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Parchman, Michael Leo MD

School of Medicine
Family & Community Medicine
(210) 617-5314
parchman@uthscsa.edu

Michael L. Parchman, MD, MPH, is the Mario E. Rameriz Endowed Distinguished Professor of Family and Community Medicine at The University of Texas Health Science Center at San Antonio. The focus of his research is on the primary care clinical micro-system as a complex adaptive system, type 2 diabetes, and practice-based research network development and methodologies. His work has been funded by the Agency for Healthcare Quality and Research and the National Institute of Health to conduct research on novel methods to improve quality and outcomes of care for patients with type 2 diabetes in primary care settings. He is also a director of the South Texas Ambulatory Research Network, a network of primary care offices and clinics across South Texas.

Appointments Education Expertise Teaching Publications Grants

1/2009 - Present	Mario E, Ramirez Endowed Distinguished Professor	University of Texas Health Science Center at San Antonio, Family & Community Medicine, San Antonio, TX
3/2008 - Present	Interim Center Principal Investigator	VERDICT Health Services Research Center, South Texas Veterans Health Care System (VA), San Antonio, TX
3/2006 - Present	Associate Professor and Faculty, Graduate School of Biomedical Sciences	University of Texas Health Science Center-San Antonio, San Antonio, TX
5/2000 - Present	Research Investigator	VERDICT Health Services Research Center, South Texas Veterans Health Care System (VA), San Antonio, TX
7/1998 - Present	Associate Professor	University of Texas Health Science Center-San Antonio, Family & Community Medicine, San Antonio, TX

Date	Description	Institution	# Students
9/2006 - Present	MEDI 6065 Health Services Research		25 students
Course Director - Enrollment: 15-25 students. A required health services research course in the Masters of Science in Clinical Investigation (MSCI) graduate program sponsored by a K30 grant from NHLBI/NIH. I was responsible for the initial design of the course including the curriculum and evaluation. I am course co-director, responsible for on-going curriculum development, instruction, coordination of scheduling of other instructors, and student evaluation and feedback.
7/2005 - Present	Family Medicine Resident Scholarly Inquiry	UTHSCSA	25 students
I developed a new curriculum for the Family Medicine Residency Program in Scholarly Inquiry that incorporates both the knowledge and skils required to conduct critical appraisal of the scientific literature and experience at conducting clinical studies in their outpatient clinic. This occurs once each month and requires 2-4 hours of preparation for the one hour conference.
9/2004 - Present	Preventing Diabetes Complications: Fact or Fiction	University of Texas Health Science Center	15 students
A one hour class taught once each month to third year medical students on the Family Medicine Clerkship clinical rotation.
8/2004 - Present	Pre-Doctoral Student Supervision	Juvenile Detention Center

7/2004 - Present	Post-Doctoral Student Supervision	University of Texas Health Science Center-San Antonio

9/2003 - Present	Patient Orient Clin Res Biostat	The University of Texas Health Science Center	15 students
Enrollment 15-25 students. Introduction to Systematic Reviews of the Medical Literature.
8/1998 - Present	Post-Doctoral Student Supervision	University of Texas Health Sciences Center, San Antonio

7/1998 - Present	Post-Doctoral Student Supervision	UTHSCSA

7/1998 - Present	Post-Doctoral Student Supervision	UTHSCSA

Journal Article

Parchman ML, Flannagan D, Ferrer RL, Matamoras M. Communication competence, self-care behaviors and glucose control in patients with type 2 diabetes Patient Educ Couns 2009 Oct;77:55-59.

Copeland LA, Zeber JE, Wang C, Parchman ML, Lawrence VA, Valenstein M, Miller AL. Patterns of primary care and mortality among patients with schizophrenia or diabetes: a cluster analysis approach to the retrospective study of healthcare utilization BMC Health Serv Res 2009 Jul;9(127).

Katerndahl DA, Parchman ML, Wood, Robert. Perceived complexity of care, perceived autonomy, and career satisfaction among primary care physicians Journal of the American Board of Family Medicine 2009 Jan;22:24-33.

Parchman ML, Pugh JA, Culler SD, Noel PH, Arar NH, Romero RL, Palmer RF. A group randomized trial of a complexity-based organizational intervention to improve risk factors for diabetes complications in primary care settings: study protocol Implementation Science 2008 Mar;3.

Pugh MJ, Palmer FR, Parchman ML, Mortensen EM, Markides K, Espino DV. Association of suboptimal prescribing and change in lower extremity physical function over time Gerontology 2008 Feb;53(6):445-453.

Parchman ML Pugh JA Wang CP Romero RL. Glucose Control, Self-Care Behaviors and the Presence of the Chronic Care Model in Primary Care Clinics Diabetes Care 2007 Nov;30(11):2849-2854.

