Although it may seem that COVID-19 has only thrown up barriers to improving health care value, the pandemic has also created new opportunities to improve the quality, equity, and value of our health care system. In particular, the pandemic has highlighted both the need for, and incredible potential, of greater collaboration between health system leaders and researchers to evaluate and learn from transformation efforts. Both health system leaders and researchers are facing unique pressures in the current COVID-19 environment. Health systems leaders must maintain overall quality and safety, while caring for incredibly sick patients suffering from a disease that the health care field is still struggling to fully understand. Meanwhile, researchers are struggling to align their own research timelines with health system’s leaders needs for fast and reliable interventions. These challenges may be weighty, but they are not insurmountable—especially if health systems leaders and researchers work together. The opportunity exists today to bring together health systems leaders and researchers in partnerships that can support health systems in evaluating their adaptations to COVID-19 in the short-run, and in the long-run, guide them through relevant, timely evidence to provide high value, equitable care to patients.
In October 2020, the AcademyHealth, the ABIM Foundation, and the Donaghue Foundation Research Community on Low-Value Care brought together 35 stakeholders representing health system leaders, researchers, and patients to discuss how to build and sustain successful partnerships between health system leaders and researchers. Although meeting participants identified and discussed various approaches to developing and maintaining such partnerships, a few considerations stood out as key to success. Namely, alignment of priorities and timelines, a patient-centered approach, and learning from existing collaborations all contribute to fruitful and lasting partnerships focused on providing high-value, equitable care.
Alignment of Priorities and Timelines
Researchers and health systems leaders need to align their frequently divergent priorities and timelines in order to develop successful partnerships and provide real time, translational research opportunities that can drive changes in practice. In general, health systems leaders need to prioritize patient experiences and outcomes while managing with razor-thin budget margins. Moreover, health systems leaders need to be able to pivot quickly to address emerging health concerns, such as COVID-19. Researchers, on the other hand, typically operate with longer timelines and may prioritize research topics that guarantee publishable results, rather than topics focused solely on patient experience, for example. As a result of this misalignment, researchers often produce results that may not directly benefit health systems, and health systems leaders may be unable to implement the findings of researchers.
When timelines and priorities are aligned, however, researchers can provide health systems leaders with the answers they need to deliver high-value, equitable care, and health systems leaders can quickly translate research results into practice. There are a number of ways to achieve such alignment, but one notable model is the embedded research model, wherein researchers are embedded in a health system and work in concert with health system leaders. Working together, as opposed to in parallel, requires both researchers and health systems leaders to change their perspectives to align with each other’s, and to be meaningfully involved in each other’s work. We must invest in systems that incentivize collaboration, help researchers to understand the challenges facing health systems, and give health systems leaders the answers they need when they need them.
A Patient-Centered Approach
A patient-centered approach is critical to establishing meaningful partnerships between health systems leaders and researchers. Our current system for research and health care delivery in many ways de-emphasizes patient needs and perspectives by creating hurdles for health systems to capture their patient’s viewpoints on their needs, preferences, and experiences with care. By working together, systems leaders and researchers can effectively engage patients and turn their innovative ideas and feedback into higher-value care by removing the above hurdles and increasingly, including engaging patients as part of multidisciplinary research and implementation teams.
COVID-19 has underscored the progress that can be achieved when health systems and researchers, together with patients, come together and focus on creative ways to deliver the best possible care to patients. During the meeting, one patient partner spoke specifically about the value of patient voices during the early days of the pandemic in allowing patients to give blood once and giving different health care providers access to the results. Cross-disciplinary teams comprised of researchers, health systems leaders, and patients will be the best way to ensure that patient insights are recognized and utilized to improve care delivery structures. Patient outcomes must be at the heart of any healthcare system overhaul, and researcher-health system leader partnerships are no exception.
Developing Champions among Health Systems Leaders and Researchers
Given the significant investment and mindset shifts required of both health systems and researchers to establish meaningful partnerships, it is likely that members of each community may be apprehensive to embark on partnership journeys. Even individuals who understand the value of partnerships and want to pursue them may lack the information and connections necessary to start the process. It is therefore imperative that researchers and health systems leaders who already understand the value of partnerships use their knowledge and influence to promote the benefits of partnerships. As was mentioned frequently at the meeting, partnerships can take a variety of forms and exist in a range of health systems, not just in very well-funded systems. Peer-to-peer networking can promote the importance of these partnerships, with the ultimate goal of increasing our understanding of how researchers and health systems leaders can best provide high-value, equitable care to patients.
Although COVID-19 has caused so much pain and loss, the potential for successful partnerships between health systems leaders, researchers, and patients to achieve high-value, equitable care remains a reality. This knowledge will be critical as we move forward from the pandemic and reimagine our healthcare system as well as the relationship between research and health system transformation. While further work is needed to evaluate the specific benefits of various partnership models, one thing is clear: the way out of this pandemic, and to achieving high-value, equitable care, is together.