1). Improving how people living with dementia are selected for care coordination
2). Improving how older adults at risk for cardiovascular outcomes are selected for care coordination
The Kern lab studies how to improve ambulatory care in the U.S., with a focus on understanding and addressing care that is highly “fragmented” across multiple physicians.
American healthcare is highly fragmented, especially for older adults with multiple chronic conditions. Patients in the U.S. routinely see multiple physicians in the ambulatory setting, which may be clinically appropriate, but which creates challenges for communication. Unfortunately, many physicians do not consistently communicate with each other about the patients they have in common, which creates gaps in clinical information that may be hazardous for patients. The Kern lab studies fragmented care, in order to understand its causes and its consequences, as well as identify opportunities for interventions to improve care.
Dr. Kern conducts both observational and experimental research, including two ongoing pragmatic clinical trials that are the first trials to include only those individuals with highly fragmented care. Dr. Kern’s research draws on a variety of data sources, including qualitative interviews and focus groups, surveys, and administrative claims (commercial, Medicare, and Medicaid claims). Several ongoing studies focus on fragmentation of care for people living with dementia and, separately, for people with or at risk for cardiovascular disease. Funding for this work has come primarily from the National Heart, Lung, and Blood Institute, the National Institute on Aging, the Agency for Healthcare Research and Quality, and the Commonwealth Fund. Dr. Kern has published more than 115 articles in the peer-reviewed scientific literature to date.
Dr. Kern has taught healthcare organization and delivery and, separately, research methodology for more than 20 years, including teaching for medical students, masters’ students, residents, fellows, and junior faculty. Dr. Kern is also an experienced research mentor, having mentored more than 15 trainees and junior faculty members.
Biography
Dr. Kern earned her bachelor’s degree from Harvard College and her medical degree from Harvard Medical School. She completed her internship and residency in internal medicine at Mount Sinai Hospital in New York, NY. Dr. Kern completed a fellowship in health policy and research methodology through the Robert Wood Johnson Clinical Scholars Program, while earning a master’s in public health from the Johns Hopkins Bloomberg School of Public Health. Dr. Kern joined the faculty of Weill Cornell Medicine in 2002.
Distinctions:
Fellow in the American College of Physicians (since 2011)
Standing member (2018-2022) and chair (2021-2022) of the Mentored Clinical and Basic Science study section for the National Institutes of Health
Selected Publications:
Kern LM, Ringel JB, Rajan M, Casalino LP, Colantonio LD, Pinheiro LC, Colvin CL, Safford MM. Ambulatory Care Fragmentation, Emergency Department Visits, and Race: a Nationwide Cohort Study in the U.S. J Gen Intern Med. 2023 Mar;38(4):873-880. PubMed Central PMCID: PMC10039160. https://link.springer.com/article/10.1007/s11606-022-07888-5
Kern LM, Ringel JB, Rajan M, Colantonio LD, Casalino LP, Reshetnyak E, Pinheiro LC, Safford MM. Ambulatory Care Fragmentation and Incident Stroke. J Am Heart Assoc. 2021 May 4;10(9):e019036. PubMed Central PMCID: PMC8200753. https://www.ahajournals.org/doi/epub/10.1161/JAHA.120.019036
Kern LM, Reshetnyak E, Colantonio LD, Muntner PM, Rhodes JD, Casalino LP, Rajan M, Pesko M, Pinheiro LC, Safford MM. Association Between Patients' Self-Reported Gaps in Care Coordination and Preventable Adverse Outcomes: a Cross-Sectional Survey. J Gen Intern Med. 2020 Dec;35(12):3517-3524. PubMed Central PMCID: PMC7728843. https://link.springer.com/article/10.1007/s11606-020-06047-y
Kern LM, Safford MM, Slavin MJ, Makovkina E, Fudl A, Carrillo JE, Abramson EL. Patients' and Providers' Views on Causes and Consequences of Healthcare Fragmentation in the Ambulatory
