Profiles of 2012-2014 Practitioners

The following people make up The Kraft Center for Community Health's first class of Practitioners. Meet the Practitioners and learn where they practice.

Lauren Avery
Lauren Avery, M.D.
Child and Adult Psychiatry, Codman Square Health Center

Project Focus: Integration of Behavioral Health and Primary Care

Project Overview: Codman Square Health Center is moving towards becoming a Patient Centered Medical Home. In this model, team care of patients is a central tenant. Providing Behavioral Health (BH) services within the primary care setting and in collaboration with primary care providers promises to improve overall quality of care for patients with BH needs and increase access to BH services overall. Lauren's projcet seeks to co-locate a dedicated behaviorist on each floor of Codman Square Health Center.

Maggie Beiser
Marguerite Beiser, N.P.
Adult Health, Boston Healthcare for the Homeless Program

Learn more about Maggie Beiser here.

Project Focus: A patient-centered approach to implementing Hepatitis C treatment

Project Overview: The burden of morbidity and mortality related to Hepatitis C (HCV) infection in the BHCHP patient population is high, and HCV care has not had a coordinated approach in the past. This project assesses homeless patients' preferences and barriers to care in order to redesign and improve Hepatitis C services, and provide a model for Hepatitis C treatment.

Jen Brody
Jennifer Brody, M.D., M.P.H.
Family Medicine, Boston Healthcare for the Homeless Program

Project Focus: Developing a chronic disease management model for substance abuse disorders

Project Overview: Unintentional drug overdose death has emerged as the leading cause of death among BHCHP patients. This project proposes to develop, implement and evaluate a chronic disease management (CDM) model for addressing the addictions at BHCHP with the goal of improving access to and quality of substance abuse services for BHCHP patients, and reducing unintentional drug overdose deaths.

Ellen Coletti
Ellen Coletti, M.S.N., F.N.P., R.N.-C.
Family Health, Brookside Community Health Center

Project Focus: Improving adolescents’ access to and utilization of services at Brookside

Project Overview: Teens at Brookside sometimes encounter a gap in service between Pediatric and Adult care. By developing and implementing a transition plan for adolescents "aging out" of Pediatric care, this project seeks to help to address adolescent care needs in a consistent and informed way, establish standards of care for providers seeing teens, and identify an adolescent care team that will specialize in meeting the needs of adolescents at Brookside. 

Joanna D'Afflitti
Joanna D'Afflitti, M.D., M.P.H.
Internal Medicine, Chelsea Healthcare Center

Project Focus: Identifying and Addressing Substance Abuse and Depression in Adult Primary Care

Project Overview: Substance abuse was the number one problem identified during the most recent Chelsea community assessment. With the support of Massachusetts Health Quality Partners (MHQP), MGH Chelsea will become one of five primary care sites in Massachusetts to implement the Partners in Integrated Care (PIC) model into the Adult Medicine Department.  The goal of the PIC model is to ensure that depression and unhealthy substance use are identified and addressed as part of routine adult primary care practice.

(This is a joint project with Kraft Fellow Joe Joyner)

Gia Leddy
Giovanna Leddy, M.D.
Internal Medicine, Bowdoin Street Health Center

Project Focus: Developing a social medicine curriculum for Beth Israel primary care residents at Bowdoin Street Health Center

Project Overview: This project will develop a longitudinal curriculum focused on community medicine for the Beth Israel primary care residents, with goal to expand the curriculum to categorical residents to further resident exposure. The Social Justice and Community Medicine curriculum aims to inform residents about current issues in medical ethics, health economics, health policy and various other topics dealing with health and disease from a socio-economic perspective, and will foster recruitment and retention of outstanding physicians devoted to practicing primary care within the community, who are readily able to integrate the biological, psychological, and social dimensions of health.

