The Ray Pediatric Health Systems Research Group

Pediatric health care system access, effectiveness, efficiency, family-centeredness, and equity

Telemedicine visit Under the leadership of Kristin Ray, MD, MS, researchers aim to understand and improve pediatric health care delivery systems. Considering the perspectives of patients, families, clinicians, and systems, the research group works to promote access to equitable, family-centered, and high-quality health care for all children.

The studies by Dr. Ray and her team have shed light on how technology, geography, and other factors impact pediatric patient health care. For example, a recent study compared differences in the quality of antibiotic prescribing among children in three different settings: doctor visit, urgent care center and remotely via telemedicine visit. Other studies have revealed differences in the amount of time some minority groups spend waiting to see clinicians.

By understanding barriers to pediatric primary, emergency, and subspecialty care and the impact of these barriers on children and their families, the Pediatric Health Systems Research Group can guide strategies to improve access to care, including optimizing the use of new health information technologies such as telemedicine and electronic consultations.

Understanding and Improving Pediatric Health Care Delivery Systems

The work of the Ray Lab incorporates qualitative and quantitative methods, including geospatial analyses, user-centered design, clinical informatics, quality improvement methodologies, and stakeholder engagement.

Research efforts are focused on:

Understanding current barriers to pediatric primary, emergency, and subspecialty care and the impact of these barriers on children and their families
Examination of the impact of health technology innovations on processes, outcomes, and unintended consequences for patients, families, clinicians, and systems, including the use of telemedicine in pediatric care
Evaluating policy and system-level strategies to improve access to care and child health outcomes

Kristin Ray, MD, MS

Principal Investigator
kristin.ray@chp.edu
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Research Coordinator
Sarah Burns, MSW, LSW

Research Analyst
Sam Wittman, MS

Post-Doctoral Scholars
James Bohnhoff, MD
Jacquelin Rankine, MD, MS
Kelsey Schweiberger, MD

Resident Researcher
Nithin Ravi, MD, MPH

Medical Student
Katherine Martin

Undergraduate Researchers
Kaila Alston
Rhea Verma

Research Group Alumni
Katherine Gitz, MD
Florence Kwok, MPH
Gina Sequeira MD, MS
Deepika Yeramosu
Justin Yu, MD, MS

Contact Us

The Ray Pediatric Health Care Systems Research Group
UPMC Children’s Hospital of Pittsburgh
Children’s Hospital Office Building
3414 Fifth Avenue
Pittsburgh, PA 15213
412-692-7497

View current achievements and presentations below featuring the research, staff and advancements of the Ray Pediatric Health Systems Research Group at UPMC Children’s Hospital of Pittsburgh’s Richard King Mellon Institute for Pediatric Research. Please check back often for continued updates.

Achievements

2020

Kristin Ray, MD, MS, and collaborators received R01 funding from the National Institute of Allergy and Infectious Diseases for a project titled “Understanding Use of Direct-to-consumer Telemedicine for Pediatric Acute Respiratory Infections”, also known as the CACTUS Study (Children and Colds Telemedicine Use Study).

Gina Sequeira, MD, MS, completed her adolescent fellowship training and will start a faculty position at Seattle Children’s Hospital, where she successfully competed for a K12 award to improve care for transgender youth.

Rhea Verma received a University of Pittsburgh Brackenridge Fellowship from Pitt Honors College.

Deepika Yeramosu was accepted to pursue graduate studies at Carnegie Mellon University.

Kristin Ray, MD, MS, became director of the General Academic Pediatrics research fellowship program.

2019

James Bohnhoff, MD, Katherine Gitz, MD, and Jacqueline Rankine, MD, MS, completed their pediatric residencies.

Dr. Gitz was recognized for Best Resident Poster at the UPMC Children’s Hospital of Pittsburgh Resident Research Day.

2018

Kristin Ray, MD, MS, was appointed to a three-year term on the American Academy of Pediatrics’ Committee on Pediatric Workforce. Dr. Ray also received the Nemours Child Health Services Research Award during at the 2018 Child Health Services Research Interest Group meeting at the AcademyHealth Annual Research Meeting in Seattle, Washington.

