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Jonathan Fischer, MD, CAQHPM (he/him/his)

Associate Professor
Duke University Health System, North Carolina, United States

I am Jonathan Fischer, MD, an Associate Consulting Professor in the Department of Family Medicine and Community Health, Clinical Faculty- Division of Palliative Care and a Medical Director for the Population Health Management Office at Duke University. My commitment to underserved and marginalized populations was visible before medical school, in my earliest work as a Social Worker with homeless families in New York City. As a clinician-educator I have continued to focus my clinical practice and teaching on population health and improving the care of vulnerable patients including those struggling with serious illness. In my first decade of practice, I served as a primary care provider in federally qualified community health centers and developed programs including outreach teams for migrant farm workers, shared visits for prenatal and diabetic care, and the founding of a refugee health coalition to meet the needs of refugees from Burma. As a Physician Consultant for North Carolina Community Care Networks I developed statewide palliative care initiatives to improve the quality of serious illness care for Medicaid recipients. My efforts included the development of a serious illness communication curriculum for care managers working in 1500 primary care practices. As faculty in the Duke Family Medicine residency program, I have taught seminars emphasizing population health skills with the core goal of reducing health care disparities and improving health. I co-chaired the NC Institute of Medicine Task Force on Serious Illness and was a guest editor of the North Carolina Medical Journal issue devoted to serious illness care. As a Medical Director with the Duke Population Health Management Office I have directed programs to integrate palliative care into the data analytics and care management efforts across the health system. A funding award from the Duke Institute for Health Innovation enabled my development of Pallialytics, a machine learning algorithm to identify patients with palliative care needs. While the algorithm identifies high risk patients, if these patients still land in front of providers unprepared to communicate effectively, we only compound patient suffering. So, while having an eye to population and systems level interventions, I have recognized the critical role of relationship centered communication. I have collaborated with VitalTalk and Ariadne Labs to develop and implement communication skills trainings nationally. I am a communication skills trainer for a multisite study funded by the Patient-Centered Outcomes Research Institute examining models of advance care planning in primary care (primarycareacp.org). Similarly, with the NIA funded UH3 Project: Advance Care Planning: Promoting Effective and Aligned Communication in the Elderly (ACP PEACE), I have served as a communication skills trainer across all study sites. With a supplemental grant from NIA, I developed ACP-COVID, a modified protocol of virtual trainings for primary care providers, teaching communication skills for goals of care conversations in response to changes brought by the COVID-19 pandemic. Recently, with the Duke Center for Research to Advance Healthcare Equity, I am working on the development and pilot testing of a training intervention to mitigate the harms of implicit bias in the medical encounter.

Disclosure(s): No financial relationships to disclose

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