Building a movement to advance care quality at home
Meet the teams from UCSF, MGH, and Johns Hopkins who have led the vision and operations of the National Home-Based Primary Care Learning Network since 2012.
Dr. Christine Ritchie is the Minaker Chair in Geriatrics and Director of Research for the Division of Palliative Care and Geriatric Medicine at Massachusetts General Hospital (MGH). At MGH, she is also working to establish the Center for Aging and Serious Illness at the Mongan Institute. Prior to joining MGH, Dr. Ritchie was the Harris Fishbon Distinguished Professor in Clinical Translational Research and Aging in the Division of Geriatrics, Department of Medicine at the University of California San Francisco (UCSF). Dr. Ritchie is a board certified geriatrician and palliative care physician with long-standing experience in clinical care delivery and
advanced illness research. With Dr. Bruce Leff, Dr. Ritchie co-leads the National Home-based Primary Care Learning Network, where they are seeking to improve care for homebound older adults through research, quality improvement and policy initiatives. Dr. Ritchie served as medical director of Clinical Programs in the UCSF Office of Population Health and Accountable Care. She is also an inaugural member of the NIH-funded national Palliative Care Research Cooperative. She is an Associate Editor for the Journal of Palliative Medicine, serves on the Editorial Board of the Journal of Gerontology: Medical Sciences, and is on the Board of the American Academy of Hospice and Palliative Medicine.
Dr. Leff is Professor of Medicine at the Johns Hopkins University School of Medicine in the Division of Geriatric Medicine and Gerontology. He holds a joint appointment in the Department of Health Policy and Management at the Johns Hopkins University Bloomberg School of Public Health, and in the Johns Hopkins School of Nursing, Department of Community and Public Health.
He is the Director of the Center for Transformative Geriatric Research and is past Associate Director of the JHOME program. His principal areas of health services research relate to the development, evaluation and dissemination of innovative models of health service delivery for older adults including Hospital at Home, Guided Care, home-based primary care, and others. His research interests also include issues related to the care of people with multiple chronic conditions, the development of quality indicators for home-based medical care and quality improvement, guideline development and case-mix issues. He is the author of more than 200 peer-reviewed publications and book chapters. Dr. Leff has a strong interest in health policy and is a recent Health and Aging Policy Fellow and has served on multiple National Quality Forum and Centers for Medicare & Medicaid Services Technical Expert Panels. Dr. Leff cares for patients in the acute, ambulatory and home settings and is an award-winning teacher and mentor.
He currently serves as the Chair of the Geriatric Medicine Board of the American Board of Internal Medicine (ABIM) and is Chair-elect of the ABIM Council. He is past -President and current board member of the American Academy of Home Care Physicians, and past-member of the Board of Regents of the American College of Physicians. He serves on the editorial board of the Annals of Internal Medicine and is a Care Redesign Thought Leader for the New England Journal of Medicine Catalyst.
Dr. Leff received his medical degree from the New York University School of Medicine and completed residency in primary care internal medicine at the Johns Hopkins Bayview Medical Center, and a fellowship in geriatric medicine and gerontology at the Johns Hopkins University School of Medicine, in Baltimore.
Dr. Sheehan is a Geriatrician who sees her primary role as an advocate for older people. She completed her undergraduate medical training and PhD in University College Dublin, Ireland. She also holds a Masters in Stroke Medicine from the University of Krems, Austria. She completed her internship, residency and both geriatric and internal medicine fellowships in Ireland. In addition to her clinical experience caring for frail older adults with multiple chronic conditions and teaching qualifications she has extensive knowledge of many aspects of research including study design, epidemiology, data acquisition, data entry, statistics, laboratory analysis and manuscript preparation. She led Ireland’s first population-based TIA epidemiology study and her PhD focused on examining the clinical, etiological and serum biomarkers that predict stroke after TIA. Since moving to the U.S., she has assumed a front-line role in the implementation of several research projects including the Roybal pilot project “Engaging Family Members in Addressing Medication Regimen Complexity in Home Health Care” and a number of projects to develop quality indicators for frail elderly patients with multiple chronic conditions (MCCs) receiving home based care. She is a co-investigator on a number of complex multisite studies specifically the Caring for Adults Recovering from the Effects of Stroke (CARES) study and the Caregiving Transitions Study. She leads analyses of NHATS and REGARDS CMS linked data examining healthcare utilization of people with MCCs and the effects of caregivers and other factors on that utilization.
Krista Harrison, PhD, is an Assistant Professor in the Division of Geriatrics within the UCSF School of Medicine. She completed a BA in Biology and English from Williams College (2004), a PhD in Bioethics, Health Policy & Management from Johns Hopkins Bloomberg School of Public Health (2013) and postdoctoral training from the University of California, San Francisco (UCSF) including an aging research fellowship and a certificate in implementation science (2016). Before joining faculty at UCSF, Dr. Harrison evaluated national policies and programs at Mathematica Policy Research and led the research and education programs at Capital Caring, a large nonprofit hospice. Dr. Harrison’s mixed-method research aims to improve the quality of life of older adults with dementia and other serious illnesses who live in home- and community-based settings by transforming clinical practice, health systems, and policy. Dr. Harrison’s work is supported by the UCSF Pepper Center, UCSF KL2 Program, UCSF Hellman Fellows Program, National Palliative Care Research Center Junior Faculty Career Development Program, and Atlantic Fellowship for Equity in Brain Health at the Global Brain Health Institute.
Dr. Carla Perissinotto is an Associate Professor in the Division of Geriatrics, Department of Medicine. She is Board Certified in Internal Medicine, Geriatrics and Palliative Medicine. In 2017, Carla was appointed the first Associate Chief for Geriatrics Clinical Programs at UCSF. Her main work is in UCSF Care at Home, which provides medical care to homebound older adults. From 2008-2017, Carla spent a portion of her clinical time at the Over 60 Health Center, a Federally Qualified Health Center, serving adults over age 55 in Alameda County. At Over 60, Carla directed the educational programs for UCSF learners and focused on practice change by establishing a team-based model for community-based Geriatrics seeing adults across a continuum of care.
Carla is dedicated to working in both community and academic settings, and she has also had the privilege to work in clinical settings internationally, most notably, El Salvador, Kenya and Mexico. Annually, she volunteers in Chiapas, Mexico at the Hospital San Carlos, which serves the indigenous people of Chiapas.
She has a particular passion for examining the effects of loneliness on the health of older adults.
Naomi Gallopyn is a Program Manager at Massachusetts General Hospital’s (MGH) Center for Aging and Serious Illness at the Mongan Institute. In this role she manages the National Home-based Primary Care Learning Network and the Investigator Development Center of the Palliative Care Research Cooperative. Prior to her current position, Ms. Gallopyn worked at MGH’s Health Policy Research Center – also part of the Mongan Institute – alongside Dr. Lisa Iezzoni. Ms. Gallopyn received her Master’s degree in Gerontology from the University of Massachusetts –Boston and her Bachelor’s degree in Human Development and Family Studies from the University of Rhode Island. She has worked on many research projects examining home and community-based services as well as the experiences of older adults and persons with significant disability at both MGH and in her educational career. She is passionate about improving the quality of care and accessibility of care to homebound older adults with serious illness and limited resources.