Agenda

The opening plenary panel will offer a broad look at opportunities for data science to accelerate advance the health of the populations we serve. Featuring speakers with deep, cross-cutting expertise in biomedical informatics, health care data analytics, and learning health system research, this session will spark the collaborative energy for the conference. The panel will be moderated by Joe Selby, MD, MPH, the Executive Director of PCORI and one of the founding board members of the HCSRN (then HMORN). Dr. Selby will be joined by three outstanding panelists:

Over time we have made progress toward gender equality in research. It is no longer extraordinary for women to be scientists. Women are increasingly in more senior and leadership positions, making salaries closer to those of their man colleagues, and achieving greater research funding longevity. While some gaps have narrowed, disparities remain that need to be addressed and efforts to promote equality for women in research are still needed. While more women than men have received doctoral degrees in the biomedical sciences over the past decade, women continue to comprise the minority at every subsequent stage of professional advancement. Despite recent progress toward gender parity in science, gaps persist in senior authorship positions and publication in high-impact journals. These gaps will inevitably lead to continued disparities in advancement and salary. The Health Care Systems Research Network (HCSRN) is home to many successful and accomplished woman scientists who are leaders in their field. The purpose of the “Women in Research: Best Practices and Changes Needed to Promote Gender Equality” panel is to explore the following themes: women in senior or leadership positions, mentoring and career development needs specific to woman researchers, pay parity, and unconscious bias. During this panel discussion, panelists will share personal anecdotes and experiences (both positive and negative) related to gender roles in research, their thoughts on current challenges for women in research, and ways the HSCRN community can promote gender equality. This panel will include both women and men across the HSCRN to ensure broader representation and provide insights from varying perspectives. At the conclusion of the panel we hope to identify characteristics of HCSRN member organizations that successfully promote gender equality and disseminate practices to ensure that they are exceptional places to work for women in research.

New medical breakthroughs can take years – even decades – to reach the point of care. New research (November 2018) from the Alliance of Community Health Plans (ACHP) identifies five replicable and scalable best practices that health plans can employ, through collaboration with physicians and communities, to accelerate the delivery of evidence-based interventions. The panelists, representing health plans featured in the report’s case studies, will share specific, adaptable examples that promote integrated care and evidence-based practice. ACHP studied the practices of nonprofit, community-based, provider-aligned health plans operating in 32 states and the District of Columbia by conducting a comprehensive literature review; establishing an Advisory Panel; conducting 90-minute phone interviews with clinical plan leaders; and identifying unique features of each plan’s work, common themes, successes and barriers. ACHP’s research demonstrates that when high-performing health plans collaborate with health systems, evidence-based decision making increases. Five best practices emerged from the research that health plans can employ to accelerate adoption of evidence-based care. As case studies for engaging clinicians and disseminating information, our panelists will illustrate these best practices at work: how to produce better care and greater value by eliminating barriers across teams; making data more transparent; and providing the right tools for the right audience. Moderator Connie Hwang, chief medical officer for the Alliance of Community Health Plans, will guide the panelists in elucidating the sizable and lasting impacts payer-provider partnerships are having on community health, and in demonstrating how they can serve as models for others to foster improved health outcomes and better patient experience. Better results are possible when organizations collaborate across traditional silos. Health plans and providers share a desire to achieve the Triple Aim — better health and patient experience at lower cost. When plans and providers work together on behalf of patients, care improves, costs go down and patients experience better outcomes—and our panel will demonstrate just how this can be done.

Hyperlink 3 is a clinic-randomized trial testing home blood pressure (BP) telemonitoring plus pharmacist care to improve uncontrolled hypertension in primary care clinics. BP-CHECK is a randomized diagnostic trial comparing three measurement methods for diagnosing hypertension with 24-hour ambulatory blood pressure: home, kiosk, or clinic. The PCORnet BP Control Lab is comparing two strategies for helping clinics improve BP control using the AMA/AHA Target:BP Initiative: self-guided vs. practice facilitation. Investigators and project staff from the three studies will briefly describe the design and methods to set the stage. We will compare and contrast the studies to highlight challenges and adaptations to implementation in real-world primary care practices. The presenters will discuss examples of challenges and solutions that serve as practical lessons for carrying out pragmatic trials: effects of national guideline changes during the study; need for protocol changes based on implementation challenges, technology and data limitations; achieving effective patient and stakeholder engagement; and obtaining informed consent. We will discuss similarities and differences in working with PCORI compared with other funders. The teams will describe how they have been able to benefit from cross-talk between the studies.

