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VA Maryland Health Care System

 

VA Doctor Awarded NIH Grant

Photo of Dr. Daniel Morgan

Dr. Daniel Morgan is being selected for a system-wide research project aimed at critically assessing and improving how physicians understand fundamental aspects of patient testing and treatment.

Friday, October 6, 2017

(BALTIMORE, Md.)  Dr. Daniel Morgan, chief of Hospital Epidemiology at the VA Maryland Health Care System and an associate professor at the University of Maryland School of Medicine, has been selected for a prestigious National Institutes of Health (NIH) Director's New Innovators Award. Morgan is being selected for a system-wide research project aimed at critically assessing and improving how physicians understand fundamental aspects of patient testing and treatment.  The $ 2.3 million, 5-year grant is given to exceptionally creative scientists proposing high-risk, high-impact research at all career stages.

"We're excited that our chief epidemiologist is thinking about innovative ways to prevent medical overuse, a problem plaguing the health care industry," said Dr. Adam M. Robinson, Jr., director of the VA Maryland Health Care System. "We hope that the research findings will further our efforts to pioneer best practices for high quality care in support of Maryland's veterans."

Morgan's research focuses on pragmatic solutions to common problems by improving clinician's testing and treatment decisions to limit medical overuse. This New Innovators project takes on the tendency among clinicians to believe that tests and treatments are more beneficial than evidence indicates. Sites in Maryland, including within the VA Maryland Health Care System and the University of Maryland Medical System, the VA medical center in San Antonio, Texas and the VA Portland Health Care System in Oregon, will evaluate the reasons clinicians make this error. A team of evidence-based medicine, psychology, anthropology and graphic design experts will develop visual aids that will explain risks implicit in clinical decisions. With a more evidence-based understanding of tests and treatments, clinicians can better inform patients making difficult decisions, and avoid harmful medical overuse.

"The overall objective is to use real-time visual-aid presentations of established medical evidence to transform how physicians and patients make decisions to order tests and treatments," Morgan said. "This has the potential to impact a diverse group of patients with a variety of illnesses within a short timeframe by reducing harms of unnecessary care, improving outcomes, and ultimately providing greater overall value."

Uncertainty in diagnosis and treatment is common in clinical medicine. Diagnosis of disease is a series of probabilities and nearly all treatments are administered based on the chance of benefit. This ‘art' of medicine is learned primarily through apprenticeship in medical training. Doctors are rational decision-makers, but they can make the same mistakes as laypeople when making decisions in situations with changing factors.

"Although the project is aimed primarily toward physicians, it will be in a format that patients can easily understand and consider when making medical-related decisions," said Dr. Thomas Hornyak, associate chief of staff for Research & Development for the VA Maryland Health Care System, which conducts over $25 million in research annually. "Clinician-scientists like Dr. Morgan offer a unique perspective on disease, using insights from the patient care they provide to drive questions they can answer with health system research. His cutting-edge research on epidemiology can improve the essential aspects of clinical care—testing and treatment."

The NIH Director's New Innovator Award initiative supports a small number of early stage investigators who propose bold and highly innovative new research approaches that have the potential to produce a major impact on broad, important problems in biomedical and behavioral research. The New Innovator Award initiative complements ongoing efforts by NIH and its Institutes and Centers to fund early stage investigators through R01 grants, which continue to be the major sources of NIH support for early stage investigators. The NIH Director's New Innovator Award initiative is a component of the High Risk - High Reward Research Program of the NIH Common Fund.

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