Dr. Phadke is a general internist at the Hoover Pavillion specializing in the management of chronic medical conditions in adult patients and preventive health. She also precepts within the Stanford Internal Medicine East resident primary care clinic and teaches students during the internal medicine ambulatory clerkship.
Her administrative and scholarly focus include ambulatory care delivery system redesign and quality improvement to achieve improvement in population health and promote the quadruple aim. She serves as Medical Direction for Population Health in Primary Care, Director of Quality for the Division of Primary Care and Population Health, and co-director for the Primary Care Performance Enhancement Program, a platform for mentoring primary care teams to improve clinical care using structured problem solving.
- Internal Medicine
Clinical Assistant Professor, Medicine - Primary Care and Population Health
Medical Director Population Health, Division of of Primary Care and Population Health, Stanford University School of Medicine (2017 - Present)
Director of Quality, Division of Primary Care and Population Health, Stanford University School of Medicine (2018 - Present)
Boards, Advisory Committees, Professional Organizations
Member, American College of Physicians (2014 - Present)
Member, Society for General Internal Medicine (2014 - Present)
Board Certification: Internal Medicine, American Board of Internal Medicine (2020)
Residency: Stanford University Internal Medicine Residency (2014) CA
Internship: Stanford University Internal Medicine Residency (2012) CA
Medical Education: Pritzker School of Medicine University of Chicago Registrar IL
Fellowship: Palo Alto VA Healthcare System CA
Qualitative Assessment of Rapid System Transformation to Primary Care Video Visits at an Academic Medical Center.
Annals of internal medicine
The coronavirus disease 2019 pandemic spurred health systems across the world to quickly shift from in-person visits to safer video visits.To seek stakeholder perspectives on video visits' acceptability and effect 3 weeks after near-total transition to video visits.Semistructured qualitative interviews.6 Stanford general primary care and express care clinics at 6 northern California sites, with 81 providers, 123 staff, and 97 614 patient visits in 2019.Fifty-three program participants (overlapping roles as medical providers [n = 20], medical assistants [n = 16], nurses [n = 4], technologists [n = 4], and administrators [n = 13]) were interviewed about video visit transition and challenges.In 3 weeks, express care and primary care video visits increased from less than 10% to greater than 80% and from less than 10% to greater than 75%, respectively. New video visit providers received video visit training and care quality feedback. New system workflows were created to accommodate the new visit method.Nine faculty, trained in qualitative research methods, conducted 53 stakeholder interviews in 4 days using purposeful (administrators and technologists) and convenience (medical assistant, nurses, and providers) sampling. A rapid qualitative analytic approach for thematic analysis was used.The analysis revealed 12 themes, including Pandemic as Catalyst; Joy in Medicine; Safety in Medicine; Slipping Through the Cracks; My Role, Redefined; and The New Normal. Themes were analyzed using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework to identify critical issues for continued program utilization.Evaluation was done immediately after deployment. Although viewpoints may have evolved later, immediate evaluation allowed for prompt program changes and identified broader issues to address for program sustainability.After pandemic-related systems transformation at Stanford, critical issues to sustain video visit long-term viability were identified. Specifically, technology ease of use must improve and support multiparty videoconferencing. Providers should be able to care for their patients, regardless of geography. Providers need decision-making support with virtual examination training and home-based patient diagnostics. Finally, ongoing video visit reimbursement should be commensurate with value to the patients' health and well-being.Stanford Department of Medicine and Stanford Health Care.
View details for DOI 10.7326/M20-1814
View details for PubMedID 32628536
SAFETY QUEST: A NOVEL WEB-BASED QUALITY IMPROVEMENT AND PATIENT SAFETY EDUCATIONAL GAME
SPRINGER. 2017: S704–S705
View details for Web of Science ID 000440259003052
Differences and Trends in DNR Among California Inpatients With Heart Failure.
Journal of cardiac failure
2016; 22 (4): 312-315
Do-not-resuscitate (DNR) orders reflect an important means of respecting patient autonomy while minimizing the risk of nonbeneficial interventions. We sought to clarify trends and differences in rates of DNR orders for patients hospitalized with heart failure.We used statewide data from California's Healthcare Cost and Utilization dataset (2007-2010) to determine trends in DNR orders within 24 hours of admission for patients with a primary discharge diagnosis of heart failure.Among 347,541 hospitalizations for heart failure, the rate of DNR order within 24 hours increased from 10.4% in 2007 to 11.3% in 2010 (P < .0001). After adjustment, DNR status correlated with older age, female gender, white race, frequent comorbidities (Charlson Score), and residence in higher income area (P < .0001). DNR use was more likely in hospitals with public or nonprofit financing or medical school affiliation, but not being a member of the Council on Teaching Hospitals (all P < .001).DNR order use among inpatients with heart failure is low but increasing slowly and varies by patient demographics and hospital characteristics.
View details for DOI 10.1016/j.cardfail.2015.12.005
View details for PubMedID 26700659