Steven Handler, MD, PhD
- Biomedical Informatics
- Clinical and Translational Informatics
- Adverse Drug Reactions
- Adverse Drug Events
- Medication management
- Medication adherence
- Patient Safety
- Patient Safety Culture
- Process and Quality Improvement
- Transitional care
Appointments and Positions
Assistant Professor of Biomedical Informatics
Assistant Professor of Geriatric Medicine
Assistant Professor of Clinical and Translational Research
Director, Clinical Informatics, Department of Biomedical Informatics
Graduate Faculty of the University of Pittsburgh School of Medicine
Core Faculty of the RAND-University of Pittsburgh Health Institute (RUPHI)
Research Health Scientist Specialists at the Geriatric Research Education and Clinical Center (GRECC) at the VA Pittsburgh Healthcare System (VAPHS)
Medical Director for Long-term Care Health information technology at the University of Pittsburgh Medical Center (UPMC)
Associate Medical Director, Asbury Heights Nursing Home
Co-Director of the University of Pittsburgh Geriatric Pharmaceutical Outcomes and Gero-Informatics Research and Training Program
Core Faculty of the Biomedical Informatics Training Program
Current Research Projects and Collaborations
Pittsburgh Older American Independence Center (Pepper Center)
The specific aims are to develop interventions to improve function and independence in older adults with balance disorders, integrate studies of physiologic, biomechanical and psychosocial mechanisms affecting balance with clinical studies, and foster multidisciplinary research and research training.
A Multicenter Evaluation of off-label Medication use and Adverse Drug Events in Adult Intensive Care Unit Patients.
The goal of this a multi-center, comparative, prospective evaluation is to is to determine the incidence of ADRs associated with off-label drug use and elucidate if off-label drug use is an independent risk factor for the development of ADRs in ICU patients. These data will be used to develop a pharmacy practice model for prevention of ADRs from off-label drug use by incorporating clinical decision support into an alerting system.
The Effect of a Computer-generated Rounding Report on Physician Workflow in the Nursing Home
The goal of this quality improvement project is to determine the impact of a paper-based computer-generated rounding report (i.e., a summary document formatted like a SOAP note that contains the most relevant clinical and demographic data as determined by geriatric practitioners) on physician workflow in the nursing home. The findings of this project will likely result in the use of an information system that will yield improved physician efficiency by reducing the effort required to gather the data necessary to generate rounding reports, improve the completeness of available information, and reduce some of the commonly reported barriers to providing patient care in the nursing home setting.
A Randomized Controlled Trial to Assess the Impact of a Telemedicine Medication Delivery Unit on Medication Adherence Following Hospitalization for Common Cardiac Conditions.
Medication non-adherence is common in older adults with common cardiac condition and can lead to medication-related problems and increased healthcare expenditures. Medication Delivery Units (MDUs) have the potential to improve medication adherence and reduce healthcare expenditures by simplifying the process of managing complicated medication regimens, providing reminders as to when and how a drug should be taken, and automating the medication delivery process. The primary goal of this randomized controlled trial is determine if a telemedicine MDU can improve medication adherence over a 3-month period in patients immediately following hospitalization for common cardiac conditions when compared to usual care.
Study of Post-Acute Care for Medicare Beneficiaries
The purpose of this Contract/Task Order is to outline the medical record review services required by the U.S. Department of Health and Human Services, Office of Inspector General (OIG) as part of a series of studies regarding quality of care and patient safety among Medicare beneficiaries discharged from hospitals to post-acute care settings. The quality of care will be assessed by first developing a global nursing home-specific trigger tool and then applying it to a random sample of 1,100 Medicare beneficiaries.
An Examination of Resident Abuse in Assisted Living Facilities
This project proposes to examine resident abuse in assisted living facilities (ALFs). Six categories of elder abuse will be examined (i.e., verbal, physical, material, psychological, medication, and sexual abuse). The proposal has three specific aims: (1) Examine resident abuse from family and staff reported by nurse aides in a nationally representative sample of ALFs; (2) Expand the scope of our understanding of resident abuse by including medication abuse in ALFs; and (3) Identify facility practices in ALFs that nurse aides and Directors of Nursing believe prevent or contribute to abuse of residents.
