Health IT and the Evolution of Health Services Research

Michael E. Gluck, PhD, MPPOctober 21, 2011

2nd Annual Workshop on HIT and Economics

Overview

What is AcademyHealth? What is health services research (HSR)?

The current policy backdrop for HSR HIT’s role in HSR

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AcademyHealth’s Mission

Supports the development of health services research

Facilitates the use of the best available research and information by decision-makers

Assists health policy and practice leaders in addressing major health challenges

As the professional society for health services researchers and health policy analysts, AcademyHealth:

In Other Words…

We help build the knowledge base and

move knowledge into actionthrough programs and services for producers and users of research.

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What is Health Services Research?

A multidisciplinary field of scientific investigation that– examines how social factors, financing systems,

organizational structures and processes, health technologies, and personal behaviors

– affect access to health care, the quality and cost of health care, and ultimately our health and well-being

– by studying individuals, families, organizations, institutions, communities, and populations.

--AcademyHealth, June 2000

Health Services Research

What works? For whom? At what cost? Under what circumstances?

The Current Policy Backdrop for HSR HITECH Comparative effectiveness research (CER)

– Health care services and its delivery– ARRA funding: $1.1 billion– Patient Centered Outcomes Research Institute (PCORI): $500

million/year by 2015 from trust fund The Patient Protection and Affordable Care Act (ACA)

– Coverage expansion– Delivery system transformation with significant reliance on HIT

Focus on the Triple Aim: – Improved care experience– Improved population health– Cost containment

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HSR Generates Knowledge About HIT

the diffusion and uptake of HIT the optimal use and implementation of HIT impact on care delivery

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HIT Changes How HSR Generates Knowledge

New sources and types of data Data that is more timely & proximate to

care New research infrastructures New professional opportunities for

researchers New challenges

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HIT Provides New Sources and Types of Data for HSR

Traditional data for HSR – surveys and claims Emerging data for HSR

– Electronic health records & registries -- clinically rich & statistically more powerful

– Patient/population contributed data – biomonitored, crowd-sourced, & self-reported

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HIT Provides Data for HSR That Is More Timely and Proximate to Care

More seamless integration of data for research, operations, and patient care.

More seamless integration of the research, operational, patient care workforces and processes.

Opportunity for iterative, learning health care system

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HIT Generates New Infrastructure and Professional Opportunities for Researchers New research and data networks

– HMO Research Network (HMORN)

– Clinical & Translational Science Awards (CTSA) consortium

– AcademyHealth’s EDM Forum– FDA’s distributed Sentinel network

Research collaborations between academics and health care delivery organizations.

Delivery system employment of health services researchers

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HIT Presents New Challenges for HSR: Some Examples

Analytic Methods– Analyzing patient/population contributed & other new data– Managing research teams across dispersed data networks

Informatics– Data exchange – Variations in use of EHR fields across sources– Implications of cloud computing

Data governance– HIPAA and other privacy concerns– IRBs and human subjects concerns– Is it research? Operations? QI?

Research workforce– Conflicts with academic incentives and norms– Training needs

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AcademyHealth Is Helping Prepare the Field for HIT-Enriched HSR

Programs and projects– Electronic Data Methods (EDM) Forum– HIT for Actionable Knowledge project– Beacon Evidence and Innovation Network– Multi-Payer Claims Database – REACH Challenge– Professional development offerings

More information?– www.academyhealth.org– michael.gluck@academyhealth.org