Katherine Gitz, MD, was awarded an American Academy of Pediatrics CATCH grant to fund research to examine parent perspectives on ways to improve access at the primary care medical home.

Jacquelin Rankine, MD, MS, received an American Pediatric Association Resident Investigator Award to fund qualitative work to understand how pediatricians and school nurses can improve partnerships.

Presentations

2019

Multiple presentations at the AcademyHealth Annual Research Meeting, Washington, D.C. Topics covered: understanding how pediatric health systems can better serve transgender youth; research validating methods to identify telemedicine encounters in claims data; and our work leading a quality-improvement initiative to enhance dental care within primary care practices.

Justin Yu, MD, MS, delivered “Family Experiences of Care Coordination Prior to Treatment at a Complex Care Center,” a poster presentation, at the Pediatric Academic Societies Meeting, Baltimore.

Gina Sequeira, MD, MS, delivered “Transgender Youth’s Disclosure of Gender Identity to Providers Outside of Specialized Gender Centers,” at the poster symposium, Annual Meeting of the Society for Adolescent Health and Medicine, Washington, D.C.

2018

At the Pediatric Academic Societies Meeting in Toronto, Kristin Ray, MD, MS, presented “How do Pediatric Patients use Direct-to-consumer Telemedicine?” and “Trends in Visits to Primary Care Physicians by Children, 2008-2015,” both platform presentations. James Bohnhoff, MD, presented on “Unscheduled Referrals and Unattended Visits after Subspecialty Referral in a Large Pediatric Primary Care Network,” a poster presentation.

UPMC Children’s Hospital of Pittsburgh Grand Rounds presentation by Dr. Ray, entitled, “Integrating Telemedicine into Pediatric Health Care Delivery Systems.”

2017

Kristin Ray, MD, MS, presented “Electronic Referrals: Improving Patient Access and Pediatrician Satisfaction,” a platform presentation at the Child Health Services Interest Group Meeting, AcademyHealth Annual Research Meeting, New Orleans.

View current news below featuring the research, staff and advancements of the Ray Pediatric Health Systems Research Group at UPMC Children’s Hospital of Pittsburgh’s Richard King Mellon Institute for Pediatric Research. Please check back often for continued updates.

Pediatric Primary Care Visits Drop & Fluctuate During COVID
UPMC Children’s Hospital of Pittsburgh News Release (5/10/21)

What do the Families of Sick Kids Need Right Now
WESA-FM, Pittsburgh (4/28/20)

Visits to Pediatricians on the Decline
UPMC Children’s Hospital of Pittsburgh News Release (1/21/20)

Antibiotics Prescribed More Often During Telemedicine Visits
NIH Research Matters (4/23/19)

Telemedicine Not Ideal for Kids With Respiratory Infections
Reuters (4/9/19)

Telemedicine Tied to More Antibiotics for Kids, Study Finds
U.S. News & World Report (AP) (4/8/19)

Telemedicine Tied to More Antibiotics for Kids, Study Finds
Washington Post (AP) (4/8/19)

Telemedicine May Be Giving Kids Too Many Antibiotics
Forbes.com (4/8/19)

Study: Telehealth use Uncommon, Particularly in Rural America
Forbes (11/27/18)

Telemedicine Surging in US but use Still Uncommon
Reuters (11/27/2018)

When There’s a Hurricane Between you and the Hospital, Telemedicine Could Save the Day
Popular Science (5/14/2018)

You Mean I Don’t Have to Show Up? The Promise of Telemedicine
New York Times (5/16/2016)

Average American Loses $43 During Each Doctor Visit
NBC News (10/7/2015)

Study: How Long You Wait to See a Doctor is Linked to Race, Employment
Huffington Post (10/6/2015)

Race and Employment Tied to US Clinic Wait Times
Reuters (10/5/2015)

