Director’s Update — February 2015

Every month, the CTSI Stories Blog will post excerpts from ongoing conversations with the institute’s co-directors.

Below, Nana Bennett discusses the spring CTSI Seminar Series on population health, and the CTSI’s emphasis on this field of growing importance.NanaBennett

Tell me a little about why this topic is so important.

The United States spends more money per capita on healthcare than any country in the world, and yet our health outcomes are very poor relative to most other developed nations. Overall, it’s evident that we, as a country, have not done well improving the health of our residents.

The CTSI is increasingly focused on health improvement and the ways in which research can contribute directly to population health improvement.  We initially described this approach as  pillar of the CTSI, but increasingly we are viewing it as an overarching goal.  Through the CTSI seminars, we hope to give everyone an introduction to population health, which is a way of thinking about how to increase the health of all of our citizens by addressing certain key issues. The US government has set a triple aim: to improve health, improve health care, and reduce cost, and in order to do that, it’s becoming more and more critical for both health care systems and health research to embrace a population health approach.

Why is there such a gap between what we spend and our outcomes?

There are a number of reasons. First, our system is set up to treat individuals, rather than populations. This means we spend a lot of money on new technologies and expensive treatments for individual problems, rather than allocating resources to prevention which will help the population’s health improve.

Additionally, it’s currently believed that the health care a person receives only accounts for about 10 percent of the health of that person. Behaviors, meanwhile, account for 40 percent. So we spend a lot of money treating the consequences of some widespread problems, such as obesity and tobacco-use, which could be more efficiently dealt with by addressing behaviors on the front end.

Those are a few examples from the clinical enterprise. On the research side, we’ve always focused on basic science discovery and exciting technologies. However, we have not ensured that our research dollars support studies that address the most important determinants of health and can be quickly translated into health improvement for the population as a whole.

With that as a backdrop, what is the CTSI doing to address population health?

The CTSI is formulating ways to place population health at its forefront. We want everything we touch — whether it’s our pilot grants, our education and career development, our research support programs — to somehow be moving towards the goal of improving the population’s health. We want to make translation into clinical and community solutions our primary goal. And, of course, this lecture series will introduce key concepts of population health and population research. We want to give everyone a grounding in this work in the hopes that they will consider this paradigm as they pursue their own interests.  We do not want to, in any way, diminish the importance of basic science, but rather hope to articulate the road to its translation into better health.

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Previous director’s updates:

January 2015 – Harriet Kitzman reflects on her time as a CTSI co-director.
December 2014  – Karl Kieburtz offers his takeaways from the CTSI all-hands retreat.
November 2014 – Nana Bennett speaks to the expansion of the role of the CTSI’s Community Advisory Council.
October 2014 – Harriet Kitzman discusses the science of team science.
September 2014 – Karl Kieburtz talks about why the CTSI is beefing up its informatics team.
August 2014 – Nana Bennett discusses the new Population Health pillar.
July 2014 – Harriet Kitzman offers her takeaways from the Mini Summer Research Institute.
June 2014 – Karl Kieburtz gives an overview of the CTSI’s six pillars.

CTSI offering NCHS consultation service

The CTSI is now offering a free consultation service for researchers who are looking to use publicly-available data collections offered by National Center for Health Statistics and Centers for Disease Control and Prevention. These databases include:

Dongmei Li, Ph.D., interim associate professor of clinical and translational research, is adept with the datasets, which can be challenging to navigate and analyze.

“These databases are particularly useful tools for new researchers and emerging investigators, because it’s an accessible way to do some analysis on a topic and produce useful publications,” said Tim Dye, Ph.D., director of biomedical informatics for the CTSI. “But they often have complicated sampling schemes, so it generally takes collaborating with someone who can work with the informatics side of it.”

For more information or to schedule a consultation, visit the Research Request Dashboard or contact Li directly at Dongmei_Li@urmc.rochester.edu.

NCDHR Data Blitz!

Researchers and community partners from the Rochester Prevention Research Center: National Center for Deaf Health Research (NCDHR) will present at this month’s SRB Data Blitz! in the Saunders Research Building atrium.

