a time. This is essential in chronic disease care. For more than a decade, researchers and physicians have tried to reform the health care system through chronic care model-based interventions to improve the management of chronic diseases and health care delivery. Social and environmental factors can determine the prevalence and severity of chronic diseases, such as heart disease, cancer, and diabetes.

This describes the driving force behind the ideas that Shauna Roberts, M.D., ’84, and William Lafferty, M.D., are developing to create the Guided Chronic Care (GCC) model to benefit patients at Truman Medical Center (TMC). Lafferty joined the UMKC School of Medicine in January as the Merl & Muriel Hicklin/Missouri Endowed Chair in Medicine, and he is now the director of the master’s degree program in the Department of Informatic Medicine and Personalized Health, for which he oversees the education and research programs.

Lafferty’s commitment to serving the underserved attracted him to Kansas City and UMKC because of the diverse, unique population and the dedication of its faculty and administration.

This slide outlines the framework of Dr. Lafferty's Guided Chronic Care model.

“I was impressed that 100 percent of my colleagues had the core values to serve those (community members) who have been forgotten or those who have had ‘the short end of the stick’ in life,” Lafferty said. “The commitment of this medical center to these groups of people was a magnet for me. The public-spirited underlying attitude is miles ahead of most other academic medical centers.”

Roberts returned to UMKC a year ago as an associate professor of internal medicine and is a cardiothoracic surgeon and the corporate medical director of Quality at Truman Medical Centers. She is working with Lafferty in efforts to reduce disparities, provide care in a more culturally competent manner and better serve patients in the community. Roberts said she is thankful to be in the academic sector of medicine, as she wanted to do later in her career, and has benefitted from Lafferty’s hands-on approach to mentoring and sharing information. Lafferty and Roberts are working together to improve quality of life, quality of service, and self-management for those with chronic diseases.

Roberts has been interested in data integrity her entire career and is aware of the issue of underlying chronic illnesses and the complexity of care for these patients.

“It isn’t just about caring for the one disease or whatever they have come in for; the treatment affects the chronic underlying disease as well,” Roberts said.

Under Lafferty, the mission statement of the UMKC Office for Health Services and Public Health Outcomes Research’s new program charter is “to establish and promote research projects, health program evaluations, health policy analyses, and professional training programs that will improve the health outcomes of individuals and population groups subject to health disparities.”

Chronic diseases are the most common and costly health problems. According to the Centers for Disease Control and Prevention, chronic diseases are the leading 70 percent of causes of death in the United States and cause major limitations in daily living for approximately one out of 10 Americans. These diseases are also preventable by practicing healthy behaviors, such as eating nutritious foods, being physically active, and avoiding tobacco and alcohol use.

“Broadening the research agenda to focus on public and population health is a refreshing direction,” Lafferty said. “This school is the perfect place to do so. Revising existing chronic care models to be more relevant to low income, ethnically diverse populations is an important step in that direction. There are current deficiencies in coordinated care, and new models for care aim to correct these deficiencies.”

The 2000 Health Assessment – part of Ford Motor Company’s Community Health Assessment – found Kansas City’s health status is comparable to national benchmarks but with profound racial disparities between African American and white residents. Racial disparities are the most pronounced in the urban areas of Kansas City. Roberts said two-thirds of the patients on the Hospital Hill campus are members of ethnic, racial, cultural or linguistic minority groups. Other victims of disparities are those working one or more jobs but still lacking resources such as health care coverage.

“The UMKC School of Medicine faculty are the attending physicians of Truman Medical Centers and are uniquely positioned in their daily management of this unique patient population,” Roberts said. “They have an opportunity to bring everyday scholarship to the bedside as they care for these individuals and do outcomes research.”

The unique approach to the GCC model builds on the idea of improving health care to patients coping with one or more chronic diseases. In addition, it will focus on serving populations affected by health disparities and poor social determinants – such as low income – that influence patients’ participation in treatment programs.

Patients with chronic diseases need ongoing care, and new research must ensure that people who are affected receive quality health care. Orchestrating this care in an efficient and cost-effective way is critical to the U.S. health care system given the enormous expenditures on health care.

In addition to Lafferty and Roberts, the UMKC Office for Health Services and Public Health Outcomes Research has engaged a local health planner, Jane Crigler, M.S.W., to facilitate a series of meetings on how UMKC and TMC can collaborate to improve chronic care delivery. The ultimate goal will be to secure funding from a foundation for TMC, so patient care can achieve the best outcomes possible for people with chronic diseases.

Social aspects of chronic care management will be important to address problems the patients may be having in their homes and how their environment affects their behavior and health. The relationship between the nurses and social workers is a missing piece in other models.

“In order to make improvements in health care, we need to create the change,” Lafferty said.



© 2009 UMKC School of Medicine • Kansas City, Missouri 64108 • (816) 235-1808 - Email questions or comments about this website to umkcmedweb@umkc.edu UMKC is an equal opportunity/affirmative action institution; Part of the University of Missouri System; Reporting Possible Copyright Infringement; Intellectual Diversity