Racial Inequality Even Affects how Long we Wait for the Doctor
Washington Post Blog (10/5/2015)

It Costs you $43 Every Time you Wait for the Doctor
Boston Globe (10/5/2015)

Disparities in Time Spent Seeking Medical Care in the United States
Medical Xpress (10/5/2015)

Paying for Health Care With Time
Harvard Gazette (10/5/2015)

Parent Perspectives on Family-Centered Pediatric Electronic Consultations: Qualitative Study
Verma R, Krishnamurti T, Ray KN
Journal of Medical Internet Research
2020 Apr 9

Trends in Pediatric Primary Care Visits Among Commercially Insured US Children, 2008-2016
Ray KN, Shi Z, Ganguli I, Rao A, Orav EJ, Mehrotra A
JAMA Pediatrics
2020 Jan 21

Quality of Antibiotic Prescribing for Acute Respiratory Infections During Pediatric Direct-to-consumer Telemedicine Visits (includes Video Abstract)
Ray KN, Shi Z, Gidengil C, Poon S, Usher-Pines L, Mehrotra A
Pediatrics
Apr 2019

Referring Hospital Characteristics Associated With Potentially Avoidable Emergency Department Transfers
Ray KN, Marin JR, Li J, Davis BS, Kahn JM
Academic Emergency Medicine
2019 Feb

Use of Commercial Direct-to-consumer Telemedicine by Children
Ray KN, Shi Z, Poon S, Uscher-Pines L, Mehrotra A
Academic Pediatrics
2019 Jan 10

Quality of Care for Acute Respiratory Infections During Direct-to-Consumer Telemedicine Visits for Adults
Shi Z, Mehrotra A, Gidengil C, Poon S, Usher-Pines L, Ray KN
Health Aff (Millwood)
2018 Dec

Trends in Telemedicine use in a Large Commercially Insured Population
Barnett ML, Ray KN, Souza J, Mehrotra A
JAMA
2018 Nov 27

Virtual First Responders: The Role of Direct-to-consumer Telemedicine in Caring for People Impacted by Natural Disasters
Uscher-Pines L, Fischer S, Tong I, Mehrotra A, Malsberger R, Ray KN
Journal for General Internal Medicine
2018 Aug

Implementation of Electronically-transmitted Referrals and Pediatric Subspecialty Visit Attendance
Ray KN, Drnach M, Mehrotra A, Suresh S, Docimo S
Academic Pediatrics
2018 May-June

Access to High Pediatric-Readiness Emergency Care in the U.S.
Ray KN, Olson LM, Edgerton EA, Ely M, Gausche-Hill M, Schmuhl P, Wallace DJ, Kahn JM
Journal of Pediatrics
2018 Mar

Trends in Visits to Specialist Physicians Involving Nurse Practitioners and Physician Assistants, 2001-2013
Ray KN, Martsolf GR, Mehrotra A, Barnett ML
JAMA Internal Medicine
2017 Aug 1

Clinician Attitudes Toward Adoption of Pediatric Emergency Telemedicine in Rural Hospitals
Ray KN, Felmet KA, Hamilton MF, Kuza CC, Saladino RA, Schultz BR, Watson RS, Kahn JM
Pediatric Emergency Care
2017 Apr

Family Perspectives on High-quality Pediatric Subspecialty Referrals
Ray KN, Ashcraft LE, Kahn JM, Mehrotra A, Miller E
Academic Pediatrics
2016 Aug

Disparities in Time Spent Seeking Medical Care in the U.S.
Ray KN, Chari AV, Engberg J, Bertolet M, Mehrotra A
JAMA Internal Medicine
2015 Dec 1

We’d Like to Hear From You!

The Ray Pediatric Health System Research Group is looking for talented post-doctoral fellows and graduate students interested in understanding and improving health care system access, equity, and outcomes. See our research group statement on inclusion and equity (PDF).

Please contact Dr. Ray via email if you are interested.

You can also follow Dr. Ray on twitter at @KRayHSR.