News and Events

Alfred Tallia with Quality Institute Board Member.

Alfred F. Tallia, MD, MPH, Professor and Chair of Family Medicine and Community Health at the Robert Wood Johnson Medical School at Rutgers University. 

You recently were named Chair of the National Board of Medical Examiners. What critical differences do you see between your medical school education and the medical school education of today?

Over the course of the last 40 years — from the time I was a medial student to where we are today — I’ve seen an enormous shift away from what I call ‘paternalism.’ The doctor was considered the arbiter of what’s right or wrong. Now we see that the patient is the driver of their health care needs and the role not just of the physician, but of all health care providers, is to get the patient to the best place he or she can possibly be with respect to their health. It’s been a cultural shift.

You have been part of the Quality Institute for two decades through your leadership at Rutgers Robert Wood Johnson Medical School. What do you value most about your membership?

My life and my work is all about improving the quality of care that we as clinicians provide to our patients. As you might imagine, I found from the very beginning of working with Quality Institute — I was there at its inception — that my work was congruent with the objectives of the Quality Institute. I can say that everything the Quality Institute does and stands for fits tightly with everything I’ve tried to do as an academic physician.

Primary care and family medicine is essential to almost all of the new alternative payment models and innovations. How are you preparing your students for these changes?

I can tell you that we’ve been preparing and waiting for these innovations for 50 years! Every other Westernized, industrialized country — except for the United States — has recognized that primary care, family medicine specifically, along with public health, is an essential ingredient to having a healthy population…My work at Rutgers Robert Wood Johnson Medical School is connected to my work on the national level. I was involved in the Patient-Centered Primary Care Collaborative in Washington that had significant influence in framing the Affordable Care Act. At Rutgers, we have participated with just about every CMS and CMS Innovation Center experiment around different modalities that promote primary care and promote patients involvement in their own care. This works synergistically with what the Quality Institute is doing to improve care for individuals and families, particularly those in lower socio-economic populations.

You talk to many medical students unsure of their path in medicine. What changes in health care do you want to see that would encourage more young doctors and medical students to pursue a career in primary care?

The evidence boils down to economics. All the data we have from around the world demonstrates the more primary care you have the better the health of the population — and it costs a lot less. The reality is we have just about opposite the work force of other OECD (Organization for Economic Cooperation and Development) nations. Those countries have about 70 percent of their health care work force in primary care and about 30 percent in sub-specialty care. The United States actually has just the opposite. We have about 30 percent workforce in primary care and that means physicians, physician assistants, nurse practitioners.

Why is that? It’s the way the reward system is set up. The reward system in the United States has been pretty much promulgated by MedPAC, a committee mostly dominated by sub-specialists, that recommends to Medicare how to reimburse for things. Medicare has followed their lead. As a result, procedural and acute services are reimbursed at a far higher rate than cognitive and chronic/preventive services — disadvantaging family physicians, who mostly work in the cognitive domain. Medical students are smart people, and a lot of them go into debt to finance their education. So the more we can promote equity in the reward systems, the more likely we will get the workforce we need.

You have seen many innovations in health care. Looking ahead, what innovations do you believe will make the most difference to patients and their families?

Transparency in health care, specifically the reporting of performance of different parts of the health care system, will empower patients to make decisions that will benefit them. Not just on cost. That’s important. But reporting of quality data on hospitals and clinicians really is something that is empowering to people and will drive change for the better.

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The Dean's Weekly View: HIGHLIGHTS OF THIS WEEK'S NEWS - May 3, 2019

Freehold Family Health Center to Serve as New Site foFamily Medicine Residency Program

