Debra Lane Stevenson has over 15 years of experience as a clinical research associate (CRA) working on various clinical trials. She has worked on trials related to cardiology, oncology, dermatology, and other therapeutic areas. As a CRA, her responsibilities include conducting site initiation visits, monitoring visits, and study closeout activities to ensure compliance with regulations and good clinical practices. She is proficient in electronic data capture systems and has worked with sponsors such as Allergan, Bayer, Trevena, and others.
Health research, clinical registries, electronic health records – how do they...Koray Atalag
This is a talk I gave at my own organisation - National Institute for Health Innovation (NIHI) of the University of Auckland on 6 Aug 2014. Abstract as follows:
In this talk I’ll first cover the topic of clinical registry – an invaluable tool for supporting clinical practice but also gaining momentum in research and quality improvement. NIHI has been very active in this space: we have delivered the prestigious and highly successful National Cardiac Registry (ANZACS-QI) together with VIEW research team and also very recently launched the Gestational Diabetes Registry with Counties Manukau DHB & Diabetes Projects Trust. A few others are in likely to come down the line. This is a huge opportunity for health data driven research and NIHI to position itself as ‘the health data steward’ in the country given our independent status and existing IT infrastructure and “good culture” of working with health data . NIHI’s ‘health informatics’ twist in delivering these projects is how we go about defining ‘information’ – using a scientifically credible and robust methodology: openEHR. This is an international (and now national too) standard to non-ambiguously define health information so that they are easy to understand and also are computable. We build software (even automatically in some cases!) using models created by this formalism. I’ll give basics of openEHR approach and then walk you through how to make sense out of all these. Hopefully you may have an idea about its ‘value proposition’ (as business people call) or Science merit as I like to call it ;)
Health research, clinical registries, electronic health records – how do they...Koray Atalag
This is a talk I gave at my own organisation - National Institute for Health Innovation (NIHI) of the University of Auckland on 6 Aug 2014. Abstract as follows:
In this talk I’ll first cover the topic of clinical registry – an invaluable tool for supporting clinical practice but also gaining momentum in research and quality improvement. NIHI has been very active in this space: we have delivered the prestigious and highly successful National Cardiac Registry (ANZACS-QI) together with VIEW research team and also very recently launched the Gestational Diabetes Registry with Counties Manukau DHB & Diabetes Projects Trust. A few others are in likely to come down the line. This is a huge opportunity for health data driven research and NIHI to position itself as ‘the health data steward’ in the country given our independent status and existing IT infrastructure and “good culture” of working with health data . NIHI’s ‘health informatics’ twist in delivering these projects is how we go about defining ‘information’ – using a scientifically credible and robust methodology: openEHR. This is an international (and now national too) standard to non-ambiguously define health information so that they are easy to understand and also are computable. We build software (even automatically in some cases!) using models created by this formalism. I’ll give basics of openEHR approach and then walk you through how to make sense out of all these. Hopefully you may have an idea about its ‘value proposition’ (as business people call) or Science merit as I like to call it ;)
A Standards-based Approach to Development of Clinical Registries - Initial Le...Koray Atalag
This is the prezo I presented at HINZ 2014 conference.
Gestational diabetes has implications for both mother and child with risk of complications during pregnancy, and type 2 diabetes later in life. This paper presents the initial lessons learned from the development of a clinical registry. The aims of the Registry are: 1) 100% successful diabetes screening within 3 months of delivery; 2) Annual type 2 diabetes screening; 3) Early warning in subsequent pregnancies.
We have employed the openEHR standard which underpins our national interoperability reference architecture to represent the dataset and also to build the web-based registry system. Use of this rigorous methodology to tackle health information is expected to ensure semantic consistency of Registry data and maximise interoperability with other Sector projects. The development work has been facilitated by the ability to transform the dataset automatically into software code – ensuring clinical requirements accurately translated into technical terms.
Dataset has been finalised, registry system has been developed and deployed for pilot implementation. Data entry is underway for participants after consenting.
This registry is expected to increase the screening of women leading to earlier detection of diabetes. It should provide a valuable picture of the condition and is intended for extension and wider roll-out after evaluation.
