Dr. Brady specializes in general nephrology with an interest in the management of patients with chronic kidney disease (CKD). His research in value-based health care delivery focuses on methods to improve care delivery for patients with CKD and end-stage kidney disease (ESKD).
In addition to authoring reports on how the quality of care for patients with kidney disease might be improved, he has given invited talks on high-value care delivery models to policymakers on capitol hill, audiences at national meetings, and health care leaders internationally.
- Chronic Kidney Disease
- End Stage Kidney Disease
Clinical Assistant Professor, Medicine - Nephrology
Director, East Bay Outreach, Division of Nephrology (2021 - Present)
Value Based Care Champion, Division of Nephrology (2021 - Present)
Boards, Advisory Committees, Professional Organizations
Member, Satellite Healthcare Home Dialysis Academy of Excellence Curriculum Committee (2020 - Present)
Member, Stanford Hypertension Center (2020 - Present)
Affiliate, Stanford Medicine Center for Improvement (2021 - Present)
Board Certification, American Board of Internal Medicine, Nephrology (2018)
Fellowship: Stanford University Division of Nephrology (2017) CA
Residency: Temple University Hospital (2015) PA
Board Certification: American Board of Internal Medicine, Internal Medicine (2014)
Residency: Temple University Hospital Internal Medicine Residency (2014) PA
Medical Education: Thomas Jefferson University - Medical College (2011) PA
- Patient-Reported Experiences with Dialysis Care and Provider Visit Frequency CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY 2021; 16 (7): 1052-1060
- Measuring Patient Experience with Home Dialysis in the United States. Clinical journal of the American Society of Nephrology : CJASN 2021
Patient-Reported Experiences with Dialysis Care and Provider Visit Frequency.
Clinical journal of the American Society of Nephrology : CJASN
2021; 16 (7): 1052-1060
New payment models resulting from the Advancing American Kidney Health initiative may create incentives for nephrologists to focus less on face-to-face in-center hemodialysis visits. This study aimed to understand whether more frequent nephrology practitioner dialysis visits improved patient experience and could help inform future policy.In a cross-sectional study of patients receiving dialysis from April 1, 2015 through January 31, 2016, we linked patient records from a national kidney failure registry to patient experience data from the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems survey. We used a multivariable mixed effects linear regression model to examine the association between nephrology practitioner visit frequency and patient-reported experiences with nephrologist care.Among 5125 US dialysis facilities, 2981 (58%) had ≥30 In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems surveys completed between April 2015 and January 2016, and 243,324 patients receiving care within these facilities had Medicare Parts A/B coverage. Face-to-face practitioner visits per month were 71% with four or more visits, 17% with two to three visits, 4% with one visit, and 8% with no visits. Each 10% absolute greater proportion of patients seen by their nephrology practitioner(s) four or more times per month was associated with a modestly but statistically significant lower score of patient experience with nephrologist care by -0.3 points (95% confidence interval, -0.5 to -0.1) and no effect on experience with other domains of dialysis care.In an analysis of patient experiences at the dialysis facility level, frequent nephrology practitioner visits to facilities where patients undergo outpatient hemodialysis were not associated with better patient experiences.
View details for DOI 10.2215/CJN.16621020
View details for PubMedID 34597265
View details for PubMedCentralID PMC8425623
Revealing Novel IDEAS: A Fiduciary Framework for Team-Based Prescribing.
Academic medicine : journal of the Association of American Medical Colleges
The importance of safe, effective, and cost-effective prescribing habits can hardly be overstated in the current pay-for-value environment. The prescribing process taught in most medical curricula focuses primarily on accurate medical indications. While this may be of utmost importance from the clinician's perspective, it falls short of addressing the other key elements of highly effective prescribing. These other elements are often paramount in the minds of patients. A patient-centric framework that associates and incorporates the necessary components of optimal prescribing is overdue. Building this framework into medical curricula will foster increased teamwork among providers and enhance shared decision making between patients and clinicians. In addition to establishing accurate medical indications, prescribing teams need to assure every prescribed medication is desired, effective, affordable, and safe for patients who receive them. Prescription writing is an honorable prerogative and doing so safely, effectively, and cost-effectively requires both teamwork and technology. Highly effective prescribing teams can implement the IDEAS (Indicated, Desired, Effective, Affordable, Safe) framework through appropriate and deliberate delegation. By empowering members of the care team to support and educate patients, this framework will allow physicians to focus on ensuring appropriate indications and real-world effectiveness. This novel IDEAS framework serves as an important mental model for medical trainees and reinforces sound prescribing habits among seasoned clinicians. High-touch and high-tech partnerships have the potential to maximize the triple aim (i.e., improving the patient's experience of care, improving the health of populations, and reducing the per capita cost of health care). In an era when costs overwhelm quality, providing a fiduciary framework to instill responsibility for optimal prescribing, especially among young physician-leaders, is invaluable.
View details for DOI 10.1097/ACM.0000000000003100
View details for PubMedID 31789844
- Integrated Care in ESKD A Perspective of Nephrologists CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY 2019; 14 (3): 451–53
- Systems Delivery Innovation for Alzheimer Disease AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY 2019; 27 (2): 149–61
Exploring Care Attributes of Nephrologists Ranking Favorably on Measures of Value.
Journal of the American Society of Nephrology : JASN
Despite growth in value-based payment, attributes of nephrology care associated with payer-defined value remains unexplored.Using national health insurance claims data from private preferred provider organization plans, we ranked nephrology practices using total cost of care and a composite of common quality metrics. Blinded to practice rankings, we conducted site visits at four highly ranked and three average ranked practices to identify care attributes more frequently present in highly ranked practices. A panel of nephrologists used a modified Delphi method to score each distinguishing attribute on its potential to affect quality and cost of care and ease of transfer to other nephrology practices.Compared with average-value peers, high-value practices were located in areas with a relatively higher proportion of black and Hispanic patients and a lower proportion of patients aged >65 years. Mean risk-adjusted per capita monthly total spending was 24% lower for high-value practices. Twelve attributes comprising five general themes were observed more frequently in high-value nephrology practices: preventing near-term costly health crises, supporting patient self-care, maximizing effectiveness of office visits, selecting cost-effective diagnostic and treatment options, and developing infrastructure to support high-value care. The Delphi panel rated four attributes highly on effect and transferability: rapidly adjustable office visit frequency for unstable patients, close monitoring and management to preserve kidney function, early planning for vascular access, and education to support self-management at every contact.Findings from this small-scale exploratory study may serve as a starting point for nephrologists seeking to improve on payer-specified value measures.
View details for DOI 10.1681/ASN.2019030219
View details for PubMedID 31727849
- Patient-Reported Experiences of Dialysis Care Within a National Pay-for-Performance System JAMA INTERNAL MEDICINE 2018; 178 (10): 1358–67