Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement
D. Subcommittee Member and Staff Biographies
David R. Nerenz, Ph.D. (Chair), is the Director of the Center for Health Services Research at the Henry Ford Health System, Detroit, Michigan. He is also Director of Outcomes Research in Henry Ford's Neuroscience Institute. Dr. Nerenz received his doctorate in Social Psychology from the University of Wisconsin-Madison in 1979. From 1980 to 1984 he did research at the Wisconsin Clinical Cancer Center and was also Coordinator of Health Services Research for the Wm. S. Middleton Veterans Hospital in Madison. From 1984 to 1986 he was Director of the VA's Great Lakes Regional HSR&D Field Program in Ann Arbor. He has been at the Henry Ford Health System since 1987. For the past 10 years, he has led a series of demonstration projects on health plans' collection and use of data on race and ethnicity to eliminate disparities in quality of care. His areas of expertise include: performance measures for health care organizations; racial/ethnic disparities in quality of care; and use of patient-reported outcomes data to assess and compare health care providers.
Margarita Alegra, Ph.D., is a professor of psychology in the Department of Psychiatry at Harvard Medical School and currently serves as the Principal Investigator of three National Institutes of Health-funded research studies. Her research focuses on how to improve health care service delivery for diverse racial and ethnic populations; patient-provider interaction when treating multicultural populations; and how to bring the community's perspective in the design and implementation of health services. Dr. Alegra also conducts research that will contribute to understanding the factors influencing mental health and substance abuse service disparities, and testing interventions aimed at reducing these disparities. Her published work centers on the effects of immigration and integration into the United States on mental health among Latinos, Asians, and Afro-Caribbeans. Dr. Alegra has conducted epidemiologic research on the generalizability of the immigrant paradox (that being foreign-born is protective against psychiatric disorders). Her recent research has examined the complex factors related to the mental health of Latino immigrant children, such as increased risk of trauma, high school dropout and lack of access to adequate health care. As a result of her contributions, Dr. Alegría received the 2003 Mental Health Section Award of the American Public Health Association, the 2006 Greenwood Award for Research Excellence, and the 2007 Latino Mental Health Scientific Leadership Award given by New York University. In 2008, she received an APA Presidential recognition for her disparities work by the American Psychological Association, the National Award for Excellence in Research by a Senior Investigator from the National Hispanic Science Network, and the Carl Taube Award given by the Mental Health Section of the American Public Health Association. She is a member of the Institute of Medicine's Public Health Board and past Chair of Academy Health. She also serves on several other boards, including the National Academy of State Health Policy and the Health Services Research Journal.
John Z. Ayanian, M.D., M.P.P., is a professor of medicine and health care policy at Harvard Medical School and a professor of health policy and management at the Harvard School of Public Health. He is the director of the Harvard Fellowship in General Medicine and Primary Care and director of the General Medicine Fellowship at Brigham and Women's Hospital. He is also a practicing general internist in the Division of General Medicine at Brigham and Women's Hospital, where he sees patients and teaches medical residents. Dr. Ayanian's research focuses on the effect of patients' race, ethnicity, gender, insurance coverage, and socioeconomic characteristics on access to care and clinical outcomes, as well as the impact of physicians' specialty and organizational characteristics on the quality of care. He is the principal investigator of the Harvard/Northern California research team in the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium, a multi-regional initiative funded by the National Cancer Institute to evaluate the experiences and outcomes of patients with colorectal cancer and lung cancer. He also leads an NCI-funded study evaluating randomized interventions to improve systems for colorectal cancer screening. Dr. Ayanian's recent research has studied trends in quality of care and racial disparities in Medicare managed care plans, the effect of Medicare coverage on previously uninsured adults, the impact of ambulatory care from primary care physicians and cardiologists on the outcomes of Medicare beneficiaries who have survived a heart attack, the relation of surgical volume to outcomes of colorectal cancer, and patients' perceptions of the quality of cancer care by race, ethnicity, and language. His previous research includes studies of the effects of race and gender on access to kidney transplants and cardiac procedures, and the quality of care for common medical conditions in teaching and nonteaching hospitals.