Severity of illness scoring systems have been developed to evaluate delivery of care and provide prediction of outcome of groups of critically ill patients who are admitted to the intensive care units. This prediction is achieved by collating routinely measured data specific to the patient. This article reviews the various commonly used ICU scoring systems, the characteristics of the ideal scoring system, the various methods used for validating the scoring systems.
The assessment, diagnosis and treatment of critically ill patients is extremely challenging. Patients often deteriorate whilst being
reviewed and their rapidly changing pathophysiology barrages healthcare professionals with new data. Furthermore, comprehensive assessments must be postponed until the patient has been stabilised. So, important data and interventions are often missed in the heat of the moment. In emergency situations, suboptimal management decisions may cause signifi cant morbidity and mortality. Fortunately, standardisation and careful design of documentation (i.e. proformas and checklists) can enhance patient safety. So, I have developed a series of checklist proformas to guide the assessment of critically ill patients. These proformas also promote the systematic recording and presentation of information to facilitate the retrieval of the precise data required for the management for critically ill patients. The proformas have been modifi ed extensively over the last twenty years based on my personal experience and extensive consultation with colleagues in several world-renowned centres of excellence. The proformas were originally developed for use in the intensive therapy unit
or high dependency unit. However, they have been adapted for use by outreach teams reviewing patients admitted outside of critical care areas. The use of these tools can direct eff orts to provide appropriate organ support and provides a framework for diagnostic reasoning.
AHIMA Game of documentation - dance with the icd10 dragonNick van Terheyden
Following on from AHIMA 2014 this AHIMA 2015 session will follow last years Successful Presentation “Game of Documentation: Winter is Coming – Surviving ICD-10” to address the genuine concerns of clinicians and demonstrate to them why they must not just accept ICD10 but should be demanding it. As Yoda said
“Always in motion is the future…a little more knowledge lights our way.”
ICD-10 has been implemented but resistance remains high and in a recent remarks by the AMA president that said
“If it was a droid, ICD-10 would serve Darth Vader… For more than a decade, the AMA kept ICD-10 at bay – and we want to freeze it in carbonite!”
But despite this the financial viability and performance of hospitals and physicians are impacted by poor quality of data that is captured with an outdated 1970s-era coding system
The first leap into big data is collecting information with precision and clarity – something that cannot be achieved with a coding system that does not capture Ebola nor the basic classification of myocardial infarction STEMI and Non-STEMI. Everyone – ICD10 supporters and opponents wants the best possible care when they access our healthcare system – but how do they know they are receiving this if we are unable to accurately collect information about diseases and treatments and link outcomes to treatments.
https://ahima.confex.com/ahima/87am/webprogram/Session6176.html
Discuss challenges of EMR content awareness and analysis, and current disconnected documentation clarification processes;
Explain methodologies to engage physicians in the CDI process
Describe how technology can assist with documentation improvement and acceptance
Identify status of current advanced CDI programs and the opportunity for integration of evolving technological innovations
A Standards-based Approach to Development of Clinical Registries - Initial Le...Koray Atalag
This is the prezo I presented at HINZ 2014 conference.
Gestational diabetes has implications for both mother and child with risk of complications during pregnancy, and type 2 diabetes later in life. This paper presents the initial lessons learned from the development of a clinical registry. The aims of the Registry are: 1) 100% successful diabetes screening within 3 months of delivery; 2) Annual type 2 diabetes screening; 3) Early warning in subsequent pregnancies.
We have employed the openEHR standard which underpins our national interoperability reference architecture to represent the dataset and also to build the web-based registry system. Use of this rigorous methodology to tackle health information is expected to ensure semantic consistency of Registry data and maximise interoperability with other Sector projects. The development work has been facilitated by the ability to transform the dataset automatically into software code – ensuring clinical requirements accurately translated into technical terms.
Dataset has been finalised, registry system has been developed and deployed for pilot implementation. Data entry is underway for participants after consenting.
This registry is expected to increase the screening of women leading to earlier detection of diabetes. It should provide a valuable picture of the condition and is intended for extension and wider roll-out after evaluation.
