Clinical Informatics and Technology

Clinical informatics and technology

Current Studies

MI-BP: mHealth to Improve Blood Pressure Control in Hypertensive African Americans

Lorraine Buis, PhD, MSI, Principal Investigator

Funded by the National Institutes of Health, National Heart, Lung, and Blood Institute ($2,970,128)

This study seeks to improve hypertension-related outcomes in a cohort of African Americans with uncontrolled hypertension between the ages of 25 and 55, through the use of MI-BP, a comprehensive, multiple health behavior change mobile intervention. This research is guided by three specific aims:

  • Determine the effect of MI-BP on blood pressure control at one year, compared with usual care controls, in a one-year RCT.
  • Determine the effect of MI-BP on secondary outcomes (physical activity, sodium intake, medication adherence) compared to usual care controls, in a one-year RCT.
  • Evaluate the cost-effectiveness of MI-BP compared to usual care methods.

Early Audiology Referral in Primary Care (EAR-PC): Improving Detection of Hearing Loss

Philip Zazove, M.D., Principal Investigator

Funded by the National Institutes of Health, National Institute on Deafness and Other Communication Disorders, Department of Health and Human Services ($1,624,469)

Dr. Zazove is lead investigator of this R21/R33 study, which seeks to increase hearing loss screenings for patients 55 and older by utilizing electronic clinical management tools in primary care setting and multimedia. The MiChart research team has designed a Best Practice Alert (BPA) which notifies primary care providers (PCPs) of HL assessment opportunities and allows clinicians to refer directly and efficiently to audiology specialists. The multimedia project, guided by Micheleen Hashikawa, M.D., also created a video to address physicians’ mental models of hearing loss. The investigation has expanded to look at patients’ decision-making around hearing testing and adoption of hearing aids. The EAR-PC study has partnered with the Beaumont Family Medicine network and Elie Mulhem, M.D., Associate Professor, Oakland University William Beaumont School of Medicine to successfully include 5,500 patients in the pilot study. Dr. Zazove anticipates over 20,000 patients in the R33 phase.

The research is guided by three aims, to:

  • Evaluate whether the EAR-PC program increases PCP identification of patients with mild to moderate HL compared to baseline data.

  • Evaluate whether the EAR-PC program increases appropriate PCP referral of patients with mild to moderate HL to audiology specialists.

  • Utilize both qualitative and quantitative inquiry to investigate how successful PCPs implement the intervention, identifying processes and tools that will allow this project to successfully scale

Speaking Their Language: Using Social Media And Texting To Create An Adolescent-Centered Approach To Healthy Weight Gain During Pregnancy

Tammy Chang, MD, MPH, MS, Principal Investigator

Funded by the National Institutes of Health, Eunice Kennedy Shriver National Institute Of Child Health & Human Development

This mixed-methods study will develop an adolescent-centered tailored eHealth intervention to reduce excess pregnancy weight gain. Researchers will integrate quantitative analyses using nationally representative data  with social media mining and corresponding qualitative interviews with pregnant and postpartum adolescents. The goals of the study are to:

  • Determine which US pregnant adolescents (aged ≤21 years) are at high risk for significant excess pregnancy weight gain;
  • Identify the baselin knowledge, beliefs, and factors that influence excess pregnancy weight gain among adolescents
  • Design and test a scalable healthy diet and exercise eHealth intervention tailored to at-risk pregnant adolescents.

Decision Aid to Technologically Enhance Shared Decision Making (DATES)

Masahito Jimbo, M.D.,Ph.D., M.P.H., Principal Investigator

Funded by National Institutes of Health

Since Colorectal Web (CW) is an interactive decision aid to facilitate Shared Decision Making for average-risk adults needing colorectal cancer screening, this randomized controlled study will compare CW to a non-interactive web-based CRC screening program.

Modeling Professional Attitudes and Teaching Humanistic Communication in Virtual Reality (MPathic VR)

Michael D. Fetters, M.D., M.P.H., M.A., Principal Investigator

Funded by The National Institutes of Health

The M-Pathic VR II project will rigorously evaluate the extent that the newly successful "virtual reality" software program (developed in Phase I) can enhance medical school curricula in professionalism, empathy, and in patient-centeredness (using verbal and non-verbal communication skills) as well as the ACGME competencies when treating a terminally ill cancer patient.

