Kimberly Noel, MD

Dr. Noel is also the Chief Quality Officer of the Patient Centered Medical Home (PCMH) for the Family Medicine Department. She creates reports for the practice’s population health management, including physician level reporting, working with quality improvement metrics and aids the Medical Director of PCMH in quality strategy and population health interventions. She co-leads the Stony Brook Readmissions Steering Committee in which she has won service awards for her initiatives promoting clinical workflow, informatics and infrastructural change to reduce preventable readmissions. Dr. Noel is also engaged in the New York State Delivery System Reform Incentive Program (DSRIP), and a member of the Transition of Care (TOC) committee for which, she aided in the implementation of a 30-day transition of care model for Suffolk County, incorporating a high risk stratification tool for the Medicaid population. At the Northport VA Medical Center, she has helped organize the Ambulatory Care Congestive Heart Failure Task force for the Assistant Chief of Staff for Primary Care/Emergency Department as well as craft group clinics for high risk CHF patients. Her long term professional goal is to incorporate data analytics and population health management using telehealth for underserved populations.

As a clinical researcher and a leader of the Readmissions Steering Committee at Stony Brook. I have dedicated a lot of time to research readmission risk stratification in collaboration with biomedical informatics. We have worked using machine learning and advanced data analytics. We have presented this work at national conferences. Furthermore, we are currently pursing publication for our most recent randomized control trials evaluating the use of Telehealth to reduce preventable readmissions.

• Hajagos, J. Noel, K. “Hack your own predictive 30-day inpatient readmission model using open source tools and data models.” Urban Health Informatics Innovation Conference & Exhibit. New York Academy of Medicine. April 30th 2018. New York.
• Noel, K. Yagudayev, S. Messina, C. Schoenfeld, E. Hou,W. Kelly, G. “Tele-transitions of Care. An approach to reduce 30-day Readmission using Tele-Health Technology; A Randomized Controlled Trial Study Design.” Pending publication to Journal: Contemporary Clinical Trials Communications
• Noel, K. Hajagos, J. Saltz, J. Saltz, M. “Risk Stratification for Population Health Management: Prognostic Analytics for Better Resource Allocation” submitted for publication to Medical Care
• American College of Preventive Medicine Portland, Oregon May 23-26, 2017 Poster Presentation: “Risk Stratification for Population Health Management: Prognostic Analytics for Better Resource Allocation”

Many of my research contributions have led to direct impact for communities and clinical care. I have worked with the Department of Health in participating in the authorship of the Community Health Assessment and Improvement Plan, using regional data and SPARCs databases. I have also helped improve preventive measures for the family medicine practice at Stony Brook Medicine.

• Suffolk County Department of Health Services. “Community Health Assessment and Improvement Plan 2016-2018”.
• Stony Brook Family Medicine Patient Center Medical Home (PCMH) Quality Improvement Project Poster Presentation: “NCQA Quality Improvement for Cancer Screening and Immunization Rate improvements”, Stony Brook, New York Research Symposium May 25th 2016

Earlier in my career, I have also taken an interest in basic science and clinical trials. I was able to present this research at the American Heart Association, with colleagues at NYU.

• International Stroke Conference AHA/ASA, Nashville, TN February 11-13th 2015. Poster Presentation: “A randomized, double-blind, placebo-controlled study of the efficacy and safety of Botulinum toxin type A in upper limb spasticity in patients with stroke”