Freehold Family Health Center
The Freehold Family Health Center, a collaboration among the medical school, CentraState Healthcare System, Visiting Nurse Association Health Group and VNA of Central Jersey Community Health Centers, celebrated its Open House this week.
The 25,000-square-foot Federally Qualified Health Center, located in Freehold on Route 33 Business, incorporates the medical school's Family Medicine Residency program into a traditional family health center model. Our residents will care for patients throughout their residency, providing not only traditional family medicine and community health services, but such services as prenatal care and geriatric services.
"This state-of-the art facility will serve as the new ambulatory teaching site for the residency, and will enable comprehensive primary care for the population linked to social services, which has been shown to reduce the need for costly downstream services as illness burdens are exacerbated by social determinants," said Alfred F. Tallia, MD, MPH, professor and chair of the Department of Family Medicine and Community Health, who spoke at the Grand Opening. "This family health center will co-locate, coordinate, and integrate the much-needed social and health services provided through the VNA with medical services provided through the hospital and residency, thereby meeting the needs of patients and families. We are excited about this landmark facility and its services, and anticipate it will be a model that will be replicated elsewhere around the state and country."

Dr. Ciminelli to Lead NJ Academy of Family Physicians

Dr. Maria Ciminelli
Maria F. Ciminelli, MD, assistant professor of family medicine and community health and program director of the medical school's Family Medicine Residency Program at CentraState Medical Center, has been elected president of the New Jersey Academy of Family Physicians. She has been serving as president elect of the organization and, in 2016, was honored by the NJAFP as the New Jersey Family Physician of the Year.
A chapter of the American Academy of Family Physicians, NJAFP, with nearly 2,000 members, is the largest primary care medical society in the state.
Dr. Ciminelli will be installed as president during the academy's annual gala on Saturday, June 15, in Atlantic City.
Congratulations, Dr. Ciminelli!

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https://info.vnahg.org/vna-health-group-board-trustee-alfred-f.-tallia-md-mph-elected-chair-of-national-board-of-medical-examiners

VNA Health Group Board Trustee Alfred F. Tallia, MD, MPH Elected Chair of National Board of Medical Examiners

04-08-2019

Tallia_Alfred_headshot 2019

Alfred F. Tallia, MD, MPH

New Brunswick, NEW JERSEY (April 8, 2019) – Alfred F. Tallia, MD, MPH, professor and chair of Family Medicine and Community Health at Rutgers Robert Wood Johnson Medical School, was elected chair of the National Board of Medical Examiners (NBME) at its annual meeting in Philadelphia on March 29, 2019. Dr. Tallia has been a Trustee of Visiting Nurse Association Health Group, the second-largest nonprofit VNA in the country, since 2015.

The NBME is the preeminent independent not-for-profit organization that provides high quality examinations for health professions around the world. Protection of the health of the public through state-of-the-art assessment is the mission of the NBME, along with a major commitment to research and development in evaluation and measurement. The NBME draws its selective membership of 80 leading academics, practitioners, and the public from across the landscape of health care.

“My life’s work has been geared to improving the quality of care we provide patients, and this role will allow me an opportunity to extend those efforts internationally. It is indeed a great honor and privilege for me, and what a wonderful reflection on Rutgers and the state of New Jersey,” said Dr. Tallia.

“Dr. Tallia has been an incredible leader, supporting this organization with his time and resources with tremendous generosity for many years,” said Steven Landers, MD, MPH, President and CEO of VNA Health Group. “We are incredibly proud of Dr. Tallia’s work to improve patient care and his most recent appointment as Chair of NBME will amplify those efforts and likely improve patient quality for more patients in New Jersey and beyond.”

Among other services, the NBME develops the three-step United States Medical Licensing Examination (USMLE), jointly owned with the Federation of State Medical Boards, which provides a common evaluation system for applicants seeking initial licensure to practice medicine in the United States. Dr. Tallia has been associated with the NBME since 1996 and served most recently as treasurer. Among many roles, he has chaired the Composite Committee governing the USMLE, and the Committee to Evaluate the USMLE, from which recommendations issued in 2008 influenced medical education around the world.

At Rutgers, during his thirteen years as department chair, Dr. Tallia has overseen growth of the department’s academic and clinical programs that now serve more than 100,000 students, professionals, and patients each year in hospitals, medical offices, post-acute and long-term care facilities, homes, schools, businesses, and other sites throughout New Jersey. Dr. Tallia is a Fellow in the Rutgers Center for Organizational Leadership, and his public service to improve health care in the state was recognized by a joint resolution of the legislature in 2017.

