Clinical Focus

  • University Health Services
  • Health Information Technology
  • Health Services for Transgender Persons
  • Feeding and Eating Disorders
  • Family Medicine

Academic Appointments

Administrative Appointments

  • Medical Director, Vaden Health Center (1997 - Present)

Professional Education

  • Board Certification: American Board of Family Medicine, Family Medicine (2002)
  • Medical Education: Rutgers Robert Wood Johnson Medical School (1983) NJ
  • Internship: University of North Carolina Hospital Pathology and Hemopathology (1985) NC
  • Fellowship: University of North Carolina Hospitals (1988) NC
  • Residency: University of North Carolina (1987) NC

Contact

  • Academic
    rtepper@stanford.edu
    University - Academic staff Department: Medicine - Med/Vaden Position: Clinical Associate Professor
    • 866 CAMPUS DRIVE
    • Stanford,  California  94305-8580 
    (650) 723-1600 (fax)
  • Clinical (Primary)  Vaden Health Center 866 Campus Dr MC 8580 Stanford, CA 94305 (650) 723-1600 (fax)

Additional Clinical Info

Additional Info

  • Mail Code: 8580

Links

2024-25 Courses

All Publications

  • Implementing Effective Care in a University Population Based on National Vaccination Recommendations. American journal of medical quality : the official journal of the American College of Medical Quality Richards, J., Brunacini, K., Stoll, N., Tepper, R. 2023

    Abstract

    Vaccines are among the most cost-effective and successful medical interventions, saving approximately 2.3 million lives annually. Unfortunately, vaccination coverage for adults remains low, leading to unnecessary and costly health consequences. An initial chart review revealed that 95% (N = 20) of students were not up to date with vaccines. In a patient survey, 100% of students (N = 21) did not recall receiving useful vaccine information, but 66.7% reported it would be helpful (≥4 of 5 on the Likert scale). Strategies supporting effective care, an Institute of Medicine quality domain, were used to address these gaps. The aim was to increase effective care in university adult students for vaccines by 30% over 90 days. The quality improvement method of Plan-Do-Study-Act cycles was used to evaluate iterative tests of change. Examining contextual elements, team and patient feedback, aggregate data, and run charts informed tests of change over 4 cycles. Core interventions included enhanced screening, vaccine shared decision-making, provider checklists, and a team engagement plan. Greater than 83% (N = 152) of students were not up to date with vaccines as per national guidelines. Over 8 weeks, the team effectively referred students for 265 of the 274 vaccines they were eligible for-an accuracy rate of 95.3%. The aim score, a mean composite score reflecting all 3 interventions, increased from 49% to 95%. Effective care for vaccine uptake increased by 83.8%-far exceeding the goal. Campus health centers and other primary care settings could benefit from adopting a similar strategy that provides clear benefits to patients and the broader community while decreasing health care costs.

    View details for DOI 10.1097/JMQ.0000000000000162

    View details for PubMedID 38127676