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That's a Wrap! A Look Back at This Year's D&I Plenaries

The 10th Annual Conference on the Science of Dissemination and Implementation in Health (D&I), co-hosted by the National Institutes of Health and AcademyHealth centered on the theme, A Decade of Progress and the Path Forward.

More than 1,100 attendees convened in Arlington, VA, earlier this week to bridge the gaps between research, practice, and policy in health and health care. Reflecting on the accomplishments of and challenges to the field, and focusing on the opportunities ahead, this year's D&I Conference program included four dynamic plenary sessions. Read on for summaries of each.  

What is the Minimum Level of Evidence Needed to Implement?

Moderator: Jeremy Grimshaw, Ottawa Hospital Research Institute
Panelists:  Austin Frakt, Boston VA Healthcare System; Mark Helfand, Oregon Health & Science University; Trish Riley, National Academy for State Health Policy; Melissa Simon, Northwestern Medicine

This opening plenary panel addressed how D&I research can inform health policy and the important role that researchers play in working with different stakeholders to identify not only the evidence needed, but the mechanism(s) for generating such evidence. Melissa Simon of Northwestern Medicine spoke about a “team approach” to identifying the right evidence, in which all stakeholders, including funders, scientists, patients, advocacy groups, leaders, health systems, and more have a seat at the table. Throughout the discussion, several panelists stressed the importance of researchers and policymakers getting on the same page, “becoming a family,” speaking a similar language, and asking the right questions.

Prompted by a question from moderator Jeremy Grimshaw of the Ottawa Hospital Research Institute, the panel delved into a discussion on the strength of evidence needed to justify the implementation of programs/initiatives to improve specific health outcomes. In a response to a question about working with policymakers, Trish Riley of the National Academy for State Health Policy said that even if the evidence is "mushy but hopeful," it is important to work with policymakers to establish guideposts so that there is continuous progress. Mark Helfand of Oregon Health & Science University stressed that in cases of non-national implementation recommendations, the standard of evidence does not need to be as high as the standard for national implementation, allowing for more implementation opportunities at the local/state levels.

The panel took a variety of audience questions, including one about the role of electronic health records (EHR) in improving evidence generation for implementation. Austin Frakt of the Boston VA Healthcare System noted the challenges researchers face in using big data due to issues with interoperability.

Achieving Health Equity: The Role of D&I Research

Moderator: Ross Brownson, Brown School and School of Medicine, Washington University in St. Louis
Panelists:  Theresa Betancourt, Boston College School of Social Work; Lisa Cooper, Johns Hopkins Center for Health Equity - Johns Hopkins University Schools of Medicine and Bloomberg School of Public Health; Irene Dankwa-Mullan, IBM Watson Health; Uche Uchendu, U.S. Department of Veterans Affairs

During this plenary session, Theresa Betancourt of Boston College School of Social Work discussed challenges in setting up evidence-based mental health intervention programs for youth in global conflict areas. Betancourt mentioned the value in both understanding what works for whom under what conditions, and to getting buy-in from key stakeholders in underdeveloped and underserved areas.

Addressing the aspiration of achieving health equity, Lisa Cooper of Johns Hopkins Center for Health Equity shared the importance of intervening on multiple levels and sharing global lessons. Irene Dankwa-Mullan of IBM Watson Health addressed the role of new technologies, including artificial intelligence, to help reduce disparities in health care.

Concluding the presentation, Uche Uchendu of the U.S. Department of Veteran Affairs, highlighted the National Veteran Health Equity report, which breaks down veteran health data by demographics; this information is used to acknowledge disparities and improve health equity for veterans.

The Next Generation of D&I Research

Moderator: Lisa Simpson, AcademyHealth
Speakers: David Atkins, University of Washington; Deborah Cohen, Oregon Health & Science University; Ross Hammond, Brookings Institution; Cara Lewis, Kaiser Washington Health Research Institute

AcademyHealth President and CEO, Lisa Simpson moderated this Tuesday afternoon panel session. During the session, participants discussed strategies D&I researchers can use to optimize the use of methods, measures, and technologies to yield high quality, high impact studies. Ross Hammond of the Brookings Institution detailed his three themes guiding the next generation of D&I research, they include the importance of context, the need to consider both the short-run and long-run consequences of interventions, and the use of complex systems models for adaptation and addressing potential intervention consequences.

Cara Lewis spoke about how the field’s best methods are not always picked up in the real world, and that we need to do a better job engaging stakeholders and bridging the gap between D&I science and practice. Deborah Cohen spoke about the importance of partnerships in leveraging best practices to create sustainable health and learning infrastructures.

Tackling technology, David Atkins spoke of the incredible growth and potential of new technology to transform health care. He acknowledged the point of tension between technology and health care but concluded that implementation scientists are well positioned to tackle technology for the benefits of implementation. 

Prompted by a question by Lisa Simpson of AcademyHealth regarding the complexity of data, the panel was in consensus that big data is not always good data, and that it’s important to figure out what questions need to be asked first before we determine what data we need.

Reflections on the Impact of a Decade of Research

Moderator: David Chambers, National Cancer Institute

Speakers: Jeffrey Brenner, United Healthcare; Russ Glasgow, University of Colorado School of Medicine; Enola Proctor, Washington University; Darshak Sanghavi, OptumLabs

In the final plenary session, the panel reflected on the impact that D&I research has made and how we can maximize the value of research. Dr. Enola Procter acknowledged that there are four challenges facing D&I research, including making Implementation evidence-based, deepening the field and our knowledge through specialization, speeding translation by accelerating innovation and implementation, and demonstrating our value-added impact systems wide.

In reference to new technologies, facilities, and platforms, Dr. Jeffrey Brenner of United Healthcare acknowledged that it’s easy to try to do too much and build too quickly. Dr. Brenner stressed that with the rising cost of health care, it’s important that we figure out how we appropriately apply brilliant technology to improve health care delivery.

Darshak Sanghavi of OptumLabs acknowledged that because of D&I science, we now have the ability to look at phenomenal ideas that are “on a shelf” and select which ones we want to expand. Dr. Sanghavi noted that, unfortunately, data does not speak on its own, and Implementation science needs champions for ideas, and people to continue to push ideas and action aggressively.

Reflecting on the “tremendous progress” made in the field, Dr. Russ Glasgow of the University of Colorado School of Medicine spoke about how D&I science is now accepted as a legitimate science, the field is taking stakeholder engagement seriously, and we are currently training the next generation of the D&I workers.

Responding to a question by moderator David Chambers of the National Cancer Institute about the state of the field, Dr. Proctor said that, “we’ve done a really good job of getting our house in order,” but that the field as much work ahead.

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