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In This Issue:
BWH's John Ayanian (background, seated) leads a discussion on health services research, hosted by the BWH Center for Surgery and Public Health.
When you hear the word 'research,' do test tubes and microscopes come to mind? Today, investigating medicine's mysteries, especially in the clinical field, extends beyond laboratories and into the emerging data-driven landscape of health services research.
John Ayanian, MD, MPP, of BWH's Division of General Medicine, is an expert in health services research-a relatively young science that analyzes large, complex databases to study how people access health care, costs of care and what happens to patients post-care. "Big data" refers to the databases studied. Last month, the BWH Center for Surgery and Public Health (CSPH) invited Ayanian to speak to its faculty about new directions in health services research-as the center prepares for its next phase of growth under health care reform.
Health services researchers compare and assess health care quality, costs and access by studying data collected by organizations such as the Centers for Medicare and Medicaid Services, Agency for Healthcare Research & Quality, and American College of Surgeons Surgical Quality Improvement Program. Ayanian believes the next stage of health services research will be finding appropriate, secure ways to link these databases with data from electronic medical records, such as the Partners Research Patient Data Registry. A key element to achieving this is collaboration with health systems, doctors and other providers.
"Speaking as a primary care physician, we serve our patients well when we collaborate effectively with specialists," said Ayanian. "My vision is that electronic medical records will help us collaborate better and allow us to do more in-depth health services research."
Ayanian also envisions big clinical research databases and electronic medical records enriched with information reported by patients themselves, such as health measurements sent via mobile devices or the Internet.
Event moderator Joel Weissman, PhD, CSPH's deputy director and chief scientific officer, is working with Ayanian on a study using big data. The NIH-funded project will merge Massachusetts All-Payer Claims Database (APCD) with the Massachusetts Cancer Registry to investigate variations in the quality and costs of care for patients with cancer in the state. They hope to help Massachusetts make this merged database a resource that can be used by other researchers in the future.
"The future of comparative effectiveness research is in the promise of big data-that is, the ability to link large clinical databases with larger administrative databases, such as health insurance claims," said Weissman.