Dr. Huebschmann is a primary care physician and Associate Professor at the University of Colorado School of Medicine with the Division of General Internal Medicine, Adult & Child Consortium for Outcomes Research and Delivery Science (ACCORDS), and the Center for Women’s Health Research.  She has had many leadership positions in research mentoring/training, including serving as: 1. founding Director of the Graduate Certificate in Dissemination and Implementation (D&I) science for the University of Colorado Graduate Program in Clinical Sciences; 2. co-Director of the Network and Outreach Unit for the Colorado Implementation Science Center for Cancer Control and Prevention (ISC3), 3. Co-Director of the Colorado NHLBI-funded D&I K12 training program; 4. immediate-past chair of the Education, Training, and Career Development Council for the Society of Behavioral Medicine. Dr. Huebschmann began her education at the University of Illinois at Urbana-Champaign, earning a BS in Environmental Engineering, then going on to earn her medical degree in 2000 from Vanderbilt University School of Medicine and complete her residency at the University of Colorado School of Medicine (2003). After her medical training, she completed the HRSA-funded Primary Care Health Services Research fellowship at the University of Colorado (2006-2009) that led her to successfully compete for a KL2 career development award from the Colorado Clinical and Translational Sciences Institute (CCTSI), followed by a NHLBI K23 career development award.

1. Why is your area of science important?

My work focuses on Dissemination and Implementation (D&I) science methods.  D&I science is important to the “scaling out” or dissemination of evidence-based interventions at a population level.  Without the use of D&I methods to actively promote dissemination, Balas and Boren published that only 14% of evidence-based interventions are ultimately translated into practice, and that it takes 17 years for even those few interventions to take root. A key premise of D&I science is that it is key to work with stakeholders to understand how best to tailor a specific evidence-based intervention to fit the specific contextual factors of their setting.  Without this type of tailoring, new settings will often decline to adopt/implement a beneficial intervention, even if it meets their priorities.

2. What was important in your Health Services Research training?

So many things!  I benefited greatly from my Primary Care Health Services Research fellowship that I completed from 2006-2009, when it was led by Dr. Allison Kempe, and I subsequently completed additional training through the CCTSI Clinical Faculty Scholars Program, the CCTSI KL2 award, and a NHLBI K23 award.  Thinking back over all of that training, I would call out 3 specific things that were important:

1. primary research mentors who sought to help me develop my personal research goals rather than seeking to create a junior researcher who was stamped in their image;
2. committed GIM Division chairs — Jean Kutner followed by Mark Earnest — who provided appropriate protected time for me to advance my independent research agenda;
3. clearly identifying training goals to address during my K-award training that would allow me to advance my independent research goals to improve chronic disease prevention and management in primary care – in my case, that included training in behavioral science, community-engaged research, and D&I science.

3. What are the major take-home messages your current research provides?

I am working on a few different projects, but in focusing on the lessons learned from the take-home messages from my D2V pilot project that implemented an evidence-based program for improving diabetes care into 3 UCHealth primary care clinics, a few key take home messages were:

1. It’s critical for our implementation strategies to fit stakeholders’ priorities and workflow for diabetes care management. 

• In terms of priorities, our UCHealth clinics are incentivized by our current value-based care contracts to improve/lower our rates of patients with certain thresholds of poor diabetes control, and it was important to match that threshold in the inclusion criteria of patients to include
• In terms of working with clinic workflows, many UCHealth clinics rely on clinical pharmacists (PharmDs) to serve as a referral source for patients who are not meeting the clinic targets for diabetes and hypertension.  The clinics have standing protocols that allow them to titrate certain diabetes medications automatically, and they can also focus their entire encounter with a patient on a specific topic – diabetes, in this case.  Given this combination of factors, we found that clinical pharmacists were well-prepared to implement in programs for chronic disease management programs such as this one.

2. Implementing online tools and coaching for patients with uncontrolled diabetes in primary care can work very well if there is the proper technical assistance in place to get patients set up with those tools.   However, in our study, we learned that clinic staff don’t have enough bandwidth to do this on their own, and need support.  I am excited to be working now with UCHealth on a new Diabetes Home and Remote Care program that provides this type of technical assistance to set up patients with type 2 diabetes with Bluetooth-enabled glucometers and mobile phone apps.

4. What are your goals or areas for future research?

Generally, my goals continue to be to conduct research that improves how primary care practices can prevent/treat chronic diseases for their patients.  Giving one specific example, I am excited for our newly funded NHLBI DECIPHeR UG3/UH3 grant that seeks to reduce disparities in pediatric asthma care by disseminating an evidence-based intervention that leverages partnerships with primary/specialist asthma care, school nurses, asthma navigators, and public health.

5. What advice do you have for researchers who want to work in this area?  OR  What is the most important advice you have received from your mentors?

When you are designing studies as a junior investigator, listen well to your stakeholders, and to input from your mentors to guide the approach.  If there are differences of opinion on how to proceed, try to hold discussions with the key thought leaders from each side, in order to come to consensus.  If you can’t build a complete consensus, then you need to trust your instincts on which way to go as the PI.