HEAL-R’s use case research projects are practical investigations in health care designed to tackle real-world scenarios and challenges. Awardees received $225,000 in funding for three year projects that analyze specific health care scenarios using data and research methods, ultimately enhancing health care practices. These projects serve as crucial bridges between theory and practice, leading to significant improvements in patient access, experiences and outcomes.
| Project | Principal Investigator | Objective and Deliverable |
|---|---|---|
| Access | ||
| P2P Qualitatively comparing Access, Experience & Trust through narratives from diverse Hoosiers |
Bernice Pescosolido, PhD, and Hank Green, PhD |
The health system lacks an infrastructure to engage community members about their day-to-day health needs and experiences in healthcare. The CTSI’s P2P initiative, launched as a part of the IU Grand Challenge, collected data from a representative sample of Hoosiers across the state to explore population health needs. We will compare the concerns and experiences voiced by Black and Latinx respondents and then compare it to zip code matched White respondents to determine if barriers to care are similar or different among these populations. Secondarily, interviews will be conducted with participants of color to explore trust and accessibility of IU Health as an institution. |
| Addressing social determinants of health among children with sickle cell disease |
Seethal Jacob, MD |
Children with sickle cell disease and their families often must choose among competing social needs that might hinder adequate access to clinical care and negatively impact health outcomes. By screening for social needs and offering services to help address these needs, children with sickle cell disease will have improved healthcare access and health outcomes. We aim to screen for psychosocial and mental health needs using validated measures (PAT, PHQ9, PedsQL) to identify patients and families that would benefit from community based resources and mental health services. |
| A culturally tailored intervention to facilitate more timely and equitable access to Hepatocellular Carcinoma (HCC) curative therapies |
Lauren Nephew, MD |
Black patients are less likely than White patients to receive curative liver directed therapies and more likely to die from the disease. Disparities in HCC survival is multifactorial, resulting from interactions between a patient’s disease and the social and structural determinants of health (SSDOH). This study aims to develop a culturally tailored, multifaceted disparities intervention (HCC-EduLink) that addresses patient and system level SSDOH barriers to facilitate access to liver directed therapies for HCC; then test the acceptability, usability and ultimate effect of the HCC-EduLink intervention on time to and receipt of liver directed therapies for HCC. This will result in a culturally tailored education tool for use in clinical care settings. |
| Experience | ||
| Health Equity Talk Research Project – establish an empirical basis for the communicative practices and skills physicians and patients use to advance health equity |
Francesca Williamson, PhD |
The IU GME team has developed modules to train IU residents in Health Equity Communication strategies, which are humanizing communicative strategies that foster psychological safety and coordinated participation in striving toward good health. Using Conversation analysis, this study aims examine how resident physicians and patients talk about health equity clinical encounters efforts, by transcribing and analyzing these encounters to characterize various practices and circumstances in which physicians and patients talk about health care disparities, and track the potentially positive (e.g., empathy) and negative (e.g., microaggressions) consequences of various communicative practices. The empirical findings can contribute to developing a novel, practice-based measure of health equity in clinical settings. |
| Does Diversity Create Externalities? |
Kosali Simon, PhD |
A fair amount of research has shown that diversity is important for health care utilization and health outcomes for Black Americans. This study aims to test whether there are spillover effects of diversity on the care of those not treated directly by diverse staff. Focusing on the emergency department, where the quasi-experimental variation is more credible, the team will study issues of timeliness, appropriateness, and disposition of care in relationship to the demographic make-up of the healthcare team members (i.e., residents, attending, nursing). |
| Outcomes | ||
| Pre-eclampsia screening/treatment and maternal mortality |
Angela Campbell, PhD | Pre-eclampsia is a preventable cause of maternal morbidity and mortality and yet quality metrics in screening and differences by race/ethnicity and insurance status are not monitored. This work will yield increased screening and treatment of mothers with pre-eclampsia. |
| Development of disparity quality performance measures |
Paul Dexter, MD, and Titus Schleyer, PhD |
The study aims to efficiently screen for health care disparities in the ordering of diagnostic and therapeutic interventions across IU Health using routinely captured electronic health record (EHR) data. This team aims to deliver a targeted list of proposed disparity-related quality performance measures that could be readily adopted by other institutions. |
| Transitions in Care: Improving Equitable Referrals |
April Savoy, PhD |
The study will design and assess a novel user interface for HIE that facilitates communication of follow-up plans from cross-institutional referrals. With an iterative design process, referrers and consultants will codesign user interfaces. Then pilot the new user interface at IU Health to evaluate whether it improves referrers’ efficiency and satisfaction with notes from cross-institutional referrals. The trial will compare efficiency and satisfaction of the two interfaces via established usability measurement tools, including the System Usability Scale. This project aims to develop new user interfaces that improve HIE and efficiency of clinical workflows, and yield results that inform the design and integration of HIE and physician-facing technologies into clinical workflows, to complete referrals and improve diagnostic processes. |