Severity of illness scoring systems have been developed to evaluate delivery of care and provide prediction of outcome of groups of critically ill patients who are admitted to the intensive care units. This prediction is achieved by collating routinely measured data specific to the patient. This article reviews the various commonly used ICU scoring systems, the characteristics of the ideal scoring system, the various methods used for validating the scoring systems.
The assessment, diagnosis and treatment of critically ill patients is extremely challenging. Patients often deteriorate whilst being
reviewed and their rapidly changing pathophysiology barrages healthcare professionals with new data. Furthermore, comprehensive assessments must be postponed until the patient has been stabilised. So, important data and interventions are often missed in the heat of the moment. In emergency situations, suboptimal management decisions may cause signifi cant morbidity and mortality. Fortunately, standardisation and careful design of documentation (i.e. proformas and checklists) can enhance patient safety. So, I have developed a series of checklist proformas to guide the assessment of critically ill patients. These proformas also promote the systematic recording and presentation of information to facilitate the retrieval of the precise data required for the management for critically ill patients. The proformas have been modifi ed extensively over the last twenty years based on my personal experience and extensive consultation with colleagues in several world-renowned centres of excellence. The proformas were originally developed for use in the intensive therapy unit
or high dependency unit. However, they have been adapted for use by outreach teams reviewing patients admitted outside of critical care areas. The use of these tools can direct eff orts to provide appropriate organ support and provides a framework for diagnostic reasoning.
AHIMA Game of documentation - dance with the icd10 dragonNick van Terheyden
Following on from AHIMA 2014 this AHIMA 2015 session will follow last years Successful Presentation “Game of Documentation: Winter is Coming – Surviving ICD-10” to address the genuine concerns of clinicians and demonstrate to them why they must not just accept ICD10 but should be demanding it. As Yoda said
“Always in motion is the future…a little more knowledge lights our way.”
ICD-10 has been implemented but resistance remains high and in a recent remarks by the AMA president that said
“If it was a droid, ICD-10 would serve Darth Vader… For more than a decade, the AMA kept ICD-10 at bay – and we want to freeze it in carbonite!”
But despite this the financial viability and performance of hospitals and physicians are impacted by poor quality of data that is captured with an outdated 1970s-era coding system
The first leap into big data is collecting information with precision and clarity – something that cannot be achieved with a coding system that does not capture Ebola nor the basic classification of myocardial infarction STEMI and Non-STEMI. Everyone – ICD10 supporters and opponents wants the best possible care when they access our healthcare system – but how do they know they are receiving this if we are unable to accurately collect information about diseases and treatments and link outcomes to treatments.
https://ahima.confex.com/ahima/87am/webprogram/Session6176.html
Discuss challenges of EMR content awareness and analysis, and current disconnected documentation clarification processes;
Explain methodologies to engage physicians in the CDI process
Describe how technology can assist with documentation improvement and acceptance
Identify status of current advanced CDI programs and the opportunity for integration of evolving technological innovations
Jane Blower, Deputy Chief Scientific Officer (Acting) NHS England. Jane's presentation from the Seven Day Services event in the East Midlands on 12th June 2014.
Medical Records is a foremost important in the healthcare accreditation bodies like JCI,NABH are very adherent about its documentation,retention and confidentiality.
Clinical Trials Conduct and Protocol Compliance in AsiaMedpace
This presentation focuses on health issues in Asia Pacific (specifically China), clinical trial challenges - operational and regulatory, and key considerations when conducting trials within this region.
Presentation slides from our first meeting, held on Tuesday 10th September 2013 at the Royal College of Surgeons.