Aisling Lydeard
Aisling Lydeard, N.P., R.N.
Adult and Women's Health, The Dimock Center

Project Focus: Implementing Centering for pregnant women at Dimock

Project Overview: This project seeks to improve resources and access to prenatal health care for pregnant patients and promote healthier pregnancies and pregnancy outcomes by implementing a new model of care called "Centering" in the obstetrical department. Centering Pregnancy is a novel approach to prenatal care that uses a group-based model: each woman has an individual and private assessment with a clinician, but she also benefits from structured group educational discussions that have the addition of increased social support from other group members. 

Julia Takahashi McManus
Julia Takahashi McManus, M.D.
Family Medicine, Neponset Health Center

Project Focus: Decreasing opiate abuse by changing provider prescribing practices

Project Overview: Opioid misuse, abuse, and overprescribing results in significant patient morbidity, increased incidence of drug overdose, and frequent utilization of health services. This project will educate staff and implement a multidisciplinary intervention led by a controlled substance abuse care management nurse in order to reduce the burden of opioid misuse, abuse and overprescribing at Neponset Health Center.

Ebele Okpokwasili-Johnson
Ebele Okpokwasili-Johnson, M.D., M.P.H.
Child Psychiatry, South End Community Health Center

Project Focus: Increasing mental health, academic, and social resource acquisition for parents and children

Project Overview: In an effort to facilitate effective collaboration among parents, teachers, and mental health providers at the Blackstone Elementary School, this project provides education, resources, and referral assistance. Strengthening the communication between both referral sources and follow up with children and their families will directly improve the mental health, academic, and social success of students. This project will implement the use of parent groups in order to increase access to these resources in the South End.

Joe Panerio-Langer
Joseph Panerio-Langer, M.D.
Internal Medicine, Brockton Neighborhood Health Center

Learn more about Dr. Panerio-Langer here.

Project Focus: Implementing team-based care in the Adult Medicine department at Brockton

Project Overview: Brockton is becoming a patient centered medical home, a process that involves implementing team-based care. This project defines health care teams in the Adult Medicine department, and monitors two of the teams’ primary functions:  assessing and addressing staff concerns, and identifying patient barriers and implementing improvement plans. Monitoring these functions will increase staff satisfaction and allow for the development of innovative solutions to healthcare barriers.

John Raser
John Raser, M.D.
Family Medicine, Greater Lawrence Family Health Center

Project Focus: Promoting active transportation to school in Lawrence

Project Overview: Obesity related illnesses represent the majority of the chronic disease burden in Lawrence. The development of safe walking routes to school will facilitate daily physical activity and peer-to-peer interaction, potentially offering a place-base solution to childhood obesity. This project engages numerous community-based, education, nonprofit, and local government stakeholders to evaluate and engineer safe routes to the Alexander B. Bruce School in Lawrence.

Nick Urbanczyk
Nicholas Urbanczyk, D.O.
Primary Care, Lynn Community Health Center

Project Focus: Evaluating group visits with diabetic patients at Lynn

Project Overview: This project will analyze the group visit model in an attempt to quantify its overall efficacy in a diabetic population at Lynn to determine if the group visit model improves patient knowledge of diabetes, patient and provider satisfaction, and diabetes metabolic parameters.  If the group visit model proves to be more effective or to be equally effective as routine office visits, then group visits will be adopted as the routine method of health care delivery for diabetic patients. 

Mark Viron
Mark Viron, M.D.
Adult Psychiatry, Massachusetts Mental Health Center

Project Focus: Creating a Behavioral Health Home at Massachusetts Mental Health Center

Project Overview: A recent study highlighted a 25-year mortality gap between populations with serious mental illness and the general U.S. population, a gap mostly attributable to early death from preventable and treatable medical illnesses that are found at higher rates in people with serious mental illness. The goal of this project is to transform Massachusetts Mental Health Center (MMHC) into a “Health Home” for patients with serious mental illness by co-locating and fully integrating wellness and primary care services within MMHC.