Leykum LK, Pugh J, Lawrence V, Parchman M, Nol PH, Cornell J, McDaniel RR. Organizational interventions employing principles of complexity science have improved outcomes for patients with Type II diabetes Implementation Science 2007 Aug;2.

Parchman ML, Pugh JA, Romero RL, Bowers, SK. Competing demands and clinical inertia: The case of the elevated glycosylated hemoglobin Annals of Family Medicine 2007 May;5(3):196-201.

Parchman ML, Pugh JA, Romero RL, Bowers KW, Bowers K. Competing demands or clinical inertia: the case of elevated glycosylated hemoglobin Ann Fam Med 2007 May;5(3):196-201.

Cornell JE, Pugh JA, Williams JW Jr, Kazis LE, Lee A, Parchman ML, Zeber JE, Montogemery KA, Noel PH. Multimorbidity clusters: Clustering binary data from a large administrative medical database Applied Multivariate Research 2007 Jan;12(3):163-182.

Noel PH, Parchman ML, Williams JW, Cornell JE, Shuko L, Zeber JE, Kazis LE, Lee AF, Pugh JA. The challenges of multimorbidity from the patient perspective Journal of General Internal Medicine 2007 Jan;22:419-424.

Parchman ML, Zeber JE, Romero RL, Pugh JA. Risk of coronary artery disease in type 2 diabetes and the delivery of care consistent with the chronic care model in primary care settings: a STARNet study Medical Care 2007 Jan;45:1129-1134.

Kaissi AA Parchman ML. Assessing chronic illness care for diabetes in primary care clinics Joint Commission Journal on Quality and Patient Safety 2006 Jun;32(6):318-323.

Parchman ML Romero RL Pugh JA. Encounters by patients with type 2 diabetes-complex and demanding: an observational study Annals of Family Medicine 2006 Feb;4.

Espino DV, Bazaldua OV, Palmer RF, Mouton CP, Parchman ML, Miles TP, Markides K. Suboptimal Medication Use and Mortality in an Older Adult Community-Based Cohort: Results From the Hispanic EPESE Study J Gerontol A Biol Sci Med Sci 2006 Feb;61(2):170-175.

Parchman ML, Nol P, Lee S. Primary care attributes, health care system hassles, and chronic illness Medical Care 2005 Nov;3(11):1123-1129.

Wen L, Parchman ML, Linn WD, Lee S. Association between self-monitoring of blood glucose and glycemic control in patients with type 2 diabetes Am J Health-Syst Pharm 2004 Nov;61:2401-2405.

Wen LK, Parchman ML, Shepherd MD. Family support and diet barriers among older Hispanic adults with type 2 diabet Family Medicine 2004 Jun;36(6):423-430.

Parchman ML, Burge SK. The patient-physician relationship, primary care attributes, and preventive services Fam Med 2004 Jan;36(1):22-27.

Wen LK, Shepherd MD, Parchman ML. Family support, diet, and exercise among older Mexican Americans with type 2 diabetes Diabetes Educ 2004 Jan;30(6):980-993.

Book Chapter

Parchman ML. How can we enhance the robustness of engineered systems. In: Fahmida Chowdhury Jeffrey Cooper Tuan Duong Theirry Emonet James Ferrell Panos Papandopoulos Vimla Patel Steven Schiff Andreas Wagner Jessika Trancik Cassandra Brooks. Complex Systems: National Academies Keck Futures Initiative. Washington, DC: National Academy Press; 2009.

Abstract

Copeland LA, Zeber JE, Parchman ML, Lawrence VA, Hosek BJ, Miller AL. Pre-diabetes and diabetes assessment in veterans with schizophrenia [Oral Presentation]; 2009 Jan. (Schizophrenia Bulletin; vol. 35, no. S1).

Leykum LK, Pugh JA, Lawrence VA, Parchman ML, Noel PH, McDaniel R. Making sense of organizational interventions using complexity science; 2007 Jan. (Society of General Internal Medicine).

Leykum LK, Pugh JA, Lawrence VA, Parchman ML, Noel PH, McDaniel R. Use of complexity science improved effectiveness of organizational interventions for patients with congestive heart failure; 2007 Jan. (Academy Health).

Parchman ML, Wang CP, Pugh JA, Romero RL. Hispanic Disparity in A1c is Moderated by the Chronic Care Model; 2006 Jun. (Diabetes).

Noel PH, Parchman ML, Zeber J, Lee S, Pugh JA. Self-Management Learning Needs of Veterans with Multimorbidity. Poster presented at 2006 HSR&D Annual Meeting; 2006 Jan.

Parchman ML, Pugh JA. Competing demands and the quality of diabetes care in primary care; 2004 Jan. (Diabetes; vol. 53, no. 2).

Parchman ML, Pugh JA. Content of primary care visits by adults with type 2 diabetes; 2004 Jan. (Diabetes; vol. 53, no. 2).