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https://globalhealth.rutgers.edu/news/health-passport-to-healthy-living/

For New Brunswick’s Poorest Residents, a Path to Better Health

For New Brunswick’s Poorest Residents, a Path to Better Health

For New Brunswick’s Poorest Residents, a Path to Better Health
by Lori Riley | May 21, 2019 | News


Special Feature: Rutgers Global Health Institute Seed Grants Series

By definition, global health involves the pursuit of health equity worldwide. This includes Rutgers’ local communities, where disparities in health and health care access are influenced by such factors as race, socioeconomic status, gender, and age.

Robert Wood Johnson Medical School’s HIPHOP Promise Clinic, which is run by students with faculty supervision, provides free primary care to the clients of Elijah’s Promise soup kitchen in New Brunswick. HIPHOP (Homeless and Indigent Population Health Outreach Project) Promise Clinic’s patients are uninsured, and many are afflicted with common chronic conditions such as hypertension and diabetes.

Located within the Eric B. Chandler Health Center, HIPHOP Promise Clinic relies on collaboration between Rutgers and community partners, including Karen WeiRu Lin, professor of family medicine and community health at the medical school (RWJMS), and her mentee, Aisha Van Pratt Levin, who graduated from RWJMS on May 20, earning a medical degree.

In 2017, as a second-year medical student, Van Pratt Levin—inspired by her own experiences growing up in Tijuana, Mexico—approached Lin with an idea aimed at empowering the clinic’s patients to become more active in their health care.

International inspiration for a local intervention

“In Mexico, all citizens use a cartilla de salud, or health booklet, to record details of their health and health care activities,” Van Pratt Levin says, referring to a nationwide program launched in 2009 as part of the country’s Estrategia Nacional de Promoción y Prevención para una Mejor Salud (National Promotion and Prevention Strategy for Better Health).

“They not only keep track of medical appointments, but also their weight, blood pressure, lab results, illnesses, prescriptions, mental health, exercise, and eating habits. The cartillas are the backbone of health care appointments in Mexico,” she says.

The cartillas also are useful for communicating among family members, caregivers, and health care providers and, in an emergency, could be a lifesaving source of information about a patient’s medical history.

A passport to healthy living

Lin, who is assistant dean for global health at RWJMS and has practiced in community health for more than 30 years, says that numerous studies show that active patient involvement in their own health management positively influences their health outcomes.

Van Pratt Levin and Lin began working together to implement a similar program—Health Passport to Healthy Living—at the HIPHOP Promise Clinic. Also involved are numerous RWJMS medical students and Rutgers professor Peter Guarnaccia, who is Van Pratt Levin’s faculty adviser in the Chancellor’s Global Health Scholars program. Guarnaccia, a medical anthropologist who studies the intersection of culture and health, has been engaged with New Brunswick’s largely Hispanic immigrant community for decades.

The collaborators initiated the Health Passport to Healthy Living pilot program last summer, using seed grant funding from Rutgers Global Health Institute, where Lin and Guarnaccia are core faculty members.

At the onset of the project, they asked patients for feedback on the health passport’s design and functionality using a prototype based on the Mexican cartillas.

“Some patients thought the blood sugar section, for example, was overwhelming because they were recording their levels four times a day,” Van Pratt Levin says. “Patients also suggested a section for personal health goals.”

As the co-principal investigator of the seed grant, Lin oversaw the data collection and worked with the medical students to redesign the health passport. In September 2018, a sample of 40 patients began using the new passports.

Evaluating outcomes

For six months, Lin, Van Pratt Levin, and RWJMS medical students observed the dynamics within the clinic as related to the health passport initiative. In March 2019, they conducted follow-up surveys with the 40 patients.

Anecdotally, Van Pratt Levin says that they gained clearer insight into the barriers affecting the health passport program. For example, she says that it appears to have been challenging for the medical students and other clinicians to find time to incorporate the passports into their patient appointments. “This preliminary observation is consistent with the literature on similar projects,” she says. “It needs to become part of the norm, with buy-in throughout the clinic’s leadership and full staff.”

