Kathryn Fantasia, MD, MSc, is an adult endocrinologist at Boston Medical Center and Assistant Professor of Endocrinology, Diabetes, Nutrition, and Weight Management at Boston University Chobanian and Avedisian School of Medicine. Dr. Fantasia is a K12 Scholar with the National NIH K12 Physician Scientist DiabDocs Program and serves as the T1DX-QI Type 2 diabetes (T2D) site PI at Boston Medical Center.

Interview with Kathryn Fantasia, MD, MSc

In this interview, Dr. Fantasia discusses her involvement with the T1D Exchange Quality Improvement Collaborative (T1DX-QI), as a diabetologist and implementation scientist focused on identifying strategies to reduce inequities in diabetes care.

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 60 endocrine clinics from across the U.S. 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 brought you to endocrinology?

“I always knew I wanted to be a doctor,” said Fantasia, who grew up in a medical household as the daughter of two physicians.

“As a child, I would go to the hospital with my dad, who was a surgical oncologist, while he made patient rounds,” said Fantasia. “Having been exposed to medicine from an early age, and witnessing how engaged my parents were in helping the people they cared for, is what brought me to medicine.”

“That said, before starting medical school, I had a formative experience in my own life — being diagnosed with a low-risk form of papillary thyroid cancer,” shared Fantasia.

“I had a wonderful endocrinologist who was empathic and understanding, and he empowered me to make my own healthcare decisions,” said Fantasia. “Having this experience also piqued my initial interest in endocrine.”

“Throughout my residency and fellowship at Boston Medical Center, I had wonderful diabetologist mentors. I learned from Dr. Steenkamp how ‘all-encompassing’ diabetes care is and how, as an endocrinologist, I can support people in achieving their goals for diabetes management,” said Fantasia. “This resonated with me, and I also found it to be endlessly interesting.”

“One of my core values as a physician is to provide information people need so they can make decisions that are best for them,” said Fantasia. “Participating in the care of someone’s diabetes offers me this opportunity — which is why I chose to focus on diabetes care.”

“While I love the physiology and detective work associated with endocrinology, developing long-term relationships with people and following them through various stages of their lives is a very appealing aspect of endocrinology, too,” said Fantasia. “I really enjoy learning about people and what matters to them as individuals.”

What led you to a Master of Science in Health Services and Systems Research program?

“Medical education has always been an interest of mine,” explained Fantasia. “So when I finished residency in 2016, I chose to spend a year as chief resident.”

“Afterward, in fellowship, I began to observe significant differences in outcomes from patient to patient, which led to an interest in understanding what those drivers were — in terms of access to endocrine specialty care and resources such as education and device use,” explained Fantasia.

“In order to answer those questions, I knew that I needed further education and training,” said Fantasia, whose desire to have a broader impact on diabetes care, and a deeper understanding of factors that were leading to downstream differences in care and outcomes, prompted her to enroll in a Master of Science in Health Services and Systems Research program during fellowship.

“Following that, I joined the faculty here at BMC, completing a two-year institutional research fellowship with the Evans Center for Implementation and Improvement Sciences at Boston University,” said Fantasia.

“Implementation science is ultimately interested in understanding ways to close knowledge to practice gaps — so generating a body of evidence that can provide insight into how we can move clinical research into clinical practice and ultimately to improving care,” explained Fantasia, who dedicates about 75 percent of her time towards research and 25 percent towards seeing patients. 

T1DX-QI and BMC

“Boston Medical Center joined the T1DX-QI in 2021 and most recently onboarded with the T2D project in late 2022,” said Fantasia, who sits on the Data Governance Committee and serves as the site PI for the adult endocrinology T2D pilot, alongside Dr. Devin Steenkamp, who serves as the site PI on the T1D side.

“As a mentor, Dr. Steenkamp involved many of us in early T1DX-QI initiatives — so I’ve been part of the meetings since we onboarded,” said Fantasia. “As someone who is growing in their career as an implementation scientist, I value many things about the Collaborative including knowledge sharing, fostering connections between centers, and learning best practices from one another to accelerate improvements in care and outcomes,” said Fantasia.

What is your current research focus?

“My particular research interests are in identifying ways to reduce inequities in diabetes care for people who come from minoritized communities including Black, Latinx, people of lower socioeconomic status, and those receiving care at safety net institutions or healthcare centers,” said Fantasia. 

“Currently, my research is focused on diabetes device use in Black and Latinx people with T1D. Again, on identifying strategies to ameliorate existing inequities in care, because as it’s been demonstrated, device use seems to partially mitigate some of the differences we’re seeing in clinical outcomes with diabetes,” said Fantasia

“Within the Exchange, my T2D project work is focused on increasing CGM use through a health equity lens. For the pilot at Boston Medical Center, we’ve been working on CGM uptake through improvements in educational materials and other opportunities,” said Fantasia, whose work with the T1DX-QI translates into her personal research.

“I’ve done all of my training at Boston Medical Center, which is the largest safety net healthcare center in New England,” explained Fantasia. “And I’m deeply committed to providing the best possible care for everyone.”

“At Boston Medical Center, language equity is very important to us, so our goal is to provide educational materials not only in English but also in Spanish and Haitian Creole,” said Fantasia. “In Boston, we have a large Haitian community who are disproportionately affected by diabetes, so a lot of our patients speak Haitian Creole, which is our third most common language.”

What’s next? What’s your hope for the future?

“As a K12 scholar, my specific project is on adapting educational materials to facilitate choices to increase the use of hybrid closed-loop insulin pumps for minoritized patients,” said Fantasia. “The big next steps will be to continue  my growth and development as a clinician scientist focused on improving the care of people with T1D.”

“If I were to sum up my research interests, they’re really about identifying strategies to reduce identified gaps in diabetes care. While I’m developing and testing one strategy, I’ll be interested in testing it more broadly, as well as identifying and testing other strategies and ways to improve care,” said Fantasia.

What do you like to do outside of work?

Outside of work, Dr. Fantasia enjoys traveling and hiking in New Hampshire with her husband, whom she aspires to summit all 48 peaks above 4,000 ft. with. Fantasia, who also loves to experience new cultures through food, and cooking for family and friends, joked, “Thanksgiving is my Superbowl.”