The SRB Data Blitz!, a monthly series from the CTSI, brings a different research group to the Saunders atrium each month to present their work. Led by Steven L. Barnett, M.D., the NCDHR is planning to present the following:

  • NCDHR research posters covering the following topics:
    -Results and methods from the Deaf Weight Wise clinical trial
    -Informed consent research study with deaf people
    -Survey methods and sign-language video surveys
  • The Bridges to the Doctorate Program, a joint venture with Rochester Institute of Technology that supports the education of deaf scientists.
  • Sign language videos produced by NCDHR, including a breastfeeding PSA and several public health journal articles that have been translated into sign language .
  • The Deaf Strong Hospital program, whereby deaf people set up a mock healthcare system in the lobby of the School of Medicine and Dentistry as a role reversal exercise for hearing first-year medical students.

Coffee and cookies will be served. Be there, and get Blitzed!

What: SRB Data Blitz! featuring the National Center for Deaf Health Research.
Where: Saunders Research Building atrium.
When: Noon – 1:00 on Wednesday, January 21.

Executive director of Greater Rochester RHIO to speak at CTSI Seminar Series

Solid data makes for solid research. Solid research makes for better patient care. But in a hyper-competitive business environment, health systems don’t always tend to share their precious data with one another.

The Greater Rochester Regional Health Information Organization (RHIO) is a step towards a more collaborative research environment.

Through the RHIO, a researcher can track a patient who first comes to Strong Hospital, and next shows up “in Rochester Regional, then Medina, then Arnot, then Borg and Ide,” said Ted Kremer, executive director for Greater Rochester RHIO.

“So it brings together a patient’s clinical information and care from multiple sources nearly in real time, and the information can be used as a dataset for analytics and population health.”

Kremer will share more about the Rochester RHIO’s capabilities at a seminar in Helen Wood Hall auditorium from noon to 1 p.m. on Tuesday, Jan. 20.

Among the topics of Kremer’s seminar will be the type of data that the organization receives, the studies that have been done through RHIO, and future directions for the collected data.

“The RHIO is really at the cutting edge of health care reform, and allows communities and providers to rethink how our data relates to patient care,” said Tim Dye, Ph.D., Director of Biomedical Informatics for the CTSI. “As a byproduct of their core service, the RHIO creates new data resources for us to learn about challenges and opportunities facing the Finger Lakes population in ways we weren’t able to do before them or without them.”

Kremer’s presentation is part of the CTSI Seminar Series on population health. Lunch will be provided, though attendees should bring their own drink.

CTSI and Center for Community Health welcome Kathleen Holt

Seeing something you love embraced by the masses can make for a wonderful feeling of validation. But the early adopters always retain bragging rights, and Kathleen Holt loved big data before it was cool.

Kathleen Holt, Ph.D.

Kathleen Holt, Ph.D.

“I have a Ph.D. in social psychology psychometrics, so I’ve been interested in big data for a long time,” said Holt, senior project research associate for the CTSI and Center for Community Health. “But recently, the applications of big data have become practical and have implications just about everywhere.”

Holt joined the CTSI’s informatics team in late 2014. She spent the previous 14 years working for the Accreditation Council for Graduate Medical Education (ACGME), a council that accredits all the medical residency programs in the United States. Among other things, she worked to  analyze residency programs.

“If you’re getting surgery training in Mississippi, is that the same training that you’d be getting if you were in New York City?” said Holt. “And how do you equate those things? How many surgeries are the residents doing, and how many do they need to do to be deemed competent?  To help address those questions, we’d work with the surgeons and experts on the review committees.”

She was brought to the university by the notion that she could work on projects that would more closely impact patients and in the Rochester area.

“I’m very passionate about the Rochester area and local health and all the forms it takes — mental health, economic health, physical health,” she said. “It seemed like UR, and the Center for Community Health and the CTSI are places where research comes together to improve people’s health.”

So far, Holt has been studying data generated by the blood pressure advocate program at the Center for Community Health. Much data has been collected for the program, and she’s helping to analyze it, and is hoping to apply a geographic information system to create a data-driven picture of the impact of the program. This means answering questions such as: Where are the patients from?  Are there things we can learn about our populations and our programs by examining where patients live?

At the CTSI, she’s worked with Tim Dye, the CTSI’s Director of Biomedical Informatics, and Dongmei Li, associate professor of Clinical and Translational Science, on a certificate program for biomedical informatics that will become a master’s degree program somewhere down the line.

“Kathleen is a critical connection between the informatics resources of the CTSI and the Center for Community Health,” said Dye. “Because she is embedded with both teams, she’s really able to match CCH needs with CTSI resources and informatics expertise. Since Kathleen has deep experience with technology and analysis, she’s also ideally suited to contribute to the design of effective community-based information systems.”

