2nd Annual Workshop on Health IT and Economics Michael E. Gluck, Ph.D., M.P.P. October 21, 2011

1. Health IT and the Evolution of Health
Services Research
2nd Annual Workshop on HIT and Economics
Michael E. Gluck, PhD, MPP
October 21, 2011

2. 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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3. AcademyHealth’s Mission
As the professional society for health services researchers
and health policy analysts, AcademyHealth:
 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
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4. In Other Words…
We help build the knowledge base
and
move knowledge into action
through programs and services for
producers and users of research.
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5. 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

6. Health Services Research
 What works?
 For whom?
 At what cost?
 Under what circumstances?

7. 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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8. 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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9. 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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10. 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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11. 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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12. 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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13. 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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14. 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