April 7, 2011

Dr. Rob Reid: Bridging research and operations at Group Health

Robert (Rob) Reid, MD, PhD, answers questions about his new role as Group Health’s first-ever associate medical director of health services research & knowledge translation:

Please tell us about your new job.      
It’s about better integrating the science of Group Health Research Institute (GHRI) into the Cooperative’s operations—specifically in designing, implementing, and evaluating innovations to learn what works and for whom. So we can bring research findings into “real time” to improve how care is  organized, financed, and delivered.

I want to deepen the partnerships between research and operations that we’ve created with the patient-centered medical home, shared decision making, and our value-based insurance plan for Group Health employees, Total Health. The goal is to bring the best science to bear as Group Health  continues to innovate for better health.    

Each of those initiatives used seed funding from the Group Health Foundation or the Cooperative and leveraged it into external grant dollars—improving Group Health while producing leading-edge research useful to other systems and populations in this nation and beyond.

Does that mean creating “a learning health care system”?
Yes. It’s where research and practice influence each other, and we translate research into practice and policy more quickly. We also orient research better around the key questions for which decision makers need answers. It’s a model for innovation as policymakers seek to improve health care while making it more affordable and patient centered.

How does your new role change what you do?      
It’s half-time, funded by Group Health Physicians. The other half, I’m still a GHRI associate investigator, as I’ve been since 2003. I work on various externally funded research projects, including examining domestic violence, genetic testing, cancer screening, and the medical home clinics.

My goal is to identify strategic research opportunities early, by discussing current and planned innovations with Group Health leaders and managers. An essential part of my role is to identify the sweet spots where we can use external research funding to develop and evaluate transformative innovations to help Group Health  and others.

Most funding for Institute researchers comes from sources outside Group Health, usually federal grants, awarded very competitively, project by project. Most projects must meet rigorous scientific and ethical standards and be highly pertinent to care beyond Group Health. Research is expensive, so collaborating with the Institute usually means securing external  funding.

What are the funding challenges and opportunities?      
Translational research has been difficult to fund, and the lagging economy constrains funding. But the Accountable Care Act has created some opportunities for us, including the new Patient-Centered Outcomes Research Institute and the Center for Medicare and Medicaid Innovation.

But most of the Institute’s work will remain more basic, right?      
Yes. Most research at Group Health Research Institute continues where we’ve traditionally excelled: exploring patterns and determinants of disease and care; doing comparative effectiveness research; and using randomized trials to test advanced innovations that aren’t ready for strategic wholesale implementation at Group Health.

Likewise, many innovations happen at Group Health that don’t need to involve GHRI.

How does your background inform your new role?      
I’m both a primary care and public health doctor at heart. I’ve always been interested in promoting health for individual patients—and by extension for populations. My background in primary care and preventive medicine helps me focus on whether system changes will work on the front lines: for patients, clinicians, and care teams.

How have your interests evolved?      
I practiced in Canada, where primary care was mostly small fee-for-service practices, with no overarching system supporting  them—aside from paying them. I realized we could benefit from new ways to coordinate care, through a systems approach.

So I got trained at Johns Hopkins with an MPH in epidemiology and a PhD in health policy and management. After my training, I joined the faculty of the University of British Columbia and worked on  health reform in Canada. But health care research and policy are often far removed from each other in  Canada, so I jumped at the chance to join Group Health with its long history of integrating research into day-to-day practice and policy.

by Rebecca Hughes