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The Feinstein Institute for Medical Research

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Renee Pekmezaris, PhD

Investigator, The Feinstein Institute for Medical Research

Vice President, Community Health and Health Services Research

Associate Professor, Department of Population Health, Hofstra North Shore-LIJ School of Medicine

Phone: (516) 465-3161
E-mail: rpekmeza@nshs.edu

About the Investigator

Renee Pekmezaris received her PhD from Hofstra University in 1987 in Psychology, specializing in Applied Research and Program Evaluation. For the first ten years of her career, she served the Long Island, New York community as Research Director, and was subsequently appointed as Executive Director of the Nassau-Suffolk Health Systems Agency, the state-designated health planning and regulatory agency for Long Island.

Dr. Pekmezaris joined the North Shore-LIJ Health System as Vice President for Community Health and Health Services Research in 1998. She is responsible for conducting studies to improve quality of life for patients, in a range of clinical and health services research investigations, including community-based participatory research. She has authored over 30 peer review publications has served as a reviewer for PharmoEconomics, Medical Education, Journal for Healthcare Quality and Health Services Research.

Part of her work involves collaborative projects with investigators in other departments throughout the health system, to whom her team provides scientific consultation. Dr. Pekmezaris previously served as Research Fellow of the Institute for Medical Effectiveness Research at Albert Einstein College of Medicine (AECOM), and is an Associate Professor of Population Health at the Hofstra North Shore-LIJ School of Medicine (HSOM). She currently chairs the Social Context Curriculum Development Committee and serves on several curriculum development committees at the HSOM. She also co-chaired the Master of Public Health Advisory Committee at Hofstra University.

Research Focus

With an emphasis on the growing population of seniors in the New York metropolitan area, Dr. Pekmezaris has extensive experience carrying out community-based research investigations with seniors, including: a randomized telehealth trial for patients living with congestive heart failure in the community, a case-matched control telehealth trial for community-dwelling patients living with congestive heart failure, a randomized trial in anemia of chronic disease, and a study to predict site of death in end of life patients.

She is presently the principal investigator of a number of applied technology grants as well as a Verizon-supported long term telehealth study of the effects of remote patient management on hospitalization associated costs and quality of life.

What kind of chronic illness does your team study?

Our team looks for solutions to improve quality of life for patients living with chronic illness. For example, we are actively studying the management of patients at home through telehealth technology. Our team has been focusing on patients with congestive heart failure (CHF).

CHF is the most frequent diagnosis in hospitalized patients over 65, and is a leading cause of disability and death. CHF is a progressive, chronic disease characterized by a variety of cardiovascular problems leading to cardiac dysfunction and eventually to typical CHF symptoms such as dyspnea, fatigue, and congestion.

CHF is characterized by recurrent periods of clinical exacerbation that often lead to recurring physician office visits, high rates of emergency room (ER) and inpatient hospital utilization. Unfortunately, most community-dwelling patients living with heart failure receive exacerbation-focused care without a comprehensive chronic management program. At present, neither patients nor their caregivers have the knowledge and the skills to participate in managing this disease. Usual care results in repetitive, inefficient and costly cycles of hospitalization, rehabilitation and home care after exacerbation followed by no monitoring, with the exception of the occasional physician office visit. This lack of management leads to poor health outcomes, including decreased quality of life, decreased functional status and increased health care costs.

How is telehealth technology used to manage
patients living with heart failure at home?

The use of telehealth is a promising approach to optimizing outcomes in the treatment of CHF for patients living in the community. As exacerbations of CHF are common in the disease progression, the use of telehealth to monitor physiologic indicators, such as weight, heart rate, lung sounds, and blood pressure enables improved management through timely treatment adjustments. Without leaving their homes, patients can upload vital signs and be monitored by clinicians through telehealth visits using voice and video equipment combined with peripheral medical technology. Telehealth self management (TSM) can provide the patient with self-management tools to facilitate follow-up care. Interactive health information technology not only provides health tools and health information that is patient centered but also engages consumers and promotes their active participation in improving their health. This is crucial in providing patient-centered care.

