NAME: Elliott, Thomas Edward OMB No. 0925-0001/0002 (Rev. 08/12 Approved Through 8/31/2015) BIOGRAPHICAL SKETCH Provide the following information for the Senior/key personnel and other significant contributors. Follow this format for each person. DO NOT EXCEED FIVE PAGES. era COMMONS USER NAME (credential, e.g., agency login): TEELLIOTT POSITION TITLE: Senior Research Fellow, HealthPartners Institute for Education and Research, Adjunct Professor, University of Minnesota Medical School EDUCATION/TRAINING INSTITUTION AND LOCATION DEGREE (if Completion Date FIELD OF STUDY applicable) MM/YYYY University of Kansas, Lawrence, KS BA 1966 Chemistry and Zoology University of Kansas, Kansas City, KS MD 1970 Medicine University of Iowa, Iowa City, IA Residency 1971 Internal Medicine University of Minnesota, Minneapolis, MN University of Iowa, Iowa City, IA A. Personal Statement Residency 1973 Anesthesiology Residency Fellowship 1977 Internal Medicine, Medical Oncology & Hematology I joined HealthPartners Institute for Education and Research (HPIER) January 2014 as a Senior Research Fellow. Previously I have had over 36 years of research experience, clinical practice, and research administration at Duluth Clinic, Essentia Health, and Essentia Institute of Rural Health (a research center sponsored by Essentia Health). My clinical training and expertise includes medical oncology, hematology, pain medicine - anesthesiology, and hospice and palliative medicine. From 1978 to 2000, I participated as an investigator in the NCI-funded Duluth Clinic CCOP. In 1990 I became Chief of Education and Research for the Duluth Clinic and conducted numerous NCI and other federal agencies-sponsored research projects over the subsequent 20 years. In 2010, I became the inaugural Executive Director of Essentia Institute for Rural Health, a new center sponsored by Essentia Health for investigator-initiated research focused on rural populations. During those four years I focused mainly on building a new research institute (hiring investigators, leading an institute with 12 full time investigators and 80 support staff), which limited time for my investigator-initiated research. Now I have left these past positions and will focus entirely on investigator-initiated research at the Institute. This project is very congruent with my past research interests and expertise, which include improving cancer care delivered by primary care providers in rural settings. As PI of this proposed project I am in a unique position to be quite effective. I have many years of experience as a medical oncologist, investigator, and physician-leader at Essentia Health, the performance site for this project. Now employed at the Institute I have joined a team of national leaders and investigators in effective point-of-care EHR-linked clinical decision support systems in primary care settings. In addition, I have served on numerous NCI study sections and special emphasis panels over the last 20 years and published over 150 scholarly works in peer-reviewed publications. My experience and previous research projects provide me with the required expertise to lead this proposed project that will implement a sophisticated, web-based clinical decision support system for primary care providers at the point of care focusing on primary and secondary cancer prevention in a large mostly rural population. We have assembled an outstanding team that includes the methodological, statistical, health behavior change, health economics, analytical, programming, and scientific expertise of the HPIER investigators with the experienced, senior investigators at Essentia Health/Essentia Institute of Rural Health, the performance site.
