Malaz A. Boustani, MD, MPH

Over the past decade, I have mastered skills in health care delivery science, public health, innovation, and implementation science. I have used these skills to build in 2009 a Clinical Aging Brain Care Learning Laboratory in central Indiana; launched in 2013 the Indiana University Center for Health Innovation and Implementation Science (CHIIS); and created in 2015 the Great Lake Practice Transformation Network. Over 48 months and under my leadership, the Great Lakes Practice Transformation Network leveraged the intellectual capital of 30 organizations and 8 universities to support the clinical transformation of more than 13,000 clinicians across the five states of Illinois, Indiana, Michigan, Kentucky, and Ohio with a $17 return on every $1 investment from Center for Medicare and Medicaid Services. In 2015, CHIIS launched Graduate Certificate in Innovation and Implementation Science, the first in the nation. This Graduate certificate (www.hii.iu.edu) aims to support the development of cadre of interdisciplinary transformational change agents who are skilled in the tools of Agile Innovation, Agile Implementation, Agile Analytics, and Agile Diffusion. 

The specific focus of my clinical research work is improving the brain health and the brain care quality at lower cost for older adults suffering from dementia or delirium in both inpatient and outpatient settings.  My studies have included patient surveys, development of new clinical assessment tools, testing of new treatment models, and implementing such models in a very rapid, scalable, and sustainable way.  My most important methodological contribution to research in this area has been my application of complexity science to the vexing problem of improving the performance of health care providers and health care systems.  My most important clinical care contribution to date has been my work elucidating the role of total anticholinergic load and anticholinergic medications in the development and clinical course of dementia and delirium.  My most important policy contribution has been my research on understanding the risks and benefits of routine screening for dementia. 

Since joining the faculty at Indiana University I continuously broke down the wall between the research laboratory and the clinics. Within less than two years from publishing in 2007 our landmark randomized clinical trial paper in JAMA demonstrating the efficacy of the collaborative dementia care model, I used the tools of Implementation Science to translate the model into a second-generation memory care clinic within the Eskenazi health system. This Healthy Aging Brain Care clinic is now in its 12 year of operation and has reduced the severity of the behavioral and psychological symptoms of more than 5,000 patients suffering from mild cognitive impairment or various dementing illnesses. In addition, the clinic has reduced the burden of the family caregivers, generated an annual net saving of close to $3,000 per patient, and facilitated the recruitment of more than 500 subjects into clinical trials.  In 2009, I led the conception, design, and staffing of the Aging Brain Care-Medical Home program which serves as a population health management and care coordination program serving the needs of older adults with dementia, mild cognitive impairment or depression, cared for in primary care clinics.  The ABC Medical Home was led by a part time medical director who was supervising two interdisciplinary teams of nurses, social workers, and care coordinator assistants working in collaboration with the patient’s primary care physician.  This Medical Home has demonstrated both improved quality of care and reduction in acute care utilization.  The Healthy Aging Brain Care clinic and the ABC Medical Home program represent clinical translations of our research findings and at the same time offer new venues for novel clinical research.  

Geriatric Medicine and Brain Health