Our panel will consist of five presenters with these topics: Dan Ng: Regulatory issues surrounding the use of death data. Dan will present formation on guidelines surrounding the use of death data in research for KPNC and other HCSRN entities. This will serve as a framework for a larger discussion involving the panel and audience around the variety and breadth of site regulatory issues. Catherine Cleveland: Integrating the SSDI (Social Security Death Index) with local death data. Catherine will discuss the incorporation of SSDI data to verify and enhance existing VDW death data. She will address KPNW’s process in deciding when to use or not use this supplemental data. As this data is made available via the UCDA (Utility for Care Data Analysis), it is accessible by all KP sites. Morgan Fuoco: A multi-site application process for an NDI (National Death Index) submission. Morgan will outline key considerations when working with multiple (and non KP) entities when obtaining death data from the CDC. They will also speak to the conditions imposed by the CDC when using NDI based death data. Phil Crawford: NDI submission and result data. Phil will address strategies for reducing the volume of records sites need to send to NDI as well as maximizing the probability of receiving a return NDI match. He will also discuss the NDI recommended and other approaches for selecting the best matching record in NDI result data when multiple matching records are returned. Marvin Yan: KP member life expectancy compared to national statistics. Marvin will present a use case demonstrating how death data can be employed in comparison to outside statistical data. The example involves using the Death and Enrollment tables from the VDW and the GEMS (Geographically Enriched Membership Sociodemographics) Race Probability data with a CDC developed methodology to calculate life expectancy for KPNC members. In addition, he will discuss findings by comparing CDC cohort with KPNC HMO members, and possible further research opportunities.

The Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC) program produces evidence synthesis reports that summarize relevant research on a topic. AHRQ recognizes there are many interim steps between having the results from a systematic review and changing practice and improving care. In 2018, the EPC Program piloted ways to make it easier for healthcare systems and hospitals to use evidence reports to improve the delivery of care and health outcomes for patients. EPC investigators engaged with health system partners to develop and evaluate possible companion products to facilitate the translation of evidence into practice. These pilot efforts resulted in the development of a wide range of products that could be broadly categorized as: dissemination products, interactive data visualizations, or implementation products. During the panel session we will provide a brief overview of the AHRQ EPC program, the types of evidence products offered and how to be involved, and describe and highlight the range of pilot products developed by EPCs. Panel members will represent products from each broad category, including Cyberseminars (a dissemination product), MAGICApp/Tableau products (an interactive data visualization), and clinical decision pathways (an implementation product) and present some of the formative evaluation results collected from health system partners during the pilot process and lessons learned. Facilitated dialogue will engage the audience to get their feedback based on their own experiences integrating evidence into care.

There is a renewed interest among granting agencies to require meaningful community engagement and/or patient participation in research activities. The Patient Centered Outcomes Research Institute (PCORI) has prioritized patient partner engagement in research [pcornet.org]. The National Institutes of Health is also increasingly emphasizing the importance of the patient voice in research activities. Kaiser Permanente also finds it important to obtain member and community feedback as part of research activities. Genetics and genomics research raise potential ethical, social, and community issues, making community members valuable collaborators. The Kaiser Permanente (KP) Research Bank, a biobanking program that includes all eight KP regions, has engaged KP members as long-term partners through three regional and one national Community Advisory Boards (CAB) for over three years. The CABs share meaningful insights about genetics/genomics, research and related topics. PORTAL’s goal was to establish a research network to develop data and science capacity for patient-reported outcomes research. PORTAL brought together three leading health care delivery systems— Kaiser Permanente, HealthPartners, and Denver Health—and their affiliated research centers and stakeholders, to build the research infrastructure. The Patient Engagement Council is composed of 10 patients from five Kaiser Permanente regions as well as Denver Health and Health Partners, who represent the conditions that the network focused on: obesity, colorectal cancer, and congenital heart disease. The PEC has since expanded to serve a more general-purpose advisory function across many topic areas. Many HCSRN members are building or plan to build community engagement groups. Attendees will hear practical advice on scoping the community group’s composition, how to recruit community members, and how to best deploy the community group to advance program goals, from both research staff and partners. Attendees will hear success stories and lessons learned in working with community partners over time, as well as how these research/community relationships have evolved.

