OHSU researchers help drive innovations in health care

Practices in EvidenceNOW

The U.S. health care system is experimenting with a range of innovative approaches to care delivery intended to address persistent quality and cost challenges. To change fundamental models of care – by knowing who patients are, by acting proactively to find what will work for an individual, and to help reduce her or his risks — requires the diffusion of innovation and exchange of knowledge.

Two articles by OHSU researchers were included in the 2018 issue of Health Affairs. This special issue on Diffusion of Innovation examines factors that accelerate the spread of new and innovative health care practices that improve care and lower cost.

Data-driven diffusion of innovations: successes and challenges in 3 large-scale innovative delivery models

This paper, authored by David Dorr, M.D., M.S.Deborah Cohen, Ph.D., and Julia Adler-Milstein, Ph.D., describes three innovations in health care delivery intended to improve the value of health care. These innovations vary substantially – from the banding together of large groups in accountable care organizations to primary care transformation in small and rural clinics – but share some similar challenges.

Dorr, professor and vice chair of medical informatics and clinical epidemiology, Cohen, professor of family medicine, and Adler-Milstein, associate professor of medicine at the University of California, San Francisco, gathered data about these three models to understand the similarities and differences in the use of data and in health information technology systems to drive these innovations.

The findings reveal high-priority areas for strengthening the US data and health IT infrastructure and policies to support the important task of driving health system innovation.

Taking innovation to scale in primary care practices: The functions of health care extension

OHSU researchers, including Sarah Ono, Ph.D., and Deborah Cohen, Ph.D., used empirical evidence in this paper to show that a health care extension model — based on the agricultural model — is feasible in health care and can provide a consistent infrastructure for innovation and knowledge exchange.

Ono, assistant professor, Department of Family Medicine, and investigator, VA Portland Health Care System, and Cohen, professor and vice chair of research, Department of Family Medicine, examined the work that the AHRQ-funded EvidenceNOW Cooperatives are doing in forming health care extensions and identified the key functions of these organizations.

The national evaluation team, ESCALATES, identified the foundational elements of health care extension — technological and quality improvement support, practice capacity building and linking with community resources — common across the seven EvidenceNOW regional cooperatives. Ono and colleagues describe how the cooperatives varied in their approaches to extension and provide early empirical evidence that health care extension is a feasible and potentially useful approach for providing quality improvement support to primary care practices.

The innovations taking place across health care in the United States are only able to drive widespread changes if knowledge is spread.


Health Affairs Paper Describes Three Innovations in Health Care Delivery to Improve the Value of Health Care

Escalates: Health Care Extension In EvidenceNOW: Taking Innovation To Scale

On Tuesday, Feb. 6, Health Affairs Diffusion of Innovation authors spoke at a forum at the National Press Club in Washington, DC. The agenda and a video of the event are available at Health Affairs Issue Briefing.