My research focuses on hepatology and liver disease, including pre- and post-transplant care. Recent literature reveals a quality chasm between current evidenced-based guidelines of care and the care actually delivered to individuals with cirrhosis. Currently, our ability to measure and improve health care in hepatology is limited by the lack of national quality indicators, a clear link between these measures and outcomes, and a rudimentary understanding of ideal health care delivery models. Since my fellowship training, I have been working to create a research platform for addressing these gaps in knowledge. I have published exciting preliminary data demonstrating that the burgeoning hospitalist-based model of inpatient care improved the odds of receiving guideline-driven care for patients with cirrhosis admitted with spontaneous bacterial peritonitis. My current on-going projects include:
- Measuring guideline-concordant care and clinical outcomes in hospitalist-based health care delivery model in cirrhosis
- Improving the use of diagnostic paracentesis in hospitalized patients with decompensated cirrhosis and ascites
- Patient Understanding of Discharge Instructions Impact Readmission Rates in Decompensated Cirrhosis
- Validating the National Institutes of Health (NIH)-sponsored Patient Reported Outcomes Measurement Information System (PROMIS) tool in patients with cirrhosis
- Clinical trial to address optimal hepatitis C—see video above right—screening methods in the community in persons who inject drugs (PWIDs)
- Clinical trial to address ideal methods of linkage to care for PWIDs (people who inject drugs).