The clinic’s above-average volume of patients during this time period also may have been a limiting factor, she says.

Where to go from here

“Now it’s under consideration for the first- and second-year medical students to be responsible, mainly, for interacting with their patients on using the health passport,” Van Pratt Levin says. “They spend a lot of one-on-one time with the patients and help them navigate their care, within and beyond the clinic.”

The project team is still reviewing the pilot data, looking at quantitative measures of patients’ health improvements (related to diabetes, hypothyroidism, and hypertension, for example) and qualitative information about the patients’ and providers’ experiences using the passports (changes in understanding of their conditions, as well as feelings of empowerment and participation).

Though Van Pratt Levin has graduated, the health passport program will continue at HIPHOP Promise Clinic, under Lin’s leadership, as an ongoing project involving RWJMS medical students. “Dr. Lin’s mission is for this to become part of the natural flow at the clinic, which takes time to develop,” Van Pratt Levin says. “Her vision is beyond Promise Clinic—she wants to expand this throughout the city of New Brunswick. This is only the beginning.”

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The articles below were reprinted from the Rutgers RWJMS - The Dean's Weekly View

July 2018
$3M Grant Supports Rutgers Initiative to Study Tobacco 21 Laws

Shawna V. Hudson, PhDCongratulations to Shawna V. Hudson, PhD, professor and research division chief, Department of Family Medicine and Community Health, who was awarded a $3 million grant from the National Cancer Institute, along with co-principal investigator Christine Delnevo, PhD, director of theCenter for Tobacco Studiesat Rutgers School of Public Health and co-leader of the Cancer Prevention and Control Research Program at Rutgers Cancer Institute of New Jersey. The team will study the effectiveness of Tobacco 21 laws in the hopes of helping determine how tobacco control policies aimed at young people can be strengthened to improve their health and avoid untimely deaths due to tobacco-related illness.

Tobacco 21 laws raise the legal age to purchase tobacco products to 21 years old. Today, five states, including New Jersey, and more than 310 cities have enacted this policy, and passage of similar laws is spreading quickly. Because of the novelty of Tobacco 21 laws, however, it is unclear how successful this type of policy change is, researchers say. Using this new grant, Dr. Delnevo and Dr. Hudson, who also is a research member of Rutgers Cancer Institute of New Jersey and professor of Social and Behavioral Health Sciences in the School of Public Health, will examine how the adoption, implementation and maintenance of these policies impacts public health outcomes, while also using the evidence to determine the impact on racial and ethnic disparities.

Learn more about the grant and team's work.

Family Medicine Residency at CentraState Partners with VNA

The Robert Wood Johnson Medical School Family Medicine Residency Program at CentraState Medical Center has partnered with the Visiting Nurse Association of Central Jersey to open a new health center in Freehold Borough in which medical school residents will train. The VNA is in the process of refurbishing a former supermarket in the borough, which will include administrative offices on one side for the VNA and a primary care clinic on the other.

Medical school residents and faculty will staff the clinic, Greater Freehold Community Health Center, offering comprehensive primary care services for the entire family, including health screenings and education, prenatal care, podiatry, behavioral health, nutrition counseling and diabetic education to individuals and families free of charge. Additional services offered to patients that also provide training and education to residents, include: sports medicine, gastroenterology, geriatrics and ophthalmology.

Read more in recent news articles by NJBIZ and cms.centraljersey.com.

March 2018
Family Medicine's CPC+ Program Reports Great Success in Clinical Quality Metrics

check list iconFamily Medicine at Monument Square (FMMS) and Family Medicine at Monroe, as part of Comprehensive Primary Care Project Plus (CPC+), recently submitted the clinical quality metrics for reporting to the Centers for Medicare and Medicaid Services (CMS), achieving the 70th percentile or higher for six of the clinical quality metrics, thus meeting the highest bar of success that CMS sets for CPC+.

This achievement is due to the hard work of all FMMS and Family Medicine at Monroe staff, clinicians and IT team members, say Cathryn Heath, MD, and Elizabeth Clark, MD, MPH, both associate professors of family medicine and community health at Rutgers Robert Wood Johnson Medical School.