Among several research interests as shown in this biographical sketch, my leading research interest is to increase primary care providers capacity to improve the care of cancer patients in their communities, but most importantly to improve primary and secondary cancer prevention. We know that nearly two-thirds of cancers result from unhealthy life styles and behaviors. However, most of these factors are modifiable and are best conducted and promoted by primary care providers, who encounter most Americans in their clinics and communities regularly. Having conducted research that promotes primary care in cancer prevention and collaboration in cancer treatment for over 30 years, I am ideally suited to lead this innovative study. Four publications that are relevant to this proposal include: 1. Elliott TE, Bianco JA. A primary care primer for cancer prevention in rural populations. Disease-a-month: DM. 2012;58(11):651-60. Epub 2012/10/16. doi: 10.1016/j.disamonth.2012.08.003. PubMed PMID: 23062681 2. Elliott TE, Elliott BA, Regal RR, Renier CM, Haller IV, Crouse BJ, Witrak MT, Jensen PB. Improving rural cancer patients outcomes: a group-randomized trial. Journal of Rural Health 2004; 20(1): 26-35. 3. Elliott TE, Elliott BA, Regal RR, Renier CM, Haller IV, Crouse BJ, Witrak MT, Jensen PB. Lake Superior Rural Cancer Care Project Part III: Provider Practice. Cancer Practice 2002; 10(2): 75-84. 4. Elliott TE, Elliott BA, Renier CM, et al. Rural-urban differences in cancer care. Results from the Lake Superior Rural Cancer Care Project. Minn Med. 2004;25:44-50. B. Positions and Honors Positions and Employment 1977-1979 Adjunct Assistant Professor, University of Minnesota Medical School, Duluth, MN 1979-1987 Adjunct Associate Professor, University of Minnesota Medical School, Duluth, MN 1987-Present Adjunct Professor, University of Minnesota Medical School, Duluth, MN 1977-2010 Medical Oncologist/Hematologist, Duluth Clinic, Duluth, MN 1978-1990 Medical Director, Hospice Duluth, St. Luke s Hospital, Duluth, MN 1990-2006 Medical Director, St. Mary s Hospice, SMDC Health System, Duluth, MN 1990-2010 Chief of Research and Education, SMDC Health System, Duluth, MN 2000-2010 Pain Medicine physician, Essentia Health East Region, Duluth, MN 2000-2010 Medical Director, Pain Management Center, Essentia Health East Region, Duluth, MN 2010-2013 Executive Director, Essentia Institute of Rural Health, Duluth, MN 2014-Present Senior Research Fellow, HealthPartners Institute for Education and Research, Minneapolis, MN Honors and Awards 1969-Present Alpha Omega Alpha, University of Kansas Medical School 1978-Present Membership in American Society of Clinical Oncology, American College of Physicians 1979, 1980, 1984, 1986, 1990 Teacher of the Year, University of Minnesota Medical School Duluth 1989-Present Membership in American Pain Society, American Academy of Hospice and Palliative Medicine, International Association for the Study of Pain, American Association for Cancer Education, American Academy of Pain Medicine, International Society for Quality of Life Research 1991-Present Fellow, American College of Physicians 1992-Present Who s Who in America 1993 AHPR, Rural Health Research Centers Peer Review Panel, member 1995-1998 NCI Subcommittee G Study Section, regular member 1998-2000 NCI Subcommittee G Study Section, chair 1998-2010 Best Doctors in America 1998-Present Journal of Cancer Education, Editorial Board 2000-Present International Directory of Distinguished Leadership 2001 NCI Subcommittee G Study Section, ad hoc member 2003 NCI Subcommittee F Study Section, ad hoc member 2005-Present Who s Who in American Education 2005-Present Who s Who in Medicine and Healthcare 2005 NCI Special Emphasis Panel/IRG ZCA1 RTRB-N, member 2006-2007 NCI Risk, Prevention and Health Behavior Study Section, member 2012 100 influential healthcare leaders in Minnesota 2015 NIH Special Emphasis Panel, ZRG1 HDM-X, member