Telehealth is one form of interactive technology that potentially offers significant cost savings in its ability to allow practitioners to monitor, evaluate and educate patients from remote locations. The reductions in hospitalization that have been seen through the use of TSM also serve to improve and enhance patients’ quality of life (QoL), as patients are able to stay in their own homes and stay connected to their support systems. Previous research has demonstrated a improvements in QoL reported by CHF patients receiving nurse-led telehealth disease management programs. Further, there is increasing evidence that the hospitalization of older adults is associated with complications such as delirium, pressure ulcers, adverse medication reactions, and falls, which often hasten functional disability and diminished QoL

Last year, Dr. Pekmezaris and her team published a series of studies that showed that telehealth visits were as effective as life nursing visits in delivering home care. At present, they are studying the application of this technology in managing patients who are living independently at home with CHF, with support from the Verizon and Fan Fox Leslie R. Samuels Foundations.

Lab Members

Unlike many of the investigators at the Feinstein, the health services research team, located within the Department of Population Health, does not operate a lab. Because of the applied nature of their research, Dr. Pekmezaris and her colleagues conduct research at the hospital bedside, in patients’ homes, and in the operating room: wherever health care is delivered, with the objective of improving quality of care through scientific research.

Paola DiMarzio, PhD
Senior research analyst working in the Division of Community Health
and Health Services Research of the Department of Population Health.

Paola joined the health system in 2011. She was awarded a PhD in Biotechnology at the University of Rome “La Sapienza” and more recently a Master of Public Health in Health Policy and Management at Columbia University. She has authored several studies in peer-reviewed journals including book reviews.  She is presently providing scientific consultation to the department of Maternal Fetal Medicine and the Center for Learning and Innovation.
Email: pdimarzi@nshs.edu

Oonagh Dowling, PhD
Senior research analyst, working in the Division of Community Health
and Health Services Research of the Department of Population Health.

Oonagh received her doctorate in biochemistry, and previously occupied research positions with the Department of Human Genetics at Mount Sinai School of Medicine and at the Feinstein Institute for Medical Research. Oonagh joined the Division in 2011. She has published papers and book chapters including work on the biological mechanisms of pediatric skeletal disorders and preterm labor. She is presently providing scientific consultation in the areas of anesthesia, gastroenterology, geriatrics and home care.
Email: odowling@nshs.edu

Andrzej Kozikowski, PhD
Research analyst working in the Division of Community Health and
Health Services Research of the Department of Population Health.

Andrzej received his doctorate from Hofstra University in January 2013 with a strong background in research methods and statistics. He specializes in survey development and analysis including questionnaire development, coding, validation and programming. Andrzej has provided scientific consultation on research studies in the anesthesia, cardio-thoracic surgery and geriatrics departments, and assists medical professionals in all aspects of proper research implementation. He has authored three studies in peer-reviewed journals.
Email: akozikowski@nshs.edu

Chris Nouryan, MA
Senior analyst, working for the health system since 2006 in the Division of
Community Health and Health Services Research of the Department of Population Health.

Chris has worked in teams with physicians, nurses, social workers, researchers, analysts and financial experts on three large telehealth projects since 2006, sponsored by the New York State Department of Health, the Samuels Foundation and Verizon. He has been responsible for training, database creation and management, analysis and manuscripts. Chris has also co-authored ten manuscripts during his tenure at NSLIJ, and has served as a manuscript reviewer and contributed to a book regarding physician orders for life-sustaining treatment which is part of a national initiative.
Email: cnouryan@nshs.edu

Jill Cotroneo, BA
Administrative support associate working in the Division of Community Health
and Health Services Research of the Department of Population Health.

