The 2022 Annual Research Meeting convened in person for the first time since the start of the COVID-pandemic at the beginning of the month. Gathering in person served as a reminder of the importance of community to collaborate, find research partners, and address pressing issues facing the field.
During the Rockstars of HSR session, board member Alyce Adams said that ARM is “not just a meeting. It’s a community. It’s all of you.” Further, AcademyHealth is more than just the ARM. We promote member research, teach members and partners how communicate their research with policymakers, as well as provide career development to meet the needs of the evolving field.
Building a Diverse Community
The essential work of advancing diversity, equity, and inclusion (DEI) in the field of health services research (HSR) featured prominently across the ARM agenda and in the #ARM22 conversation accompanying the in-person meeting on Twitter. Indeed, the meeting agenda included 53 sessions related to the topic, weaving DEI into everything from research methods to data quality to workforce. In a special session on the 20th anniversary of the Unequal Treatment Report, panelists summarized where we’ve been and emphasized how the report served as an impetus for change at a health system and among a new generation of health services researchers.
Panelist Brian Smedley, equity scholar and senior fellow at Urban Institute’s Health Policy Center Office of Race and Equity Research, outlined the way racism functions at different levels and how those levels augment one another.
“It’s sobering to reflect back on the publication of the report as we’ve made very little progress since then,” he said. “But our ability to have a frank conversation about racism is in itself an important bit of progress.”
Kimberlydawn Wisdom, chief wellness and diversity officer at Henry Ford Health, agreed. She noted how the report sparked the Health Equity Campaign at her health system. This led to an expanded focus on justice as opposed to equality, with additional research on adverse childhood experiences and a focus on trauma-informed care.
“The destination is justice,” Wisdom said. “We have to move from equality – ‘I treat all patients the same’ – to asking ourselves how we are going to remove the institutional barriers to achieving justice.”
Panelist Rachel Hardeman, associate professor of Division of Health Policy and Management at the University of Minnesota, echoed this sentiment and noted that the field must move towards dismantling racism by examining its systemic causes.
“We’ve focused on bad actors and the solution was implicit bias training, but now we need to think about the totality of ways our societies are reinforcing racism in multiple systems from housing to transportation and everything in between,” Hardeman said.
The concept of diverse community also featured in presentations from the 2022 ARM awardees, who emphasized the value of working in teams, communicating with their peers and working to reach broader audiences. Panelists noted that there are people in academia who want to change things to improve policy and health equity, address disparities, and do important research outside of what is typically funded. Cross-disciplinary work is a huge investment and people will offer different perspectives on your research.
For example, M. Kit Delgado described how Penn Medicine’s Center for Health Care Innovation developed a program called COVID Watch in which patients were enrolled in an electronic health program to receive text messages to monitor COVID-19 systems so small teams of nurses could manage thousands of patients. Text message data could then be analyzed to monitor health outcomes and reduced mortality by an estimated of 68 percent. There have been no barriers to enrollment, which bolsters equity and enables patients to get treatment faster. “It took a village,” Delgado said, noting how it required considerable time and investment by others.
Timely and Accessible Research
Awardees at the Rockstars of HSR sessions also noted that for research to carry weight in the field, the word must get out. Specifically, using social media proactively to ensure your work reaches broader audiences. Throughout the closing plenary, Connecting Science, Management, and Policy for More Timely and Relevant HSR, panelists echoed this idea; Research has to be communicated outside of academia. This can be done using Twitter, press releases, quotes, bylines in the media, direct communications with policymakers, and more. All while being accessible in terms of language and reading level, with a clear story to tell. This often involves publications that don’t count towards peer review, so the field needs new ways to measure engagement and effectiveness of dissemination.
Throughout ARM, we asked attendees at the AcademyHealth booth to share the challenges they face when communicating their research for impact, many wanted to learn how to communicate so the general public would understand their work, translate academic publications into community and policy change, and ensure their findings would reach key stakeholders. AcademyHealth is currently working to address this need in the field. Stay tuned for more learnings on this topic, coming this fall.
Health worker burnout is an issue for everyone, Surgeon General Vivek Murthy said during his fireside chat at the closing plenary of ARM. As doctors and nurses exit the workforce, care delivery worsens because of lack of capacity. Like most complicated problems, there isn’t one way to address it.
“This is one of those times where we have to work on multiple fronts,” Murthy said. “Private payers will need to step up.” Public health and health systems will need to be better funded and work together. “If we don’t use this moment to finally address work burnout, we will not be prepared for the next public health emergency and we will lose people,” he said.
We always think about the people at the top of the pyramid, Murthy noted, referring to frontline providers such as doctors and nurses. But the needs of part-time staff, janitorial staff, pharmacists, and public health workers also need to be considered. “It’s an invisible field,” he said. And these positions are more likely to be staff by Black, Indigenous, and people of color (BIPOC) and women who make an income below the poverty line and lack health insurance.
There is also an issue with workflow within systems; people went into this workforce to spend time with the patients and deliver care, but many health workers find themselves burdened with paperwork, managing records, and billing than over focusing on patient care.
Teamwork is critical, he concluded. There are many opportunities for people to get to know each other, work across disciplines, and provide support to combat loneliness in the workplace and improve care.
Continue to follow the AcademyHealth blog for more summaries of discussions from the 2022 Annual Research Meeting.