Enhancing the Detection and Management of Adverse Drug Events in the Nursing Home
The long-term objective of the proposed project is to improve patient safety with respect to medications in nursing homes (NH). The short-term objectives, or specific aims, of this proposed project are to determine if NH patients managed by physicians who receive active medication monitoring alerts have more adverse drug effects (ADE) detected, have a faster ADE management response time, and can result in more cost-savings from a societal perspective compared to usual care. The study includes a cluster randomized controlled trial among eighty-six NH physicians working in one of four NHs in Southwestern Pennsylvania.
University of Pittsburgh Program for Pharmaceutical Outcomes Research in Aging
The overall goal of this project is to build a strong research program in Pharmaceutical Outcomes Research in Aging. The specific aims are to create an educational series that provides a solid foundation of knowledge and skills in geriatric pharmaceutical outcomes research, to build a cadre of well trained investigators in the field, and to provide experiential learning and support for data management and analysis of pharmaceutical data.
Roshanov PS, Fernandes N, Wilczynski JM, Hemens BJ, You JJ, Handler SM, Nieuwlaat R, Souza NM, Beyene J, Spall HG, Garg AX, Haynes RB. Features of effective computerised clinical decision support systems: meta-regression of 162 randomised trials. BMJ. 2013 Feb 14; PMID:23412440 [PubMed - in process]
Thorpe-Jamison PT, Culley CM, Perera S, Handler SM. Evaluating the Impact of Computer-Generated Rounding Reports on Physician Workflow in the Nursing Home: A Feasibility Time-Motion Study. Journal of the American Medical Directors Association. 2013 Jan 11; PMID: 23318665
Boyce RD, Hanlon, JT, Karp JF, Kloke J, Saleh A, Handler SM. A Review of the Effectiveness of Antidepressant Medications for Depressed Nursing Home Residents. Journal of the American Medical Directors Association. 2012;13(4):326-331. PMID: 22019084 PMCID: PMC3340502.
Smith KJ, Clark S, Kapoor W, Handler SM. Information Primary Care Physicians Want to Receive about Their Hospitalized Patients. Family Medicine. 2012; 44(6):425-30. PMID: 22733420 PMCID:PMC In progress.
Castle NG, Wagner LM, Smith ML, Handler SM. Alcohol Misuse and Abuse in Assisted Living [Letter to the Editor]. Journal of the American Medical Directors Association. (Epub ahead of print). 2012;13(1):e7. PMID: 21764389
Schwarz EB, Parisi SM, Handler SM, Koren G, Shevchik GJ, Fischer GS. Clinical Decision Support to Promote Safe Prescribing to Women of Reproductive-age: A Cluster-Randomized Trial Journal of General Internal Medicine. (Epub ahead of print). 27(7):831-838, 2012. PMID:22297687 PMCID:PMC In progress.
Marcum ZA, Pugh MV, Amuan ME, Aspinall SL, Handler SM, Ruby CM, Hanlon JT. Prevalence of Potentially Preventable Unplanned Hospitalizations Caused by Therapeutic Failures and Adverse Drug Withdrawal Events among Older Veterans. The Journal of Gerontology: Medical Sciences (Epub ahead of print).
Kane-Gill SL, Forsberg E, Verrico MM, Handler SM. Evaluating Adverse Drug Reactions Occurring in the Medical Intensive Care Unit: Using Three Pharmacovigilance Algorithms. Drug Safety. (Epub ahead of print). In print: Comparison of three pharmacovigilance algorithms in the ICU setting: A retrospective and prospective evaluation of ADRs. Drug Safety 2012;35(8):867-874, 2012. PMID: 22720659 PMCID:PMC In progress.