Enhancing the Sustainability of Depression Disease Management Support for Primary Care

Michael S. Klinkman M.D., M.S., Principal Investigator

Funded by Ethel & James Flinn Foundation

Designing a more efficient self-management component for M-DOCC. During the first six months of the project, we will create a series of self-management modules that can be delivered in paper or Web-based format, each linked to a self-assessment instrument, and integrate this into the M-DOCC case management software. During Year 2, we will evaluate the success of this new module by tracking the proportion of new enrollees who complete each module, identify a goal, make progress, or reach a goal, as well as the length of time enrollees remain active in the program. We will also conduct qualitative interviews of enrollees to assess its perceived value.

MyVoice- Real-time Text Messaging Polling to give Adolescents a Voice

Tammy Chang, MD, MPH, MS, Principal Investigator

There is a critical need to understand the opinions and needs of adolescents regarding issues that affect them. Until interventions and policies are tailored to meet adolescents’ needs, they will continue to experience worse health and social outcomes. Thoughts and beliefs of adolescents are difficult to illicit through traditional surveys and interviews because they often have difficulty verbalizing their beliefs due to their ongoing cognitive, social, and emotional development, and limited health literacy. We will use text messaging, a platform used by nearly all teens, to ask weekly open-ended and multiple-choice questions to allow adolescents to ‘speak’ to researchers in real-time using a method they are familiar with.

MCubed study page
MyVoice logo

My Voice study site

Great Lakes Research Into Practice Network (GRIN)

Michael S. Klinkman M.D., M.S., Co-Investigator

Funded by Michigan Academy of Family Physicians Foundation

GRIN is a statewide primary care research network of office practices in family practice, internal medicine, pediatrics, obstetrics and gynecology, and independent-practice nursing. Its goal is to assist primary care researchers to conduct studies in primary care settings. This, in turn, will help practitioners apply research findings that are reflective of the complexities of primary care practice.


Media and Infographics

Video abstract for Timothy Guetterman's 2017 MPathic-VR validation study in Advances in Medical Education and Practice


U-M Family Medicine Research Trailers #4: Text message alerts for medication adherence 

Recent Publications

  1. Senteio C, Veinot T, Adler-Milstein J, Richardson CR. Physicians’ perceptions of the impact of the EHR on the collection and retrieval of psychosocial information in outpatient diabetes care. International Journal of Medical Informatics. 2018;113:9-16. doi:10.1016/j.ijmedinf.2018.02.003.
  2. Braciszewski JM, Wernette GKT, Moore RS, et al. Developing a tailored substance use intervention for youth exiting foster care. Child Abuse & Neglect. 2018;77:211-221. doi:10.1016/j.chiabu.2018.01.013.
  3. DeJonckheere MNichols LP, Moniz MH, Sonneville KR, Vydiswaran VGV, Zhao X, Guetterman TC, Chang T. MyVoice National Text Message Survey of Youth Aged 14 to 24 Years: Study Protocol. JMIR Res Protoc. 2017 Dec 11;6(12):e247. doi: 10.2196/resprot.8502.
  4. Buis LR, Roberson DN, Kadri R, et al. Utilizing Consumer Health Informatics to Support Management of Hypertension by Clinical Pharmacists in Primary Care: Study Protocol. JMIR Research Protocols. 2017;6(10). doi:10.2196/resprot.8059.
  5. Wan ES, Kantorowski A, Homsy D, Teylan M, Kadri R, Richardson CR, et al. Promoting physical activity in COPD: Insights from a randomized trial of a web-based intervention and pedometer use. Respiratory Medicine. 2017 Sept; 130:102-110. doi: 10.1016/j.rmed.2017.07.057.
  6. Guetterman TC, Kron FW, Campbell TC, Scerbo MW, Zelenski AB, Cleary JF, Fetters MD. Initial construct validity evidence of a virtual human application for competency assessment in breaking bad news to a cancer patient. Advances in Medical Education and Practice. Available online 25 July 2017, 8:505—512. doi: 10.2147/AMEP.S138380
  7. Rai M, Moniz MH, Blaszczak J, Richardson CR, Chang T. Real-Time Data Collection Using Text Messaging in a Primary Care Clinic. Telemed J E Health. 2017 May 24. doi: 10.1089/tmj.2017.0022. [Epub ahead of print]
  8. Braciszewski JM, Tran TB, Moore RS,Bock BC, Tzilos GK, Chamberlain P, Stout RL. Developing a Tailored Texting Preventive Intervention: A Card Sort Methodology. Journal of Applied Biobehavioral Research. 19 April 2017. doi: 10.1111/jabr.12060 [Epub ahead of print]