C. Contribution to Science 1. Rural Cancer Care: As an oncologist and cancer researcher, improving rural cancer care ranging from prevention and screening to diagnosis and treatment, and to survivorship and end-of-life care has been my primary research focus. From 1978 to 2000, I participated as an investigator in the NCI-funded Duluth Clinic Community Clinical Oncology Program that offered hundreds of clinical trials and resulted in hundreds of publications over 22 years. I also served as PI of Lake Superior Rural Cancer Care Project (R01CA56334), a cluster-randomized trial conducted in 18 communities in rural Minnesota, Wisconsin & Michigan that tested interventions to improve primary care providers knowledge, competencies and practice behaviors and their cancer patients outcomes. This project resulted in 18 publications. Four publications in this area include: 1. Elliott TE, Elliott BA, Regal RR, Renier CM, Haller IV, Crouse BJ, Witrak MT, Jensen PB. Improving rural cancer patients outcomes: a group-randomized trial. Journal of Rural Health 2004; 20(1): 26-35. 2. Elliott TE, Elliott BA, Regal RR, Renier CM, Haller IV, Crouse BJ, Witrak MT, Jensen PB. Lake Superior Rural Cancer Care Project Part III: Provider Practice. Cancer Practice 2002; 10(2): 75-84. 3. Elliott TE, Elliott BA, Regal RR, Renier CM, Crouse BJ, Gangeness DE, Witrak MT, Jensen PB. Lake Superior Rural Cancer Project Part II: provider knowledge. Cancer Practice 2001;9(1):37-46. 4. Elliott TE, Bianco JA. A primary care primer for cancer prevention in rural populations. Disease-a-month: DM. 2012;58(11):651-60. Epub 2012/10/16. doi: 10.1016/j.disamonth.2012.08.003. PubMed PMID: 23062681. 2. Cancer Pain Management: As a pain medicine/anesthesiologist-oncologist, my clinical and research interests intersect at improving pain associated with cancer and cancer therapies. I served as the PI of Minnesota Cancer Pain Project (R25CA57803), a cluster-randomized trial conducted in six Minnesota cities that tested interventions to improve providers knowledge, competencies and practice behaviors and their cancer patients pain outcomes. This project resulted in 14 publications. Four publications in this area include: 5. Elliott BA, Johnson KM, Elliott TE, Day JJ. Enhancing cancer pain control among American Indians (ECPCAI): a study of the Ojibwe of Minnesota. J Cancer Educ 1999;14:28-33. 6. Elliott TE, Murray DM, Oken MM, Johnson KM, Braun BL, Elliott BA, Post-White J. Improving cancer pain management in communities: main results from a randomized controlled trial - the Minnesota Cancer Pain Project. J Pain Symptom Manage 1997; 13:191-203. 7. Elliott TE, Murray DM, Elliott BA, Braun BL, Oken MM, Johnson KM, Post-White J, Lichtblau L. Physician knowledge and attitudes about cancer pain management: A survey from the Minnesota Cancer Pain Project. J Pain Symptom Manage 1995;10:494-504. 8. Elliott TE, Murray DM, Oken MM, Johnson KM, Elliott BA, Post-White J. The Minnesota Cancer Pain Project: design, methods, and education strategies. J Cancer Educ 1995;10:102-112. 3. Chronic Non-cancer Pain Management: I also have experience researching chronic non-cancer pain management. In particular I am interested in safe and appropriate use of opioids in pain management and improved quality of life for patients in hospice and palliative care medicine as well in primary care setting. Because primary care providers manage most chronic non-cancer pain patients and prescribe the majority of opioids in the U.S. and in view of the current overuse and misuse of opioids across the country, I continue to have special research interest. Now I will be leading a recently funded study to explore the use of opioids during pregnancy. Four publications in this area include: 9. Raebel MA, Newcomer SR, Reifler LM, Boudreau D, Elliott TE, DeBar L, Ahmed A, Pawloski PA, Fisher D, Donahoo WT, Bayliss EA. Chronic use of opioid medications before and after bariatric surgery. JAMA.2013;310(13):1369-1376. (October) 10. Elliott TE, Fox OM, Renier CM, Palcher JA. Opioid rotation to methadone in hospice patients. J Palliative Med. 2008;11 :379. 11. Harris JM, Elliott TE, Davis BE, et al. Educating generalist physicians about chronic pain: live experts and online education can provide durable benefits. Pain Medicine 2008;9:555-563. 12. Elliott TE, Harris JM, Chabal C, et al. Improving chronic pain management skills of primary care physicians: A randomized trial. Pain Medicine. 2007;8:89-9.
