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Presentation on Compass

November 6, 2022 from 10:30 am to 10:55 am (25 min)

COMPASS CP is a cloud-based chronic care management platform built to integrate within a health systems  EHR platform, delivering patient-specific care plans across a variety of chronic care conditions.   Initially launched for stroke, COMPASS CP will be continue to be refined and expanded across many other chronic care domains including cardiovascular, dementia, obesity and others.

Pamela Duncan, PhD, PT

Dr. Duncan has led clinical trials, epidemiological studies, health services research, and developed a patient-centered outcome measure, Stroke Impact Scale. As director of the Veterans Administration (VA) Stroke Quality Improvement Enhancement Initiative, she developed quality initiatives to improve acute and post-acute stroke care and to reduce caregiver burden. She was co-PI of Agency for Healthcare Research and Quality (AHRQ) evidence-based review on transitions in care for Acute Myocardial Infarction and Stroke, was co-chair of guidelines for post-acute stroke care, and co-author of recommendations for AHA stroke systems of care. She is a member of the NC Stroke Advisory Council of the Justus-Warren Heart Disease and Stroke Prevention Task Force. Her role on this legislative Task Force is to support the development of statewide systems of care. Her responsibilities for WFBH have included serving as the Director of Transitional Care and Outcomes (2011-2015). In this role, she partnered with health system and clinical leaders (neurology, internal medicine, geriatrics, cardiology, nephrology, behavioral health, and pharmacy), post-acute providers (home health, skilled nursing homes) and community-based agencies to redesign transitional and post-acute care of medically and socially complex patients. She is currently the PI of a large PCORI-funded pragmatic trial which implements and evaluates comprehensive post-acute stroke services across 41 hospitals in North Carolina. She is recognized nationally and internationally for her clinical expertise, research and innovation to transform post-acute care.