TY - JOUR
T1 - Developing an Institute for Health Care Delivery Science
T2 - successes, challenges, and solutions in the first five years
AU - Mazumdar, Madhu
AU - Poeran, Jashvant V.
AU - Ferket, Bart S.
AU - Zubizarreta, Nicole
AU - Agarwal, Parul
AU - Gorbenko, Ksenia
AU - Craven, Catherine K.
AU - Zhong, Xiaobo (Tony)
AU - Moskowitz, Alan J.
AU - Gelijns, Annetine C.
AU - Reich, David L.
N1 - Funding Information:
Selected media mentions and feedback from external collaborators and patients have demonstrated the value of these projects. I-HDS members (CC and MM) led a project with members from seven Clinical Translational and Science Award (CTSA) institutions and developed a questionnaire for supporting data reproducibility in a learning health system. This project obtained sponsorship from CTSA Informatics executive committee (EC), Clinical Data to Health (CD2H), and Healthcare Data Analytics Association and surveyed appropriate representatives about clinical data quality-related practices, assessed awareness and perspectives on related issues, and gauged training needs []. Dr. Adam Wilcox, CD2H Co-Program Director, commented that “As this information becomes available, it will be important in informing the national data quality metrics development efforts.” Another project provided a year-long Spanish language-preferred patient navigation services for MyChart and OpenNotes (ON) “NotasAbiertas Para Todos: OpenNotes For All”, which also engaged family caregivers. The program received great reviews from participating patients, eliciting many positive comments: “Magnificent! I appreciate the program in Spanish and your patience for explaining everything so well and clearly”; “During this difficult time for immigrants, this is such a wonderful way to show that Mount Sinai really does care about us!” This project received grant support from New York State Health foundation and OpenNotes founders at Beth Israel Deaconess Medical Center - Harvard have called this program “ground-breaking”. The GRITT-IBD™ program (Gaining Resilience Through Transitions for patients with Inflammatory Bowel Diseases) members including I-HDS member (KG) won a team science award for working collaboratively across various disciplines from gastroenterology/medicine, nursing, clinical pharmacy, nutrition, social work, child life, population health, and behavioral/psychological health, to provide the best patient care using a team-based, patient-centered approach (sponsored by Mount Sinai Clinical and Translational Award Program).
Funding Information:
This work was supported in part by the National Cancer Institute (P30 CA196521);
Funding Information:
We acknowledge Jeremy Boal, MD, President of Mount Sinai Downtown and Executive Vice President and Chief Clinical Officer of the Mount Sinai Health System. He was the Associate Director of the Institute for its first three years and was instrumental in its initiation and growth. We also recognize the I-HDS Internal Advisory Board (IAB), which comprises Dean Dennis S.?Charney and?the Presidents, Chief Medical Officers, and Chief Nursing Officers from the Mount Sinai Health System?s seven hospitals, and the chairs/vice chairs/directors of all collaborating departments and Institutes. We thank our External Advisory Board: Peter R. Orszag, PhD, Vice Chair, Corporate and Investment Banking, Citigroup, Inc.; Patricia Wang, JD, Chief Executive Officer, Healthfirst, Inc.; Isaac Kohane, MD, PhD, Co-Director, Center for Bioinformatics, Henderson Professor of Pediatrics and Health Sciences and Technology, Harvard Medical School; and Gregory L. Burke, MD, MSc, Senior Associate Dean for Research and Chief Scientific Officer, Wake Forest Baptist Health. We acknowledge all members of the I-HDS: Umut Ozbek, PhD, Denise Williams, BS, Jiayi Ji, MS, Lihua Li, MS, PhD, Erin Moshier, MS, Liangyuan Hu, PhD, Rachel Jia, PhD, Jung-Yi (Joyce) Lin, MS, Meng Ru, MS, Xiaoyu Song, PhD, Hsin-Hui (Vivien) Huang, MS, PhD, MD, Himanshu Joshi, MBBS, PhD, and Serene Zhan, MS. Finally, we thank our collaborating clinical departments, centers, and institutes for their support. This work was supported in part by the National Cancer Institute (P30 CA196521); The National Heart, Lung, and Blood Institute (U01 HL088942); and the National Institute of Aging (P30 AG028741?and?P30 AG028741- 09S1).
Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2021/3
Y1 - 2021/3
N2 - Medical knowledge is increasing at an exponential rate. At the same time, unexplained variations in practice and patient outcomes and unacceptable rates of medical errors and inefficiencies in health care delivery have emerged. Our Institute for Health Care Delivery Science (I-HDS) began in 2014 as a novel platform to conduct multidisciplinary healthcare delivery research. We followed ten strategies to develop a successful institute with excellence in methodology and strong understanding of the value of team science. Our work was organized around five hubs: 1) Quality/Process Improvement and Systematic Review, 2) Comparative Effectiveness Research, Pragmatic Clinical Trials, and Predictive Analytics, 3) Health Economics and Decision Modeling, 4) Qualitative, Survey, and Mixed Methods, and 5) Training and Mentoring. In the first 5 years of the I-HDS, we have identified opportunities for change in clinical practice through research using our health system’s electronic health record (EHR) data, and designed programs to educate clinicians in the value of research to improve patient care and recognize efficiencies in processes. Testing the value of several model interventions has guided prioritization of evidence-based quality improvements. Some of the changes in practice have already been embedded in the EHR workflow successfully. Development and sustainability of the I-HDS has been fostered by a mix of internal and external funding, including philanthropic foundations. Challenges remain due to the highly competitive funding environment and changes needed to adapt the EHR to healthcare delivery research. Further stakeholder engagement and culture change working with hospital leadership and I-HDS core and affiliate members continues.
AB - Medical knowledge is increasing at an exponential rate. At the same time, unexplained variations in practice and patient outcomes and unacceptable rates of medical errors and inefficiencies in health care delivery have emerged. Our Institute for Health Care Delivery Science (I-HDS) began in 2014 as a novel platform to conduct multidisciplinary healthcare delivery research. We followed ten strategies to develop a successful institute with excellence in methodology and strong understanding of the value of team science. Our work was organized around five hubs: 1) Quality/Process Improvement and Systematic Review, 2) Comparative Effectiveness Research, Pragmatic Clinical Trials, and Predictive Analytics, 3) Health Economics and Decision Modeling, 4) Qualitative, Survey, and Mixed Methods, and 5) Training and Mentoring. In the first 5 years of the I-HDS, we have identified opportunities for change in clinical practice through research using our health system’s electronic health record (EHR) data, and designed programs to educate clinicians in the value of research to improve patient care and recognize efficiencies in processes. Testing the value of several model interventions has guided prioritization of evidence-based quality improvements. Some of the changes in practice have already been embedded in the EHR workflow successfully. Development and sustainability of the I-HDS has been fostered by a mix of internal and external funding, including philanthropic foundations. Challenges remain due to the highly competitive funding environment and changes needed to adapt the EHR to healthcare delivery research. Further stakeholder engagement and culture change working with hospital leadership and I-HDS core and affiliate members continues.
KW - Comparative effectiveness research
KW - Decision modeling
KW - Health Care delivery research
KW - Pragmatic clinical trials
KW - Predictive analytics
KW - Qualitative research
UR - http://www.scopus.com/inward/record.url?scp=85095582338&partnerID=8YFLogxK
U2 - 10.1007/s10729-020-09521-5
DO - 10.1007/s10729-020-09521-5
M3 - Article
C2 - 33161511
AN - SCOPUS:85095582338
SN - 1386-9620
VL - 24
SP - 234
EP - 243
JO - Health Care Management Science
JF - Health Care Management Science
IS - 1
ER -