BeneFIT is a research project that partners with Medicaid/Medicare health plans in Washington state and Oregon to develop, implement, and evaluate mailed FIT (fecal immunochemical test) programs to address disparities in colorectal cancer (CRC) screening. The health plans planned and implemented tailored mailed FIT programs matching their resources and context. Both programs increased screening among the unscreened Medicaid/Medicare population. Our research team sought to increase the reach of health plan-based mailed FIT programs. Two members of our research team attended an AcademyHealth communications workshop demonstrating how to build an effective communications strategy. We used our workshop learnings to create a step-by-step communications worksheet, define dissemination goals, and identify which would be most impactful. In Washington, our goal is to advocate for the Medicaid program to include colorectal cancer screening as one of its incentivized performance measures. In Oregon, we will raise awareness of BeneFIT’s success and engage other health plans in implementing similar programs. We have developed a 10-month action plan to reach our goals. In this panel presentation: 1) AcademyHealth’s Director of Communications will provide an overview of the communications workshop that inspired the research team’s dissemination work, including topics such as setting a communications goal, identifying and researching your audience, developing effective messaging, and choosing the right communications channels. 2) The BeneFIT team will share the practical tools and step-by-step processes we developed based on our learnings at the workshop, and that led to actionable plans. 3) The Oregon BeneFIT team will share its action plan, as well as obstacles and supports in engaging new health plans to implement mailed FIT programs. 4) The Washington-based BeneFIT team will share its communications plan, obstacles and supports related to creating incentives for colorectal cancer screening by the Washington State Health Care Authority. 5) The panel will engage the audience in sharing their successes and obstacles in spreading their work, and provide strategies for increasing success in communicating and disseminating research findings.

The development and demonstrated effectiveness of cancer prevention tools have led to implementation of screening for breast, cervical, colorectal, and lung cancers. Increased knowledge of the etiology of these cancers has improved understanding of risk, enabling the shift from a one-size-fits-all screening strategy to a more tailored approach that seeks to personalize age at screening entry, screening modality, screening intensity, and age at screening exit based on an individual’s risk. While there is general agreement that risk-based cancer screening could optimize the balance of benefits and harms of screening, there is growing concern that a risk-based approach also increases the complexity of clinical prevention and presents considerable implementation challenges across multiple levels of health care delivery. Implementing complex, personalized screening regimens may strain already limited resources, increase disparities, and worsen outcomes, especially if the efforts required to identify and communicate varying levels of risk and implement appropriate screening detract from the ability to track and intervene on screen-detected abnormalities. Ultimately, this could also detract from the population impact of these cancer prevention and control strategies. The objective of this panel presentation is to increase awareness of the challenges of delivering risk-based cancer screening and its potential impact on patients, providers, and health care systems. The presentation will describe the evolution and current context for risk-based breast, cervical, colorectal, and lung cancer screening. Panelists will then describe delivery experiences and challenges from the perspectives of primary care, specialty care, quality improvement, and population health management, and highlight the lessons learned from the implementation of risk-based screening. The moderator will facilitate a dialogue examining whether and how barriers to risk-based screening can be overcome, and what long-term resources will be needed to realize optimal cancer prevention and control in the era of risk-based screening. The moderator will also highlight next directions for research and the role of the National Cancer Institute-funded Population-based Research to Optimize the Screening PRocess (PROSPR) consortium in this research.

Don’t miss out on this modern take on the classic scavenger hunt! Your team will be provided with a Mission Pack full of clues and challenges, the HCSRN Search Party will give you a chance to see the sights and sounds of Downton Portland. Pre-registration required.

Join your peers on a scenic walk through downtown Portland! The group will meet in the lobby of the Hilton Portland Downtown and will leave promptly at 7:30 am. We look forward to seeing you bright and early! Pre-registration is not required.

The world of data and analytics invokes a sense of cool precision, and is essential for transforming health care. By themselves analytic insights can be persuasive, yet adding a human-centered design lens can yield an even more impactful and compelling approach to improving health and health care. Dr. Estee Neuwirth will share how her journey from an academic sociologist to the Senior Director of the Kaiser Permanente Design Consultancy has led to meaningful improvements across the health care ecosystem, from care transitions to preventable readmissions and most recently to the implementation of new digital therapeutics for enhancing emotional health and wellness. She will share case studies, tools, and insights that can be applied in a research setting and leveraged to accelerate learning and spread.