Andrea Mucci, MD, MASc, MEd, is a pediatric endocrinologist at Cleveland Clinic Children’s and an Assistant Professor of Pediatrics at Case Western Reserve University and the Cleveland Clinic Lerner College of Medicine. Dr. Mucci also serves as the Medical Director for the Klinefelter Syndrome Clinic at Cleveland Clinic Children’s.

 

Interview with Andrea Mucci, MD, MASc, MEd

In this interview, Dr. Mucci discusses her involvement with the T1D Exchange Quality Improvement Collaborative (T1DX-QI) and her career as an endocrinologist focused on T1D, medical education, and transition medicine.

The T1DX-QI was established in 2016 — with the support of The Leona M. and Harry B. Helmsley Charitable Trust — to refine best practices and improve the quality of care and outcomes for individuals living with T1D. Growth has been tremendous, with over 60 endocrine clinics across the US participating in the Collaborative. 

Fueled by top leaders in diabetes care, the T1DX-QI has become an engine of innovation and inspiration. By engaging with the shared, data-driven, and systematic methods of the T1DX-QI, clinics have seen unprecedented success in their approach to diabetes management. 

With members working closely to identify gaps in care, discover and refine best practices, and share research — the process has become knowledge-sharing at its very best. While collated data gives clinics a clear sense of “where they are,” it also demonstrates “where they can be” by applying shared, evidence-based methods for improving care.

 

What led you to medicine and endocrinology?

“I think I always wanted to be a pediatrician,” said Mucci. “Although I initially studied eight years of engineering and have a Master’s degree in Biomedical Engineering, it lacked human interactions, which is a strength of mine, so I decided to pursue medicine.”

“After medical school, I focused on pediatrics — and early on, became increasingly interested in endocrinology.” Mucci went on to complete her training in pediatric endocrinology at Rainbow Babies and Children’s Hospital in Cleveland, Ohio, and has been working at Cleveland Clinic Children’s since, treating endocrine conditions, including type 1 diabetes.

“When we talk about medicine, clinical practice is usually at the core — as well as research, education, and other efforts. Being fully clinical, I love education and the impacts it has on my interactions with patients and their families,” said Mucci, who describes herself as a “forever student,” most recently earning a Master’s degree in Medical Education.

“I don’t pull out a PowerPoint in appointments,” laughed Mucci, “But I think it’s important for patients and families to understand the conditions they’re living with and their treatment options.”

“That’s why I’m always educating others and not just patients, but medical students, residents — and myself. I enjoy sharing what I’ve learned as my knowledge grows.”

“Unlike other sub-specialties, endocrinology often treats life-long conditions. Developing relationships, watching kids with T1D grow, and being a part of their lives for so many years is wonderful,” said Mucci. 

“As a physician, being involved in a young person’s life, guiding their care, and watching them evolve is truly a privilege, and I enjoy it .”

 

Cleveland Clinic and the T1DX-QI: Transitions of Care

“We’ve been actively involved in the Collaborative for three or four years and are excited to be a part of it,” said Mucci, who serves as the Pediatric Site PI and as a Transition Subcommittee member for the T1DX-QI at Cleveland Clinic Children’s.

“With every challenge, the Collaborative helps to support ideas, processes, and tools that institutions have spent years developing to implement in their clinic. And, they’re willing to share that information with you, which has been amazing as a recipient and contributor.”

“In diabetes care, things are more similar than they are different,” said Mucci. “Many of us from across the country face similar challenges. While there isn’t a single solution to overcome some issues, it’s often worth tailoring what’s been successful for others, so you don’t have to start from scratch.”

Mucci’s particular interest in transitions began in her residency program. As the recipient of a Banting award from the Banting Foundation, she received support for a one-month fellowship in transition medicine as it relates to diabetes.

“That work anchored my interest in diabetes. Of course, transition is important with any kind of chronic diagnosis, but this fellowship was focused on the transition of care in T1D. That passion has continued and become our special project at Cleveland Clinic Children’s, and we’re really working on improving our support and processes related to transitions of care.”

With the “Readiness Assessment Questionnaire or Ready Questionnaire,” transition policies in place, and the setup of “Got Transition,” Mucci hopes to mitigate gaps in transition care and their impacts on health outcomes in emerging adults with T1D. 

“These are all pieces of the puzzle for addressing transitions and improving our transition program at Cleveland Clinic Children’s. Providers are really just doing what they feel is best for their patients in terms of preparation for transition,” said Mucci. “That’s why we’re working on the transition timing as more of a process.”

“Transition care is my passion, and it’s so important. By building it into our system, we’ll be sure our providers have the necessary tools to support their patients and prepare them for transition into adult care.”


What do you like best about what you do?

“Honestly, where I’m happiest is being in the room with a patient and family, listening to them, providing them with supportive information, and helping them succeed,” said Mucci. “I love these relationships — and if we step out a little bit more — working in the diabetes care environment with other endocrinologists and nurse practitioners, and our team of nurses, dietitians, and social workers.”

“Looking more broadly, it’s been great to connect with a larger network of passionate people from across the country who are also dedicating their lives to improve the care of people with type 1 diabetes,” said Mucci. “It’s special on so many different levels.”

“Getting to know, learn from, and share information with others in the Collaborative helps to build and strengthen connections with other institutions, which is fantastic.”

 


What’s next?

“We’re hoping to participate in a Stanford multi-site study: Teamwork, Targets, Technology, and Tight Control in Newly Diagnosed Pediatric T1D — 4T Study,” that involves research on newly diagnosed youth between the ages of 6 months and 21 years.

“Stanford’s had great success implementing early CGM technology and remote patient monitoring in this population,” said Mucci. “Being a part of this would allow us to demonstrate that improved T1D outcomes at Stanford could work widely at other institutions, too.”

“In January, we attended a meeting with other centers in the Collaborative, and we’re hoping 4T will be an NIH-funded study in the coming years. If they receive initial planning funding, it’ll be an active area that we’ll be preparing to participate in.”

“Again, we plan on expanding our transition project, which we’re continuously working on, as well as mapping education pieces to the Ready Questionnaire that’s in its initial stages,” said Mucci.

“I’m also in the process of writing up a research study I did on activity monitor use in youth who live with elevated BMI or obesity. And finally, I’m working on a T1D food insecurity project under the collaborative umbrella with a pediatric resident who lives with T1D.” More to come.

 

What do you like to do outside of work?

“I love art. I picked up painting when I finished my board exams,” said Mucci. “So when I have the magical time to unwind, I enjoy doing that, as well as traveling and spending time with family and friends — and my pugs, whom I’m obsessed with, Gnocchi and Jetta.”