It goes without saying that we are living in unprecedented times. We are now over a year into what we all hope is a once in a lifetime pandemic, and we are therefore gathered here together - virtually - for the second ARM in a row. I, for one, miss catching up with my colleagues from all over the country and the world, and look forward to returning to what we all anticipate will be a changed version of normal in the coming months and years. 

There are signs of hope around the corner. Vaccine rates are up, and infection rates are down here in the U.S., though COVID-19 remains an existential threat in many areas of the world, and we should not minimize the very real trauma and disruption the pandemic continues to cause around the world. 

Meanwhile much of the U.S. continues toward reopening plans and contemplating what our future work life will look like, this seems like a good time for us to take a step back and think about how what we learned over the past year should impact our field going forward.  

As Lisa has mentioned in her opening remarks, even prior to the pandemic, it had become clear that there are serious challenges to the way that we in health services research have traditionally financed, conducted, and published (or disseminated in other ways) our research. These challenges require a major rethinking of how we do things and how we can potentially do our work better and faster in the future to produce timely evidence that can inform policy and practice and, ultimately, improve population health. 

And to be clear, these are issues that AcademyHealth has been grappling with for the past several years, in particular through the Paradigm Project, which hopefully will soon produce results and recommendations that help move our field into the future. Creating a new normal is crucial if we in the field are going to continue to fulfill our mandate to provide the best evidence to improve the functioning of our health care system, and to do so in a way that addresses issues of profound importance – such as how we can deliver the best possible care, at the right time, and in the right place, with fewer errors and greater equity and affordability for all?

And, critically, we are now in a time when government and policy makers may be more receptive to the kind of evidence that we as health services researchers produce. Nonetheless, significant parts of our society remain emmeshed in echo chambers that ignore or reject evidence. We cannot be complacent.

I see a number of challenges that we as a field need to deal with in the coming years to achieve our mission and promise.

First, AcademyHealth has been focused on the area of science innovation as a critical challenge for our future. There are tremendous opportunities for innovation. For example, the funding models that support health services research have become a poor match for the work that needs to be done in our field. Evidence is needed when policy makers are grappling with decisions, and a model that often takes two or three years from the inception of a research idea to the start of its funding, at least for Federal grants, is not workable or useful. We must innovate around the ways we fund our work.

Moreover, we have to remember that though our field includes many traditional researchers in the academy, the nature of HSR is moving quickly and now includes a broad community of researchers beyond those in traditional academic settings. We are privileged to count among our ranks embedded researchers in systems such as the VA and Kaiser, as well as professionals in technology companies such as Google and Apple who are harnessing new tools and data sources to produce research at an accelerating pace. We have to innovate our tools and methods to keep pace. It should come as no surprise that among the goals that AcademyHealth adopted as part of its most recent strategic plan is the embrace of innovation, technology, and other societal trends to advance and inform new and relevant evidence to achieve health improvement for all. Certainly, the ways in which our field needs to evolve to meet this goal are just beginning to be defined.   

The pandemic that caused us to change the way that we approach and conduct our work has also taught us to leverage technology to effectively continue our work.  In many ways, it has even enhanced our productivity. But unanswered questions remain about what our field will look like in the future and how these new work patterns will impact creativity and workplace culture. I suspect that more of our work will remain virtual than it has in the past, and that this is probably a good thing, but we also have to adjust to this new normal in a way that still allows for the creative spark that emerges from face-to-face, human contact. We need to innovate around the way we organize our workplaces and teams, the technology we use, and the ways we connect.

Second, the ways in which HSR is disseminated and achieves impact are evolving rapidly. The use of social media and other non-traditional channels to promote our work and get it in front of the right decision makers is growing. I have to admit this is not an area where I have excelled. Nevertheless, the academy must also change and expand the ways in which research is evaluated for the purposes of promotion and even for funding decisions. Impact is about much more than getting your paper published in a top tier journal, and the field has to embrace these new modalities and adapt to maximize their use over time. Of course, the next generation of researchers is already doing a much better job at this than some of the more senior people in the field.  

Finally, this past year has shined a light on deep seated issues stemming from systemic racism and how this impacts the ability of the health system to achieve the outcomes we so desire. Though this problem extends far beyond what AcademyHealth can impact, we as an organization have recognized the importance of diversity, equity and inclusion within health services research, including within our workforce, the data we use, and our standards of practice. As one of our key strategic foci, we have made efforts to develop and sustain a diverse workforce a centerpiece of our strategic plan. AcademyHealth has long had a large and active disparities interest group and a Center for Diversity, Inclusion and Minority Engagement. Recently, we also convened a national expert advisory group this year to help us develop our future policies. We are also looking inward to assess the performance of the organization in this area as well as outward as we try to work with our members and partners to be an advocate and lever for progress.  

As I mentioned at the start of my remarks, this year’s ARM is taking place at an unprecedented time, both with respect to the global pandemic, but also among the related challenges and opportunities facing our field. As we look to the next few years, I want to highlight the continued importance of the work we do in providing the evidence base for policy makers and implementers to build upon when making decisions that impact the health and lives of millions. 

Fortunately, this year's rock stars are already setting a stellar example of the contributions that we in health services research aspire to, and I again want to extend to them my deepest congratulations. 

Bruce Landon headshot

Bruce Landon, M.D., M.B.A., M.Sc.

Professor - Harvard Medical School AcademyHealth Board Past Chair

Bruce E. Landon, MD, MBA, MSc, is a professor of health care policy at Harvard Medical School and a professor ... Read Bio

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