Integrating Research and Practice Health System Leaders Working Toward High-Value Care: Workshop Summary (2015) / Chapter Skim
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9 Multiuse Infrastructure for Continuous Learning
9 Multiuse Infrastructure for Continuous Learning
Pages 109-118
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From page 109... ...
• Research works best, Brent James said, when it is integrated into routine care delivery at the level of data systems and or ganizational structure. • An organization can foster a culture in which its leadership team and medical professionals work together consistently to create a virtuous cycle between research and operations to cre ate value at speed, according to Scott Armstrong.
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From page 110... ...
Members of the panel included Patrick Conway, the chief medical officer and deputy administrator for innovation and quality at CMS; Brent James, the chief quality officer and executive director of Intermountain Healthcare's Institute for Health Care Delivery Research; Scott Armstrong, the president and CEO of Group Health; and John Warner, the vice president and chief executive officer of the University of Texas Southwestern Medical Center. Sarah Greene, a senior program officer with PCORI's CER Methods and Infrastructure Program, moderated the discussion that followed the panel presentations.
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From page 111... ...
For a pioneer ACO, for example, the infrastructure needs to become part of the financial model in a way that enables investments in research infrastructure that drives continuous learning to improve population health and the efficiency of care delivery. Conway concluded his remarks by saying that he was fairly confident that the nation's health care system is heading in the right direction, both in terms of quality and cost.
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From page 112... ...
This covers what James characterized as a tremendously broad and interesting set of research questions, often around competing treatments for the same condition, and answering these questions has proven to be a fruitful area of research that generates more peer-reviewed publications than most academic medical centers generate. "The reason it works is that it is integrated into routine care delivery at the level of data systems and organizational structure," James said.
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From page 113... ...
is a large, complex university health system that not only operates the university hospitals and clinics, Warner said, but also provides faculty who account for more than 90 percent of the physicians at the Parkland Health and Hospital System. UT Southwestern Medical Center also provides faculty physicians who staff both Children's Medical Center in Dallas and the Dallas Veterans Administration Hospital.
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From page 114... ...
James replied that the entire purpose of the research institute that he runs at Intermountain Healthcare is to answer questions for the system's administration that will allow the administration to make good decisions, and it is why the institute is 100 percent internally funded. As an example, he said that the administration was trying to decide whether it should put psychologists in its primary care clinics based on the argument that doing so would reduce utilization enough to pay for extra nurses.
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From page 115... ...
Armstrong replied that there is a balance that needs to be struck but that, overall, the health care industry is grossly conservative and far too slow to change. The key is to protect patients in terms of safety and quality, Armstrong said, and the industry should be proud that it does that well, but it needs to accelerate the pace of change.
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From page 116... ...
Greene added that creating a sustainable public good is also going to require broad patient engagement. Joel Allison of the Baylor Health Care System said that there is a general lack of individual accountability with respect to health decisions and asked how the health care system can change patients' behavior to become more engaged in personal accountability.
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From page 117... ...
Conway added that CMS's Innovation Center is considering broadening its research portfolio to look at ways of engaging consumers and patients in a real way with the decision-making process. Rachel Hess from the University of Pittsburgh commented that she was impressed with how operational motivations have been embedded within a research infrastructure.
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