These quality metrics show that the practice performed equal to or better than 90 percent of U.S. practices in the areas of tobacco screening and cessation, controlling high blood pressure, and lack of imaging for low back pain. It also met or exceeded performance requirements in the areas of breast cancer screening, cervical cancer screening and colorectal cancer screening.

The practice plans to use the data to identify additional opportunities to improve the care provided to patients, including increased outreach efforts for patients with diabetes and additional services to improve patient engagement. Congratulations on your achievements thus far!

This article appeared in March 15, 2018 Patients First! Updates about Rutgers Health initiatives.

CentraState Honors Drs. Swee and Tallia

 Drs. Swee and Tallia

Congratulations to David E. Swee, MD, professor and former chair of family medicine, and associate dean for faculty affairs, and Alfred F. Tallia, MD, MPH, professor and chair of family medicine and community health, who were honored at the 56th Annual Celebration Ball to benefit CentraState Medical Center in Freehold.

Dr. Swee and Dr. Tallia received the Excellence in Healthcare Award for their support and leadership of the Family Medicine Residency Program at CentraState, which is sponsored by the medical school.

Photo From l-r: David Swee, MD; John Gribbon, president and CEO of CentraState; Nancy Barone, vice president of development for the CentraState Healthcare Foundation; and Alfred Tallia, MD.

May 2017
Edward J. Ill Awards Recognizes Dr. Tallia

Alfred Tallia, MD, MPH, professor and chair of Family Medicine and Community Health, was one of this year's honorees at the Edward J. Ill Excellence in Medicine awards. Dr. Tallia received the Peter W. Rodino, Jr., Citizen's Award in recognition of his distinguished service in advancing and promoting the health and well-being of the people in New Jersey. Dr. Tallia, who is an alumnus of the medical school, is nationally recognized as an expert in quality of care, organization, and function of health care in the United States, particularly at the primary care and health system levels.

Dr. Al Tallia is pictured with former Senator Peter Inverso and Ken Miller, president, BD Diabetes CareDr. Tallia was recently elected as treasurer of the National Board of Medical Examiners Executive Board, for which he has served as a volunteer for more than 20 years as part of USMLE Step 3 examination committees, the Family Medicine Subject Examination task force, the USMLE Budget, Finance and Audit, and Test Accommodations committees, the centennial steering committee, chair of the USMLE evaluation program, as a board member, and executive board member-at-large, among other roles. Dr. Tallia chairs the Composite Committee governing the USMLE program, the common licensure assessment pathway for all foreign and domestic medical school graduates. Congratulations, Dr. Tallia!

Photo Dr. Al Tallia is pictured (left to right) with former Senator Peter Inverso and Ken Miller, president, BD Diabetes Care

April 2017
New Report Identifies Local High-Utilizer Hotspots

the Greater New Brunswick Hotspotting Report coverThe Office of Community Health, along with the Department of Family Medicine and Community Health, has released the Greater New Brunswick Hotspotting Report, an analysis of the geography and factors associated with high utilizers of health services in the greater New Brunswick community. Many of the high utilizers -- patients who visited New Brunswick emergency rooms five or more times in a two-year period or had three or more hospital stays -- are concentrated in 10 percent of the census blocks and eight buildings and apartments complexes in New Brunswick and neighboring Franklin Township, which are designated "hotspots."

The study, funded by The Nicholson Foundation, was conducted along with the Camden Coalition of Healthcare Providers, Robert Wood Johnson University Hospital and Saint Peter's University Hospital. Maria B. Pellerano, MA, MBA, MPH, assistant professor; Eric Jahn, MD, professor and senior associate dean of community health; and Alfred F. Tallia, MD, MPH, professor and chair -- all of the Department of Family Medicine and Community Health and the primary authors of the report -- indicated that this information is a critical first step in determining how to improve care and lower costs for some of the area's most in need residents. Working with local health providers and partners, they hope the report can be used to develop targeted programs to keep the patients healthy and out of the hospital.

View the Greater New Brunswick Hotspotting Report