Find us on
Twitter @STARSurgUK
Facebook.com/STARSurgUK
Email: STARSurgUK@gmail.com
A standards-based approach to development of clinical registries - Initial lessons learnt from the gestational diabetes registry. Presented by Koray Atalag, National Institute for Health Innovation, University of Auckland, at HINZ 2014, 12 November 2014, 12pm, Plenary Room 2
YCN Breast Educational Meeting 2015 -Network breast data-Geoff Hall
dsCVJun2016
1. Debra Lane Stevenson
1350 Arapaho Trail
Geneva, FL 32732
Office 407-388-8682
FAX 407-349-9578
shimasu@citlink.net
POSITION: Regional Consultant Clinical Research Associate
EMPLOYMENT: Self-employed contractor, Geneva, FL 2001 - Present
Contract Clinical Research Associate working with multiple organizations in the therapeutic areas of
Interventional cardiology, cardiology (surgical studies), oncology (malignant melanoma) and cardiac
Devices:
Allergan: Dry Eye Syndrome and Wet Age Related Macular Degeneration: Nov 2015 to present
Bayer: Prostate Cancer with Bone Metastasis: May 2015 to Dec 2015
Trevena: Acute Cardiac Heart Failure: April 2014 to July 2016
Celladon: Gene Therapy Cardiovascular: July 2013 to April 30, 2015
Endologix: Renal artery stent: May 2013 to August 2015
Pfizer: Lung Cancer, October 2012 to March 2014
Phase Two Diuretic study in Heart Failure, May 2012 to December 2013
Type I diabetes phase IV study: May 2012 to September 30, 2012
Canine Diabetes Study: January 2012 to January 2013
Genetech: Severe Asthma, March 2012 to September 30, 2012
Endologix: Cardiac device, May 2010 to October 2012
Corthera: Inpatient Continuous Infusion study in Heart Failure, May 2011 to September 30 2012.
Cardioxyl Pharmaceuticals: In patient Infusion study in Decompensated Heart Failure,
February 2011 to October 2011.
Teva Pharmaceuticals: Asthma, August 2010 to February 28, 2011
GSK: Phase 1 Hepatic, May 2010 to July 2011
Stiefel Laboratories: Dermatology, Phase 1 studies: January 2008 to July 2010
Hilltop Research: Phase 1 studies: October 2009 to March 2010
GSK: Oncology: October 2007 to June 2009
Bioforce Solutions: Cardiac studies 2006-2008
LaJolla Pharmaceutical Company: Lupus Nephritis 2006-2007
Medtronics: Cardiac stent, 2005-2006
Scios: CABG 2003-2005
PAREXEL International: Melanoma January 2001- August 2003
CRA Tasks:
Conduct initiation, monitoring, and termination visits for up to 17 sites using electronic data capture
(EDC) throughout the trial. Trained site staff, new CRAs, and sponsorpersonnelin the use of EDC.
Project Management Tasks:
•Report to project management on status ofall outstanding items to be completed for all sites scheduled
for terminations. Maintain tracker with updates from Primary CRA and team CRAs. Provide report to
management and sponsoron weekly basis of updates and status. Document all pending items from
Termination Visits.
•Assisted with Quality Control Audit of Site Central Files (QC) to identify findings and report them to
project management.
• Liaison between site CRAs and the Primary CRA to collect all outstanding regulatory documents noted
on the QC spreadsheets.
QUINTILES, INC., Cranbury, NJ 2000 - 2001
Regional Senior Clinical Research Associate (CRA)
Hired as a Senior CRA to monitor clinical sites for several cardiology trials including Phase III Acute
Myocardial Infarction (with CABG) and Phase II Arrhythmia with ICD. Maintained 18 sites on AMI
trial located between Nebraska and New York, working with the sites from Qualification through
termination. Mentored new CRAs on various studies,reviewing their job performance per Quintiles
2. SOPs. Other therapeutic areas include: pain management, weight loss,cholecystitis, diabetes type II,
asthma.
COROMED, INC., Troy, New York 1999 - 1999
Clinical Research Associate
Hired as CRA to monitor clinical sites for a large Phase III Congestive Heart Failure (CHF) trial.
Maintained 16 sites from qualification through monitoring phases of trial.
PAREXEL INTERNATIONAL, Waltham, MA 1998 - 1999
Regional Clinical Research Associate
Monitored large multicenter Osteoporosis trial, capturing bone density measurements of women post
menopause to form a national database for further research into this disease. Identified patient
populations,presented trial information to physicians at local offices, consented patients fortrial and
retrieved data for sponsor.
Substitute Teacher, BOCES, Johnstown, and Greater Amsterdam School District 1994 - 1997
Taught English, math, science, physical education and special education classes as needed.