4. Implementation and Use of Patient-Reported Outcomes in Clinical Practice: I have been studying the implementation and use of patient-reported outcomes (PROs) for over 20 years, initially in cancer patients, then patients at end-of-life and in hospice and palliative care, and now patients in primary care settings. These studies of PROs resulted in over 30 peer-reviewed publications. My first use of PROs was in the Lake Superior Rural Cancer Care Project (R01CA56334), in which we used the FLIC-Health Related Quality of Life survey. Subsequently various PROs were used in several studies of hospice and palliative care patients resulting in many publications. In studies of both cancer and non-cancer pain patients, many PROs were used, such as BPI, PHQ-9, SF-36 and SF-12, and various functional scales. Now I am focusing on implementing and use of PROs in primary care settings. Four publications in this area include: 13. Snyder C, Aaronson N, Choucair A, Elliott TE, Greenhalgh J, Halyard M, Hess R, Miller D, Reeve B, Santana M. Implementing patient-reported outcomes assessment in clinical practice: a review of the options and considerations. Quality of Life Research November 3, 2011, DOI 10.1007/s11136-011-0054-x 14. Elliott BA, Renier CM, Haller IV, Elliott TE. Health-related quality of life (HRQoL) in patients with cancer and other concurrent illnesses. Quality of Life Research 2004; 13(2): 457-462. 15. Elliott TE, Renier, Palcher JA. The prognostic value of measuring health-related quality of life in hospice patients. J Palliative Med. 2007;10:696-704. 16. Elliott TE, Renier CM, Palcher JA. Chronic pain, depression, and quality of life: correlations and predictive value of the SF-36. Pain Medicine. 2003;4:331-9. D. Research Support Active Research Support HealthPartners Institute Elliott (PI) 03/01/2015 02/29/2016 Opioid Prescribing During Pregnancy: An Exploratory, Discovery Study This proposed research will discover past and current practices of opioid use (prescribing or dispensing) during pregnancy among HealthPartners member-patients, address significant clinical questions, and provide direction for future investigations and interventions to improve the safety of opioid prescribing, as well as improve maternal and newborn outcomes. Results from this proposed study could be used as preliminary data for future, externally funded research projects, especially if other populations beyond HealthPartners members are included to increase generalizability and impact Completed Research HealthPartners Health Plan Elliott (PI) 04/01/13 06/30/14 Evaluation of Essentia Health s Accountable Care Model: HealthPartners Insured Essentia Health Employees (EH-HP ACO Study) The objective is to determine the predictive performance of the Essentia Health Patient Stratification Model (PSM) tool to identify high-risk patients in real time using EHR data in order to create alerts for providers. The goal of the tool is to improve patients experience and outcomes while also lowering costs in accordance with the triple aim. Pfizer, Inc. Elliott (PI) 06/01/13 11/30/14 Performance of 3 Opioid Risk Stratification Tools in Predicting Patient Behaviors and Outcomes: An Exploratory Study (ORST Study) The study objective is to determine whether pre-existing EHR data can be used retrospectively using Natural Language Processing tools to populate data elements of 3 commonly used opioid risk stratification tools and determine the sensitivity, specificity and predictive performance of the 3 tools. AHRQ/R01 HS019912 Daley (PI) 10/01/10 09/30/13 Scalable PArtnering Network for CER: Across Lifespan, Conditions and Settings (SPAN) The objective is to develop a distributed research network that is interoperable across a range of health care systems and sites, incorporating large and diverse patient populations. The network infrastructure will have
the capability to conduct large comparative effectiveness research (CER) studies using data collected on patient-reported outcomes collected at the point of care and real-time data collection. Role: Co-Principal Investigator/Site PI