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Developing an Institute for Health Care Delivery Science: successes, challenges, and solutions in the first five years

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Abstract

Medical knowledge is increasing at an exponential rate. At the same time, unexplained variations in practice and patient outcomes and unacceptable rates of medical errors and inefficiencies in health care delivery have emerged. Our Institute for Health Care Delivery Science (I-HDS) began in 2014 as a novel platform to conduct multidisciplinary healthcare delivery research. We followed ten strategies to develop a successful institute with excellence in methodology and strong understanding of the value of team science. Our work was organized around five hubs: 1) Quality/Process Improvement and Systematic Review, 2) Comparative Effectiveness Research, Pragmatic Clinical Trials, and Predictive Analytics, 3) Health Economics and Decision Modeling, 4) Qualitative, Survey, and Mixed Methods, and 5) Training and Mentoring. In the first 5 years of the I-HDS, we have identified opportunities for change in clinical practice through research using our health system’s electronic health record (EHR) data, and designed programs to educate clinicians in the value of research to improve patient care and recognize efficiencies in processes. Testing the value of several model interventions has guided prioritization of evidence-based quality improvements. Some of the changes in practice have already been embedded in the EHR workflow successfully. Development and sustainability of the I-HDS has been fostered by a mix of internal and external funding, including philanthropic foundations. Challenges remain due to the highly competitive funding environment and changes needed to adapt the EHR to healthcare delivery research. Further stakeholder engagement and culture change working with hospital leadership and I-HDS core and affiliate members continues.

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Acknowledgements

We acknowledge Jeremy Boal, MD, President of Mount Sinai Downtown and Executive Vice President and Chief Clinical Officer of the Mount Sinai Health System. He was the Associate Director of the Institute for its first three years and was instrumental in its initiation and growth. We also recognize the I-HDS Internal Advisory Board (IAB), which comprises Dean Dennis S. Charney and the Presidents, Chief Medical Officers, and Chief Nursing Officers from the Mount Sinai Health System’s seven hospitals, and the chairs/vice chairs/directors of all collaborating departments and Institutes. We thank our External Advisory Board: Peter R. Orszag, PhD, Vice Chair, Corporate and Investment Banking, Citigroup, Inc.; Patricia Wang, JD, Chief Executive Officer, Healthfirst, Inc.; Isaac Kohane, MD, PhD, Co-Director, Center for Bioinformatics, Henderson Professor of Pediatrics and Health Sciences and Technology, Harvard Medical School; and Gregory L. Burke, MD, MSc, Senior Associate Dean for Research and Chief Scientific Officer, Wake Forest Baptist Health. We acknowledge all members of the I-HDS: Umut Ozbek, PhD, Denise Williams, BS, Jiayi Ji, MS, Lihua Li, MS, PhD, Erin Moshier, MS, Liangyuan Hu, PhD, Rachel Jia, PhD, Jung-Yi (Joyce) Lin, MS, Meng Ru, MS, Xiaoyu Song, PhD, Hsin-Hui (Vivien) Huang, MS, PhD, MD, Himanshu Joshi, MBBS, PhD, and Serene Zhan, MS. Finally, we thank our collaborating clinical departments, centers, and institutes for their support.

This work was supported in part by the National Cancer Institute (P30 CA196521);

The National Heart, Lung, and Blood Institute (U01 HL088942); and the National Institute of Aging (P30 AG028741 and P30 AG028741- 09S1).

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Authors and Affiliations

  1. Institute for Health Care Delivery Science, Center for Biostatistics, Department of Population Health Science and Policy, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA

    Madhu Mazumdar

  2. Institute for Health Care Delivery Science, Departments of Population Health Science and Policy, Medicine, and Orthopedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Jashvant V. Poeran

  3. Institute for Health Care Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Bart S. Ferket, Nicole Zubizarreta, Parul Agarwal, Ksenia Gorbenko & Xiaobo (Tony) Zhong

  4. Institute for Health Care Delivery Science, Department of Population Health Science and Policy, Clinical Informatics Group, Information Technology, Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Catherine K. Craven

  5. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Alan J. Moskowitz & Annetine C. Gelijns

  6. Mount Sinai Hospital, Mount Sinai Queens, New York, NY, USA

    David L. Reich

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Mazumdar, M., Poeran, J.V., Ferket, B.S. et al. Developing an Institute for Health Care Delivery Science: successes, challenges, and solutions in the first five years. Health Care Manag Sci 24, 234–243 (2021). https://doi.org/10.1007/s10729-020-09521-5

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