See more

  1. Bian RR, Piatt GA, Sen A, Plegue MA, De Michele ML, Hafez D, Czuhajewski CM, Buis LR, Kaufman N, Richardson CR. The Effect of Technology-Mediated Diabetes Prevention Interventions on Weight: A Meta-Analysis. J Med Internet Res 2017;19(3):e76 DOI: 10.2196/jmir.4709
  2. Buis L, Hirzel L, Dawood RM, et al. Text Messaging to Improve Hypertension Medication Adherence in African Americans From Primary Care and Emergency Department Settings: Results From Two Randomized Feasibility Studies.  J Med Internet Res. 2017 Feb; 5(2). doi: 10.2196/mhealth.6630
  3. Schwartz DD, Stewart SD, Aikens JE, et al. Seeing the Person, Not the Illness: Promoting Diabetes Medication Adherence Through Patient-Centered Collaboration. Clinical Diabetes 2017 Jan; 35(1): 35-42. doi: 10.2337/cd16-0007
  4. Admon L, Haefner JK, Kolenic GE, Chang T, Davis MM, Moniz MH. Recruiting Pregnant Patients for Survey Research: A Head to Head Comparison of Social Media-Based Versus Clinic-Based Approaches. J Med Internet Res. 2016 Dec 21;18(12):e326. doi: 10.2196/jmir.6593
  5. Zivin K, Sen A, Plegue MA, Maciejewski ML, Segar ML, AuYoung M, Miller EM, Janney CA, Zulman DM, Richardson CR. Comparative Effectiveness of Wellness Programs: Impact of Incentives on Healthcare Costs for Obese Enrollees. Am J Prev Med. 2016 Nov 17. pii: S0749-3797(16)30513-X. DOI: 10.1016/j.amepre.2016.10.006
  6. Kron, FW, Fetters MD, Scerbo MW. White CB, Lypson ML, Padilla MA, Gliva-McConvey GA, Belfore II LA, West T, Wallace AM, Guetterman TC, et al. Using a computer simulation for teaching communication skills: A blinded multisite mixed methods randomized controlled trial. Patient Education and Counseling. 2017 April, 100(4):748-759. DOI: 10.1016/j.pec.2016.10.024
  7. Gold KJ, Andrew LB, Goldman EB, Schwenk TL. "I would never want to have a mental health diagnosis on my record": A survey of female physicians on mental health diagnosis, treatment, and reporting. Gen Hosp Psychiatry. 2016;43:51-57. PMID: 27796258
  8. Chaddha A, Jackson EA, Richardson CR, Franklin BA. Technology to Help Promote Physical Activity. Am J Cardiol. 2016 Sep 29. pii: S0002-9149(16)31586-7. DOI: 10.1016/j.amjcard.2016.09.025
  9. Mckee M, Case B, Fausone M, Zazove P, Ouellette A, Fetters MD. Medical Schools' Willingness to Accommodate Medical Students with Sensory and Physical Disabilities: Ethical Foundations of a Functional Challenge to "Organic" Technical Standards. AMA J Ethics. 2016;18(10):993-1002. DOI: 10.1001/journalofethics.2016.18.10.medu1-1610
  10. Riley M, Ahmed S, Lane JC, Reed BD, Locke A. Using Maintenance of Certification as a Tool to Improve the Delivery of Confidential Care for Adolescent Patients. J Pediatr Adolesc Gynecol. 2016 Aug 16. DOI: 10.1016/j.jpag.2016.08.006
  11. Moy ML, Martinez CH, Kadri R, Roman P, Holleman RG, Kim HM, Nguyen HQ, Cohen MD, Goodrich DE, Giardino ND, Richardson CR. Long-Term Effects of an Internet-Mediated Pedometer-Based Walking Program for Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial. J Med Internet Res. 2016;18(8):e215. DOI: 10.2196/jmir.5622
  12. Janevic MR, Aruquipa yujra AC, Marinec N, Aguilar J, Aikens JE, Tarrazona R, Piette JD. Feasibility of an interactive voice response system for monitoring depressive symptoms in a lower-middle income Latin American country. Int J Ment Health Syst. 2016;10:59. DOI: 10.1186/s13033-016-0093-3
  13. Scruggs E, Guetterman TC, Meyer AC, Vanartsdalen J, Heisler M. "An absolutely necessary piece": A qualitative study of legal perspectives on medical affidavits in the asylum process. J Forensic Leg Med. 2016;44:72-78. DOI: 10.1016/j.jflm.2016.09.002
  14. Gold KJ, Normandin MM, Boggs ME. Are participants in face-to-face and internet support groups the same? Comparison of demographics and depression levels among women bereaved by stillbirth. Arch Womens Ment Health. 2016 Aug 25. DOI: 10.1007/s00737-016-0657-x
  15. Wu JP, Gundersen DA, Pickle S. Are the Contraceptive Recommendations of Family Medicine Educators Evidence-Based? A CERA Survey. Fam Med. 2016;48(5):345-52. PMID: 27159092
  16. Chang T, Verma BA, Shull T, et al. Crowdsourcing and the Accuracy of Online Information Regarding Weight Gain in Pregnancy: A Descriptive Study. J Med Internet Res. 2016;18(4):e81. DOI: 10.2196/jmir.5138
  17. Braciszewski JM, Stout RL, Tzilos GK, Moore RS, Bock BC, Chamberlain P. Testing a Dynamic Automated Substance Use Intervention Model for Youths Exiting Foster Care. J Child Adolesc Subst Abuse. 2016;25(3):181-187. DOI: 10.1080/1067828X.2014.981771
  18. Piette JD, Marinec N, Janda K, Morgan E, Schantz K, Yujra AC, Pinto B, Soto JM, Janevic M, Aikens JE. Structured Caregiver Feedback Enhances Engagement and Impact of Mobile Health Support: A Randomized Trial in a Lower-Middle-Income Country. Telemed J E Health. 2016;22(4):261-8. DOI: 10.1089/tmj.2015.0099
  19. Heapy AA, Higgins DM, Lachappelle KM, Kirlin J, Goulet JL, Czlapinski RA, Buta E, Piette JD, Krein SL, Richardson CR, Kerns RD. Cooperative pain education and self-management (COPES): study design and protocol of a randomized non-inferiority trial of an interactive voice response-based self-management intervention for chronic low back pain. BMC Musculoskelet Disord. 2016;17:85. DOI: 10.1186/s12891-016-0924-z  