Ignatius Bau, J.D., is a Program Director at the The California Endowment, a private statewide health policy foundation. He focuses on issues of language access, cultural competency, health workforce diversity, and reduction of health care disparities and currently oversees grants to several national quality, health care accreditation and health professions educational accreditation organizations, as well as to hospitals and health systems, health plans, physician organizations, community health centers, health professions educational institutions, and community- based organizations throughout California. Bau previously worked as a program manager and policy director at the Asian and Pacific Islander American Health Forum (APIAHF) and as a staff attorney at the Lawyers' Committee for Civil Rights of the San Francisco Bay Area. Bau and APIAHF led community efforts that resulted in the creation of the White House Initiative on Asian Americans and Pacific Islanders and he was the principal author of the first report from the President's Advisory Commission on Asian Americans and Pacific Islanders. He has served on the board of directors of numerous organizations, including Funders for Lesbian and Gay Issues, the National Minority AIDS Coalition, the Northern California Coalition for Immigrant and Refugee Rights, the Asian and Pacific Islander Wellness Center, and the California Budget Project and on several government committees, including the President's Advisory Council on HIV/AIDS, the Centers for Disease Control and Prevention's National HIV Prevention Planning Group, and the California Department of Health's Task Force on Multicultural Health. He has been a member of the Institute of Medicine's Forum on the Science of Health Care Quality Improvement and Implementation, the Joint Commission Public Advisory Group, the National Quality Forum Work Group on Minority Healthcare Quality Measurement, and several Technical Advisory Committees for the California Health Interview Survey.
Roderick J. Harrison, Ph.D., is a scholar at the Joint Center for Political and Economic Studies, Howard University. Previously, he served as chief of the U.S. Census Bureau's Racial Statistics Branch where he helped to expand the content and number of the Bureau's publications and releases on racial and ethnic populations and director of DataBank, an online clearinghouse of data on African Americans and other ethnic populations. In 1998, the American Statistical Society awarded him the Roger Herriot Award for Innovations in Federal Statistics for his work in revising the racial and ethnic classifications used by all federal agencies and efforts in developing new classifications on race and ethnicity for the 2000 Census. Dr. Harrison held a joint appointment in the Afro- American Studies and Sociology departments at Harvard University and also taught at UCLA. He currently teaches in the Department of Sociology and Anthropology at Howard University. He received his Ph.D. in sociology from Princeton and his A.B. from Harvard.
Romana Hasnain-Wynia, Ph.D., is director, Center for Healthcare Equity and Associate Professor, Research at Northwestern University, Feinberg School of Medicine. Prior to joining Northwestern University, Dr. Hasnain- Wynia was vice president of research for the Health Research & Educational Trust (HRET), the research and education affiliate of the American Hospital Association, where she oversaw the overall HRET research agenda, maintained an individual portfolio of research projects focusing on equity and quality of care, and developed the HRET Toolkit on collecting race, ethnicity, and primary language information from patients, which has been endorsed by the National Quality Forum. She is the principal investigator of a number of studies examining quality of care for underserved populations and of studies that examine the impact of performance incentive programs on the health care safety net. She serves as a co-investigator on the evaluation team for the Robert Wood Johnson Foundation's national initiative, Aligning Forces for Quality, and is responsible for leading the evaluation of the disparities-equity component of the program. Dr. Hasnain-Wynia serves on a number of expert advisory panels and is Senior Associate Editor for the journal, Health Services Research. Dr. Hasnain-Wynia received her doctoral degree in health policy from Brandeis University's Heller School for Social Policy and Management.
Ninez Ponce, Ph.D., is an Associate Professor at UCLA's Department of Health Services. She is also Senior Research Scientist at the UCLA Center for Health Policy Research and member of UCLA/Jonsson Comprehensive Cancer Center, Division of Cancer Prevention and Control Research. Dr. Ponce's research has focused on understanding macroeconomic effects on health and health care access in low income countries, and, more recently, in low-SES neighborhoods and ethnic minorities in the United States. She was RAND's resident adviser to the Ministry of Health, Republic of Macedonia, and has worked at the World Bank, Catholic Relief Services in Thailand, the Asian and Pacific Islander American Health Forum, and the Berkeley Free Clinic. As Co-Principal Investigator of the California Health Interview Survey 2001 and 2003, she led efforts in the measurement of race/ ethnicity, acculturation, physician-patient communication, and discrimination. In addition, she conceptualized the rationale and implementation of CHIS 2001's Asian ethnic oversamples and the cultural and linguistic adaptation of the survey. Dr. Ponce received a 5-year career-development award from the National Cancer Institute (NCI) to explore neighborhood effects and health care market factors that may explain persisting racial and ethnic disparities in cancer screening. Recently, NCI's Special Populations Health Network recognized Dr. Ponce as a "Rising Star" in cancer disparities research as part of her work with the Asian American Network in Cancer Awareness Research and Training. Dr. Ponce is faculty advisor to UCLA's student-run Samahang Pilipino Education and Retention (SPEAR) Project and Samahang Pilipino Advancing Community Empowerment (SPACE), and serves on several state and national committees: the Cultural and Linguistics Work Group of California's Office of the Patient Advocate, the Policy Board of the California Pan Ethnic Health Network, and the Executive Board of the Asian and Pacific Islander Caucus of the American Public Health Association.
