Clinical and Translational Research

Seth Eisen, MD, MSc

The Division of Rheumatology is committed to identifying and responding to social risk factor (SRF) challenges of our patients (e.g., financial, housing, food, transportation issues) through referrals to Division social workers and community resources, and research. With pilot funds from the Arthritis Foundation, competitive Division research sources, and the pharmaceutical industry, a

program was developed that assesses the feasibility of routinely collecting SRF information from patients (10.1002/acr.25572), greatly reduces staff effort to obtain and upload SRF into individual patient Epic records (10.1002/acr2.70018), documented the high prevalence and co-occurrence of SRFs among our patients (10.1002/acr.24833; 10.1002/acr2.70018), and observed that few changes in patient SRFs occur over time (10.1007/s11606-026-10786-9).

We are currently developing methods to measure provider attention to SRFs, the impact of SRF interventions on provider time allocation in Epic, and are collaborating with Washington University computer scientists to apply AI methods to identify SRF information in Epic notes and create a validated patient SRF score based on Epic and publicly available geospatial data. In collaboration with community partners, we are preparing to evaluate the impact of interventions on SRF change and health outcomes among outpatients with lupus.

Research team participants in these efforts include Drs. Lisa Zickuhr, Daphne Lew, Al Kim, Akhil Sood, and Seth Eisen (all Rheumatology faculty), Rachel Ancona (Emergency Medicine), Amy McQueen (School of Public Health), rheumatology fellows and staff, internal medicine residents, and computer science students and their supervisors.

Michael Paley, MD

Paley Lab: HLA-B27 Research

The goal of the Paley Lab is to better understand how HLA molecules lead to autoimmunity. Our current focus is on HLA-B27 and its role in spondyloarthritis and uveitis. We have developed a cohort of patients with HLA-B27+ autoimmunity and corresponding healthy controls to understand why some people develop T cells that cause disease, while others do not. We are interested in what tissues these cells are first activated and what happens to them to initiate disease.

Deepali Sen, MD

Team PHV Drives 4-Fold Increase in Rheumatology Clinic Follow-Ups Through Transitional Care and Social Work Intervention

Under the leadership of Dr. Deepali Sen, the multidisciplinary team, Team PHV: Waleed Ali, MD, Brendan Lally, MSW, LCSW, Andrew Robinson MSW, LCSW, Ashley Poore, Patrice Odom, Jessica Seal, Kelly Nessel MBA, has helped hospitalized patients transition to outpatient care in rheumatology clinic.

With the addition of Brendan Lally MSW to the group, the team has been able to provide discharged patients with social work screening and assistance with barriers to care. Transitional interventions also included placing a medical assistant call within a week to establish early follow up. These interventions have shown significant impact, recent analysis show patients who received phone call within 1 week had a four-fold higher chance of follow up within 1 month. Patients who received social work screening showed higher rates of follow up even at 6 months post intervention.

Team PHV helps patients with continuity of care. Long term impact on clinic follow up seen with social work intervention post hospitalization. The rheumatology division has focused on transition care interventions after hospital discharge since 2021.

These interventions have shown significant impact, recent analysis show patients who received phone call within 1 week had a four-fold higher chance of follow up within 1 month. Patients who received social work screening showed higher rates of follow up even at 6 months post intervention.