Collaborative Partners and External Affiliations

    Clinical Informatics and Technology: In the News

    image of melissa dejonckheere, Ph.D.

    December 19, 2017:  MyVoice explained two ways, in TED talk and a new protocol publication

    A fresh approach to longitudinal, mixed methods research design, MyVoice harnesses the power of mobile SMS technology and rapid algorithmic text analysis toward their goal of “strategic science.”

    photo of Dr. Michael Fetters

    December 12, 2017:  A new way to consume research--video abstracts come to family medicine

    Two family medicine faculty have produced short web videos, with support from the department and Michigan Medicine

     lede image of tammy chang presenting myvoice at mcubed

    October 31, 2017: Family medicine research featured by one of the largest governmental technology services companies

    MyVoice is an adolescent health and well-being research project, led by Tammy Chang, M.D., M.P.H., M.S.. In just a year, MyVoice has deployed 90 unique text message-based surveys to a population of over 1,000 adolescents and young adults across the United States. And the project is starting to gain national attention.

    image of doctor in a hospital counseling virtual patient on a laptop screen

    August 2, 2017:  Virtual human technology tested as a cost-effective tool in medical education

    A validation study led by Timothy Guetterman, found promising results for a new tool in medical education

    image of virtual reality goggles viewing medical scenes

    April 27, 2017:  Virtual Humans Help Aspiring Doctors Learn Empathy

    Delivering bad news in a caring way — and coping with a patient’s reaction — is a key skill for doctors. Intuitive technology is helping medical students learn the best approaches.

    image of smart phone with health app

    April 1, 2017: Digital interventions for prediabetics seeking weight loss shown to be effective

    A new meta-analysis published in the Journal of Medical Internet Research found that significant weight loss can be achieved with digital translations of diabetes prevention programs.

    image of smart phone with medication reminder message

    February 21, 2017: Text Message Alerts Help Patients with Hypertension Remember to Take Meds

    In a new study from assistant professor Lorraine Buis, mobile reminders boosted medication adherence in high blood pressure patients.

    Arm 3: Internet-enabled pedometer

    November 6, 2016: Internet-enabled pedometers are most effective for weigh loss in Veterans Walk for Health study

    A recent study, led by Dr. Caroline Richardson, compares the effectiveness of three low-cost walking programs. The three-arm, multisite study found that Web-enhanced pedometers were most effective for weight loss, compared with traditional logbook and simple pedometer walking interventions.

    image of dr. caroline richardson, distinguished mentor award

    August 9, 2016: Pedometer Use Wanes at 12 Months

    A study in JMIR finds that pedometer use, although efficacious at 4 months, is much lower at 12 months. 

    Primary Investigators