Wayne S. Rawlins, M.D., M.B.A., is a national medical director at Aetna and Head of Medical Operations for Aetna Government Health Plans, Aetna's business unit responsible for Department of Defense uniformed services and VA customers. Prior to this, he was head of Aetna Condition Analysis, leading medical cost management activities. In addition, he is co-lead for Aetna's Racial and Ethnic Disparities in Health Care Initiatives. Dr. Rawlins is a liaison member of the National Vaccine Advisory Committee representing America's Health Insurance Plans. He also serves as the corporate clinical lead representing the chief medical officer in crisis and disaster preparedness, as well as the corporate clinical lead for pandemic planning at Aetna. Dr. Rawlins has been involved in crisis management at Aetna since September 11, 2001, when he was the senior physician in charge of clinical operations for Aetna's New York market. While at Aetna, Dr. Rawlins has served in several senior clinical operational roles prior to assuming his current role. These included head of business planning and reporting for National Medical Services reporting to Aetna's Chief Medical Officer. Prior to this he served as the regional medical director for Aetna's northeast region, providing access to health care services for more than two million members. He was senior patient management medical director for the northeast region. Dr. Rawlins also led the design, development, and implementation of Aetna's industry-leading end-of-life care program. Dr. Rawlins received his medical degree from the University of Connecticut in 1980, then completed an internal medicine residency and chief residency at the University of Rochester in New York. He is board certified in internal medicine. Dr. Rawlins received his M.B.A. from Rensselaer Polytechnic Institute in 2001. Prior to joining Aetna in 1997, he was a physician manager with the Northeast Permanente Medical Group for 13 years, treating a wide variety of patients in a busy primary care practice. He is a member of the National Medical Association, American College of Physicians, and the American College of Physician Executives.
Paul M. Schyve, M.D., is the Senior Vice President of The Joint Commission and is knowledgeable of requirements for language access in hospitals and disability issues. Prior to joining The Joint Commission in 1986, Dr. Schyve was the Clinical Director of the Illinois Department of Mental Health and Developmental Disabilities. Dr. Schyve received his undergraduate degree (Phi Beta Kappa) and his medical education and residency in psychiatry at the University of Rochester. He has held a variety of professional and academic appointments in the areas of mental health and hospital administration, including as Director of the Illinois State Psychiatric Institute and Clinical Associate Professor of Psychiatry at the University of Chicago. Dr. Schyve is certified in psychiatry by the American Board of Psychiatry and Neurology and is a Distinguished Life Fellow of the American Psychiatric Association. A former member of the Board of Directors of the National Alliance for Health Information Technology, a Founding Advisor of Consumers Advancing Patient Safety, the Chair of the Ethical Force Oversight Body of the Institute of Ethics at the American Medical Association, and a former Trustee of the United States Pharmacopeial Convention, he has published in the areas of psychiatric treatment and research, psychopharmacology, quality assurance, continuous quality improvement, health care accreditation, patient safety, the role of language, cultural competence, and health literacy in communication, and health care ethics.
Alan M. Zaslavsky, Ph.D., is a professor of health care policy (statistics) in the Department of Health Care Policy at Harvard Medical School. His methodological research interests include surveys, census methodology, microsimulation models, missing data, hierarchical modeling, small-area estimation, and applied Bayesian methodology. His health services research focuses primarily on developing methodology for quality measurement of health plans and other units and understanding the implications of these quality measurements. Other major areas include: health care disparities, psychiatric epidemiology, quality of care for cancer patients, and health effects of social networks.
Michelle Bruno, M.P.P., is a Research Associate on the Board on Health Care Services. Michelle joined the IOM in 2007 and has contributed to a range of significant reports, including Resident Duty Hours: Enhancing Sleep, Supervision, and Safety, Retooling for an Aging America: Building the Health Care Workforce, and Opportunities for Coordination and Clarity to Advance the National Health Information Agenda. She is currently part of the staff for the Committee on the Future Directions for the National Healthcare Quality and Disparities Reports. Prior to joining the IOM, Michelle completed her master's degree in public policy with a dual concentration in health policy and public and nonprofit management at the Georgetown Public Policy Institute.