Lawrence VA, Pugh JA, Noel PH, Parchman ML, Best RG. Creating SynERGI through organizational interventions to implement clinical practice guidelines for QUERI diseases; 2003 Dec. (Veterans Health Administration).

Editorial

Parchman ML. Preventive Services and Family Medicine Offices: The Dynamics of Patient Care Annals of Family Medicine 2005 Sep;3:430-435.

Electronic/Web Publication

Parchman ML. Clincal Inertia or Competing Demands: Author''s response to Dr. Phillips 2007 Jul. 1 p. Available from: http://www.annfammed.org/cgi/eletters/5/3/196 .

Parchman ML. Changes in the Supply and Distribution of Primary Care Physicians within Market-Defined Areas and Counties of Texas 1990-2000 2005 Oct. 41 p. Available from: www.uthscsa.edu/rchws This report describes the research that preceded Assessing Health-Workforce Disparities in the U.S./Mexico Border Region: A Geographic Information Systems Approach, a larger work reporting on the use of GIS techniques to develop adequate tools for public administrators charged with defining health workforce shortage areas. The aim of the research reported here has been that of assessing changes in the distribution of primary care physicians and non-physician clinicians in Border and rural areas of Texas using the newly developed definitions of Primary Care Service Areas (PCSAs). The use of PCSA geography was employed, as opposed to more-traditional, politically configured county boundaries, to produce findings that reflected actual health-service areas rather than administrative conventions. The findings from this research project provided insights to the methodological and data- collection challenges facing policy makers and researchers alike. They suggest that further analyses are needed to inform policy that addresses physician-shortage areas.

Not Specified

Copeland LA Zeber J Wang CP Parchman ML Lawrence VA Valenstein M Miller LA. Patterns of primary care and mortality among patients with schizophrenia or diabetes: a cluster analysis approach to the retrospective study of healthcare utilization BMC Health Services Research 2009 Jul;9.

Federal
Funding Agency	HRSA Bureau of Health Professions
Title	Academic Administrative Units
Status	Active
Period	9/2009 - 8/2012
Role	Co-Investigator
Grant Detail
Funding Agency	HSR&D
Title	Learning and Relationships in Primary Care Clinical Microsystems
Status	Active
Period	7/2008 - 6/2011
Role	Principal Investigator
Grant Detail	Goal: To improve the health of veterans by designing interventions at the clinical microsystem level that will capitalize on the characteristics of complex adaptive systems rather than work against them.
Funding Agency	HSR&D/VA
Title	Patterns of Late-life Healthcare among VA Patients with Schizophrenia
Status	Active
Period	7/2006 - 3/2010
Role	Co-Investigator
Grant Detail	The retrospective cohort study analyzes administrative data (FY02-FY05) on veterans age 50 or older receiving VA care for schizophrenia, diabetes, or both schizophrenia and diabetes to compare patterns of care (inpatient, outpatient, medical, psychiatric), compare prescription profiles (e.g., use of antipsychotic or antidiabetic agents) and clinical indicators (e.g., blood glucose, A1c testing, lipids), and to assess the impact of patterns of care and intermediate measures on mortality among the three groups of patients. Generalized linear models will assess study hypotheses, controlling for demographic and clinical correlates as well as facility-level clustering of patients.
Funding Agency	Agency for Healthcare Research and Quality
Title	San Antonio Health Services Research Program: Direct Observation of Competing Demands for Diabetes Care
Status	Active
Period	2/2006 - 1/2010
Role	Co-Investigator
Grant Detail	This is a sub-contract from a grant to the University of Texas at San Antonio from the Agency for Healthcare Research and Quality. The purpose of the grant is to improve minority involvement in health services research. I am PI for one subaward of 3 projects that are conducted with faculty at UTSA: the Competing Demands study. This is the first grant in San Antonio that involves all 3 University of Texas campuses here: the Health Science Center, the School of Public Health and UTSA.
Funding Agency	Veterans Affairs HSR&D
Title	Systematic Review and Tracking Database for CPG Implementation Research
Status	Complete
Period	9/2003 - 8/2008
Role	Co-Investigator
Grant Detail	Systematically review the literature on organizational strategies of implementing evidence-based medicine into clinical practice; designed to improve the quality of care provided to veterans with QUERI diseases high prevalence, chronic conditions (e.g., diabetes, CHF, colon cancer, schizophrenia, depression, etc.)
Funding Agency	VA Health Services Research and Development Service
Title	Multifaceted Assessment of Coordination of Care for OEF-OIF Veterans
Status	Complete
Period	8/2007 - 2/2008
Role	Co-Investigator
Grant Detail	To provide timely and valuable information to improve the transition from DoD to VA care for OEF/OIF service members/veterans.1) describe care coordination experiences from the perspective of both the patient and health care providers of the healthcare team and 2) identify factors that are most helpful or harmful to facilitate or inhibit transition and clinical care.
Funding Agency	National Institute of Diabetes, Digestive and Kidney Diseases
Title	Diabetes and cardiovascular risks in primary care
Status	Complete
Period	1/2005 - 12/2006
Role	Principal Investigator
Grant Detail	Although more than 97% of adults with diabetes seek their care from a primary care physician, translating theoretically sound strategies that work in research settings into real world primary care practices has been a challenge. This planning grant project had as its ultimate goal the development of an R18 proposal for a full study of interventions to improve risk factor control for diabetes complications. In preparation for an R18 translational grant application, we accomplished the following specific aims: 1)Development of a primary care practice-based research network for the purpose of developing an adequate population of practices to sample from for the full study; 2)Development and testing of methods to assemble and follow a cohort of diabetic patients within multiple independent small group primary care practices; 3)Testing of the feasibility of the proposed intervention in a small sample of primary care practices; 4) Assessing outcome measures for feasibility, reliability, intra-and inter-practice variability, and responsiveness to intervention for purposes of sample size estimation; and 5)Preparation of an R18 grant proposal for a randomized trial of both practice-level and patient-level interventions to reduce cardiovascular risk factors among adults with type 2 diabetes in primary care practice settings.
Private
Funding Agency	Physicians Foundation for Health Systems Excellence
Title	Improving Diabetes Care Through Implementation of Health Information Technology in Solo and Small Family Physician Practices
Status	Active
Period	1/2007 - 12/2008
Role	Principal Investigator
Grant Detail	The purpose of this study is to implement and evaluate a diabetes registry as a means of improving medical care to type 2 diabetics in small family practice offices located in rural and underserved areas of Texas. The specific aims are to: 1. Assess the effectiveness and sustainability of the implementation of a diabetes registry on the quality of care delivered to patients with type 2 diabetes Hypothesis 1a: Quality of care for patients in intervention practices will be better than those of patients in control practices at the end of the intervention Hypothesis 1b: This improvement will be sustained over the subsequent 12 months after withdrawal of the intervention. 2. Evaluate the effect of a diabetes registry intervention on design of the care delivery system in each practice. Hypothesis 2a: Care delivery systems in intervention practices will be more consistent with the Chronic Care Model than control practices. Hypothesis 2b: This change will be sustained over the subsequent 12 months after withdrawal of the intervention.