She has worked at NSLIJ for the past 15 years, operating in the Division of Community Health and Health Services Research during the past five. Jill is responsible for budget management and day to day administration of the research team.
Email: jcotroneo@nshs.edu

Education

Long Island University, CW Post College, Brookville, NY
Degree: BS
1982
Major: Psychology
Minor: Spanish

Hofstra University, Hempstead, NY
Degree: MS
1983
Field of Study: Applied Research Psychology

Hofstra University, Hempstead, NY
Degree: PhD
1987
Field of Study: Applied Research Psychology

Honors and Awards

1983 Fred Valgerakis Award, Hellenic University Research Grant
1996 Woman of the Year Award, Long Island Heart Council
1997 Executive of the Year Award, United Way of Long Island
2005-2007 Fellow, Institute for Medical Effectiveness Research, Albert Einstein College of Medicine

Publications
  1. Pekmezaris, R., Breuer, L., Zaballero, A., Wolf-Klein, G., Jadoon, E., D’Olimpio, J., Guzik, H., Foley, C., Weiner, J., Chan, S.: “Predictors of Site of Death of End-of-Life Patients: The Importance of Specificity in Advance Directives.” Journal of Palliative Medicine, 2004 Feb; 7(1):9-17. PMID: 15000779.
  2. Wallace, M.P., Weiner, J., Pekmezaris, R., Almendral, A., Cosiquien, R., Auerbach, C., Wolf-Klein, G.P.: “Physician Cultural Sensitivity in African American Advance Care Planning: A Pilot Study.” Journal of Palliative Medicine, 2007 Jun; 10(3):721-7. PMID: 17592984.
  3. Pekmezaris R, Cooper L, Efferen L, Mastroangelo A, Silver A, Eichorn A, Walia R, Mir T, Liberman T, Weiner J, Steinberg H. “Transforming the Mortality Review Conference to Assess Palliative Care in the Acute Care Setting: A Feasibility Study.” Palliative and Supportive Care. 2010 Dec;8(4):421-6. PMID: 20875205.
  4. Pekmezaris R, Walia R, Nouryan C, Katinas L, Zeitoun N, Alano G, Guzik H, Lester P, Wolf-Klein G, Steinberg H.: “The Impact of an End of life Communication Skills Intervention on Physicians-in-Training.” Gerontology & Geriatrics Education 2011;32(2):152-63. PMID: 21598148.
  5. Lustbader D, Frankenthaler M, Smith F, Hussain E, Pekmezaris R, Walia R, Napolitano B, Lesser ML. “Palliative Medicine Consultation Impacts DNR Designation and Length of Stay for Terminal Medical ICU Patients.” Palliative and Supportive Care 2011 Dec; 9: 401-406. PMID: 22104416.
  6. Digwood G, Lustbader D, Pekmezaris R, Lesser ML, Walia R, Frankenthaler M, Hussain E. “The Impact of a Palliative Care Unit on Mortality Rate and Length of Stay for Medical Intensive Care Unit Patients.” Palliative and Supportive Care 2011 Dec;9: 387-392. PMID: 22104414.
  7. Wagner B, Meirowitz N, Shah J, Nanda D, Reggio L, Cohen P, Britt K, Kaufman L, Walia R, Bacote C, Lesser ML, Pekmezaris R, Fleischer A, Abrams KJ. “Comprehensive Perinatal Safety Initiative to Reduce Adverse Obstetric Events.” Journal for Healthcare Quality. Feb 2012; 34(1):6-15. PMID: 22060764.
  8. Pekmezaris R, Nouryan C, Pecinka K, Swiderski J, Mitzner I, Lesser M, Siegel M, Moise G, Younker R, and Smolich K. “The Impact of Remote Patient Monitoring (Telehealth) Upon Medicare Beneficiaries with Heart Failure.” Telemedicine and e-Health. 2012; 18 (2): 101-108. PMID: 22283360.
  9. Pekmezaris R, Kozikowski A, Moise G, Clement PA, Hirsch J, Kraut J, Levy L. “Aging in Suburbia: An Assessment of Senior Needs.” Educational Gerontology 39: 1–11, 2013.
  10. Sinvani LD, Beizer J, Akerman M, Pekmezaris R, Nouryan CN, Lutsky L, Cal C, Dlugacz Y, Masick K, Wolf-Klein G. “Medication Reconciliation in Continuum of Care Transitions: A Moving Target.” Journal of the American Medical Directors Association. 2013 Apr 19. doi:pii: S1525-8610(13)00112-6. PMID: 23608529

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