Cassandra Cacace, B.S., is a Senior Program Assistant for the Board on Health Care Services, assisting on a variety of projects, including the Committee on Continuing Education, the Committee on Resident Duty Hours and Patient Safety, and the Forum the Science of Health Care Quality Improvement and Implementation. She provides administrative and research support to the teams, as well as logistical support for all committee meetings. Prior to the IOM, Cassandra worked as a research associate at Oxford Outcomes, a health care consulting firm, where she performed outcomes research on a variety of health conditions. She is currently pursuing her master's degree in health policy from the George Washington University School of Public Health and Health Services.
Roger Herdman, M.D., born in Boston, MA, Phillips Exeter Academy, 1951; Yale University, Magna Cum Laude, Phi Beta Kappa, BS, 1955; Yale University School of Medicine, MD, 1958. Interned at the University of Minnesota. Medical Officer, U.S. Navy, 1959-1961. Thereafter, completed a residency in pediatrics and continued with a medical fellowship in immunology/nephrology at Minnesota. Held positions of Assistant Professor and Professor of Pediatrics at the University of Minnesota and the Albany Medical College between 1966-1979. In 1969, appointed Director of the New York State Kidney Disease Institute in Albany. During 1969-1977 served as Deputy Commissioner of the New York State Department of Health responsible for research, departmental health care facilities and the Medicaid program at various times. In 1977, named New York State's Director of Public Health. From 1979 until joining the U.S. Congress's Office of Technology Assessment (OTA) was a Vice President of the Memorial Sloan-Kettering Cancer Center in New York City. In 1983, named Assistant Director of OTA and then Acting Director and Director from January 1993-February 1996. After the closure of OTA, joined the National Academy of Sciences' Institute of Medicine as a Senior Scholar, and subsequently served as Director of the National Cancer Policy Board and the National Cancer Policy Forum. He is now the Director of the Board on Health Care Services.
Bernadette McFadden, M.Sc., joined the Board on Health Care Services as a Research Associate in November 2008. Prior to joining the IOM, she completed a master's degree in social research at Trinity College Dublin and was employed by Dublin City Council's Homeless Agency, where she edited a volume of essays on homelessness in Ireland and wrote a report on how the city's management of public space impacts homeless persons. Her interests in health policy developed while serving as an AmeriCorps teacher in an Atlanta Public School. She graduated summa cum laude, Phi Beta Kappa, from Dickinson College in Carlisle, Pennsylvania. While in central Pennsylvania, she conducted research on local effects of implementing Medicare Part D and the state's long term care policies, interned with the Executive Policy Office of the Pennsylvania Department of Health, and served as a board member on the United Way of Cumberland County.
Adam Schickedanz, B.A., is a senior medical student at the University of California, San Francisco, graduate of Washington University in St. Louis, and Boston native. At UCSF Adam has developed a clinical focus in urban underserved patient care, while also advancing interests in professionalism and cultural competency in medical education, novel approaches to clinician-patient communication in medical decision making (particularly at the end of life), and the intersections of education and health. Adam was with the Board on Health Care Services as part of the staff and as a Mirzayan Policy Fellow through April of 2009, when he returned to UCSF to complete his MD.
Cheryl Ulmer, M.S., recently served as Co-director of the Resident Duty Hours study for the Institute of Medicine. Before that, she worked as an independent consultant on a wide-ranging set of health care issues, but with a primary focus on the delivery and content of health care services, disparities in health status across populations, options for financing and insurance, and quality of clinical care. Previous consulting work for the IOM included surveying CEOs of the state Quality Improvement Organizations and providing writing/editing services on the Pathways to Quality and the Consequences of Uninsurance series. Other illustrative independent consulting projects include: Serving Patients with Limited English Proficiency: Results of a Community Health Center Survey (NACHC, The California Endowment and National Health Law Program, 2007); Giving Back and Moving Forward, Finding a Future through Service in Community Health Corps (NACHC, 2006); Changing Lives through Service to Medically Underserved Communities (NACHC and Corporation for National Service, 2005); Assessing Primary Care Content: Four Conditions Common in Community Health Center Practice-Hypertension, Diabetes, Otitis, Asthma (HRSA, 2000); The Role of Behavioral Factors in Achieving National Health Outcomes (Robert Wood Johnson Foundation, 2004); Schools as Health Access Points for Underserved Children and Adolescents: Survey of School-based Programs (NACHC, CDC, and HRSA, 2003). She has served as a Senior Associate with MDS Associates, a health care consulting firm with public and private sector clients and in various positions within the U.S. Department of Health and Human Services including the Office of the Secretary, Assistant Secretary for Planning and Evaluation/Health; the Health Services Administration; the Health Resources Administration; Medicaid Services; and NIH. She has a master's degree from Georgetown University and a BS from Mary Washington College of the University of Virginia.