Funding Agency	NIDDK/NIH
Title	Improving Risk Factors for Diabetes Complications in Primary Care
Status	Active
Period	5/2007 - 4/2012
Role	Principal Investigator
Grant Detail	Current control of hemoglobin A1c, blood pressure and lipids among patients with type 2 diabetes in primary care settings is not adequate to prevent complications. The purpose of this study is to use a Practice Facilitation intervention in a group randomized controlled trial to improve these risk factors among patients with type 2 diabetes seen in primary care practices. The intervention is based on complex adaptive system theory and will use the Chronic Illness Care model to support the selection, tailoring, and implementation of one of 5 evidence-based strategies to improve risk factors in each intervention practice. Forty practices/clinics across South Central Texas will be enrolled.
Funding Agency	VA HSR&D
Title	Genomic Health Service Research Program for Veterans in South Texas (GHSP)
Status	Active
Period	3/2008 - 9/2009
Role	Co-Investigator
Grant Detail	To encourage novel research for evidence-based planning of veteran HSR in genomics and to begin the development of models and tools for genomic translation within the VA health system. The GHSP will also enable effective collaborations of multidisciplinary team(s) of basic, clinical and HSR interested in genomics.
Funding Agency	VA/HSR&D
Title	A Practice-Based Research Network for Clinical Microsystem Research
Status	Active
Period	4/2008 - 9/2008
Role	Principal Investigator
Grant Detail	The goal of this short term research project is to develop a PBRN in South Texas comprised of clinicians from the 8 primary care VA staffed non-contract OPCs. This will be the first step to establish a VA-based primary care "Practice-Based Research Network" (PBRN) in VISN 17.

Year	Degree	Discipline	Institution
2001	MPH		University of Texas School of Public Health Houston , TX
1994	Postdoctoral Fellowship		Regenstrief Institute, Indiana University School of Medicine Indianapolis , IN
1990	Postdoctoral Fellowship		Faculty Development Center of Texas Waco , TX
1985	Residency	Family Practice	Waco Family Practice Residency Program Waco , TX
1982	MD	Medicine	University of Texas Southwestern Medical School Dallas , UT
1978	BA	Chemistry (Magna Cum Laude)	Baylor University Waco , UT

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Parchman, Michael Leo MD

Complexity Science

Diabetes, Type 2

Geographic Information System (GIS) Analysis

Health Care Workforce

Health Services Research

Primary Care