THERAPEUTIC AREAS: Heart Failure, Congestive Heart Failure, Acute Myocardial Infarction (with CABG), Arrhythmia,
HTN, DVT, Diabetes Type II, Osteoporosis, Pain Management (pre and post-op),Cholecystitis,
Asthma, Weight Loss, Oncology (Malignant Melanoma, Colon) and Antisense drug therapy,
Peripheral Arterial Disease, Acute Care Studies, PCI, non-emergent CABG, including surgical and
non-surgical trials, Lupus Nephritis, Acne and Seborrheic Dermatitis.
Ophthalmology: Dry Eye; Glaucoma
Pediatric: Anticoagulant use in cath lab
Phase 1 Trials: Various indications
Devices: AICD, Thoracic Stent, Abdominal Stent, Renal Artery Stent, Closure Device
SKILLS: Electronic Data Capture (RAVE, Oracle RDC, InForm, eTrials, Target)
EDUCATION: ACRP Clinical Research Associate Certification and Member 2000
CRA (Clinical Research Associate) Training 1998
PAREXEL International, Waltham, MA
Master of Arts, Health Care Administration 1997
Empire State College, Saratoga, NY
Bachelor of Science, Human Development 1996
Empire State College, Saratoga, NY
CONTINUING ED: Icon GCP Updated certification January 2014
Pfizer/Icon GCP and CRA certification November 2012
Covance GCP Training August 31, 2012
LSU Health Science Center Hemodynamic training August 10, 2011
Drug and BiologicGCP and Monitoring Seminar November 19, 2007
Association of Clinical Research Professionals (ACRP) Annual Convention
Phoenix, Arizona April 2006
Philadelphia, Pennsylvania April 2003
Toronto, Canada April 2002
San Francisco, California April 2001
Quintiles University
Clinical Quality Assurance Review of Investigators January 29, 2001
Time Management January 16, 2001
Better Business Writing January 16, 2001
Overview of the Regulatory Process and GCPs November 10, 2001
Site Identification and the Clinical Quality Assurance
Process of Clinical Investigators August 24, 2001
Clinical Communications Workshop August 22, 2001
CRA Mentoring Workshop July 25, 2000
Electronic Records and Signatures June 6, 2000
3. Account Management and Business Development May 11, 2000
Clinical Data Management May 7, 2000
Adverse Event Workshop April 19, 2000
Handling Investigational Product April 19, 2000
Clinical Overview of Fraud and Misconduct April 12, 2000
Drug Development Training System April 2, 2000
Clinical Compliance in Action March 14, 2000
Economics of Our Business March 14, 2000
Sara Cannon Seminar: Lung Cancer June 10, 2003
Breast Cancer March 14, 2003
Online Collaborative Oncology Group Seminar: Hematology March 2002
EXPERIENCE:
Study Initiation: •Conduct site selection visits to determine appropriate Investigator resources necessary for completing
successful research trials.
•Ensure completion of regulatory documents.
•Instruct Investigator and staff in protocol specifications and study management.
•Review Investigator’s 1572 responsibilities.
Study Monitoring: •Participate in phase I, II, III and IV trials in a variety of settings with Investigators ranging fromgeneral
practitioners to surgical physicians.
•Assess Investigator’s study performance and adherence to GCPs, protocol requirements and FDA
regulations.
•Maintain current site regulatory files.
•Perform source document review to ensure accuracy of CRF and eCRF data.
•Review AEs and SAEs for thoroughness and timeliness of reporting.
•Resolve data queries including using the eCRF system.
•Perform drug accountability.
•Prepare site reports and maintained regular written and telephone contact with sites.
Study Termination: •Resolve all residual site issues including retrieval of outstanding CRFs, and unused study drug, and
resolution of remaining data queries.
•Complete final site reports.
General: •Mentor new CRAs in various study functions. Provide monitoring training for new CRAs.
•Maintain strict adherence to protocol requirements, FDA regulations, ICH Guidelines, Good Clinical
Practice (GCP), and Sponsor and CRO standard operating procedures
•Involved in creation of study documents, including tracking forms, slides for presentations, etc.