When she’s not at the CTSI, Holt and her husband (a family physician) spend some of their time performing in the Rochester Medical Orchestra, a group of musicians in the medical community who come together for several concerts a year. Holt (who plays the oboe) founded the group in 2007 with her husband (who plays the clarinet), and the orchestra’s concerts  each year are fundraisers for local medical charities.

Holt’s office will soon be located on the 4th floor of the Saunders Research Building; for now, she’s in the CTSI Director’s Office. Stop by and say hello.

Director’s Update – January 2015

Director’s Update — January 2015

Every month, the CTSI Stories Blog will post excerpts from ongoing conversations with the institute’s co-directors.HarrietKitzman2

Below, Harriet Kitzman, who is stepping down from her post as a CTSI co-director to focus on her stewardship of the institute’s “Collaborations and Services” pillar, reflects on her time as co-director and offers a few thoughts on the institute’s future directions.

Care to share some thoughts on your time as co-director?

Well, I was interested in joining the CTSI because of my commitment to translational science and belief in the need to ensure an interdisciplinary climate that supports it. I was particularly interested in understanding how the CTSI could foster strong relationships between the SMD and the SON and how those relationships could contribute to a vigorous and productive translational science institute. It has been a particularly wonderful opportunity to serve in this role during the changes in NCATS nationally and reformulation of goals and initiatives of the CTSI locally. Thinking about how new goals, structures and processes contribute to the integration of ideas and the development of novel approaches to science and public policy has been rewarding.

How do you think your approach benefited the CTSI?

My background is as a nurse and a scientist who has been conducting clinical trials of developmentally based nurse home visiting interventions of economically disadvantaged women and their infants in the community. Because of this, I bring a perspective that differs from others on the leadership team — one that contributes to challenging and creative dialogues. Have those dialogues created some new ways of thinking about translational science? I’d like to think that they have, but the paths to modified or new conceptualizations in the field are often indirect, not easy to document and even more difficult to declare as evidence that some group/activity has produced change. This is not unusual, for among the best team scientists, it is the integration of the unique perspectives and complex concepts held by individuals with great depth in their respective fields that leads to both subtle exploration and changes in world views and illumination of novel questions and hypotheses.

You’re not leaving the CTSI entirely, of course, but were just reluctant to sign on long term to the next leadership team. You’re still going to head the Collaborations & Services pillar. What should we look for in the future from that pillar?

From the literature and everything we know at this point in time, it’s person to person interactions — one-on-one, face-to-face interactions — that are often informal, but purposeful and centered around critical questions of the day, that are really the nexus for developing teams and team science. Everyone helps in the process of developing connections that lead to the interactions of scientists  by introducing others to people they think might be interested in the same problem. While often invisible to leaders, these connecting activities are a natural outgrowth in a climate where values as well as structures and processes support collaboration in science. So we need to ensure that we have initiatives in place that make those connections easier, and what we’re trying to do within the pillar is to consider collaborations in all initiatives regardless of location — not only those that are more strictly tied to the collaborations pillar. For example, the pilot programs and the educational programs have the potential to incentivize collaboration.

So we want collaborations to become integrated as a theme throughout the structure of the CTSI. Our pillar is primarily the unit that takes the lead ensuring that activities support their development.

Any final thoughts?

Clearly, we’re a institution with a unique set of characteristics: research-intensive, medium-sized, focused, private, and situated in an engaged community and region. But more importantly, collaborations are valued at all levels of leadership internally, and there is a desire to remove barriers that exist. Those characteristics allow for phenomenal flexibility in terms of developing structures and processes to facilitate collaborations and team science. So while we’ll never be the biggest, there’s no reason we shouldn’t be one of the most exciting, future-oriented translational science institutes in the country, one that embraces not only the medical center community but the entire university and community.

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Previous director’s updates:

December 2014  – Karl Kieburtz offers his takeaways from the CTSI all-hands retreat.
November 2014 – Nana Bennett speaks to the expansion of the role of the CTSI’s Community Advisory Council.
October 2014 – Harriet Kitzman discusses the science of team science.
September 2014 – Karl Kieburtz talks about why the CTSI is beefing up its informatics team.
August 2014 – Nana Bennett discusses the new Population Health pillar.
July 2014 – Harriet Kitzman offers her takeaways from the Mini Summer Research Institute.
June 2014 – Karl Kieburtz gives an overview of the CTSI’s six pillars.