Lisa speaking at the 2018 Annual Research Meeting

It is hard for me to believe that 13 years have passed since I began as President and CEO of AcademyHealth. As I reflect on my time as President and CEO and prepare to welcome Aaron Carroll to the role next week, I am both pleased at the progress we have made and humbled at how much more needs to be done to truly advance evidence into policy and practice. I have learned so much along the way, and I will be forever grateful for the opportunity to work with so many talented colleagues and collaborators. 

Every step of my career prepared me for this role, and each informed my approach to leading and advocating for this field. From generating evidence to advance better policy for children’s health and services to working to apply that evidence in federal and state policy and programs, and from serving in leadership at the lead federal agency for health services research to advocating for funding, I came to AcademyHealth passionate about our mission and well versed in the opportunities and challenges of our field. As I step down to reflect and refresh, I want to leave you with some reflections from my time as President and CEO and highlight some areas of impact that require our ongoing commitment.

Health Services Research (HSR) Must Continue to Move Toward Solutions and Implementation 

Thanks to decades of HSR findings, we have learned the “epidemiology” of care – who does and does not get health care and its safety, quality, outcomes, and costs. We have come to understand better the root causes of these patterns and the profound links to economic and social factors. However, we have made far less progress actually using this knowledge to develop, test, and implement effective policies, programs, and services. AcademyHealth's mission always energizes me because it focuses on action; on supporting our field to have an impact. Through our state networks, learning communities, and partnerships AcademyHealth is continually developing better ways to support the use of evidence. This is important work that needs sustained investment of time, talent, and resources.

The Journey Toward Diversity, Equity, Inclusion and Accessibility Must Continue Apace 

I published my first paper documenting disparities during my post-doctoral program at the Institute for Health Policy Studies in 1991. Despite many studies since then, it is only in recent years that I have begun to fully grasp how limited many of our dominant research frameworks and methods are in supporting truly actionable and equitable HSR. For me personally, it has been an area of growth and continued learning. As a field we must do better. AcademyHealth has made a public commitment to driving this work forward. An integral part of our success will be how welcoming our broad community is to differing voices, perspectives, and ways of knowing. Addressing systemic challenges requires effective, systemic responses. From our methods and data, to training and workforce development, incentives, narratives, and funding, the work of DEIA must continue at every level of our field. Understanding the complexity of these commitments and the need to uplift what works, AcademyHealth recently launched a new award to recognize organizations or teams that have created a more diverse, inclusive, just, and welcoming experience and sense of community for their employees and/or members.

Data and technology are transforming society, health care and science

Each day brings a new report on how the “fourth industrial revolution” is affecting our daily lives. Less well chronicled – and understood – are the fundamental shifts that are occurring in science. The growth in data from electronic health records has led to many new insights into patient outcomes and this is now being further expanded by a flood of patient reported data from wearables and other applications. Advances in generative AI over the last 18 months are enabling efficiencies in research conduct while also presenting ethical challenges at each step of the research process. The pace of improvement in these AI models is no less than mind-boggling yet research remains a slow and deliberative process. Can the field of HSR keep up? I think HSR has two important roles to play: first, in evaluating the impact of new data and technology on health, care, and equity and second, in using these new tools to improve the relevance, speed, and quality of HSR itself. AcademyHealth has an important role to play here.

Every system is perfectly designed to achieve the results it gets 

While this is an adage I learned from quality improvement, it aptly describes one of the challenges of HSR. Our field is an applied one and should be more directly linked to measurable improvements in care and health. Yet, researchers are not rewarded for impact, for patient engagement, or for community based participatory research as much as they are for publications and more funding. We must move the incentives toward social impact – and the biggest incentive is money. Federal research funders, including the National Institutes of Health (NIH), the Patient Centered Outcomes Research Institute, the Agency for Healthcare Research and Quality, and the Veterans Administration Health Services Research Program have a critical leadership role to play, and can affect significant change through their funding practices. Each has launched initiatives to drive implementation and impact, yet the proportion of total funding on these is small compared to total research funding. This must change. 

The context for our work has become more challenging

 When I came to the nation’s capital for my first policy job (working on health reform in the Clinton administration), I quickly learned that the national policy community is rich with experts and knowledgeable individuals eager to use evidence and work together to improve health and health care –even if they disagree on the most appropriate policy solutions. As Senator Daniel Patrick Moynihan once famously said, “You are entitled to your opinion. But you are not entitled to your own facts.” Sadly, this has changed dramatically. 

Misinformation and disinformation have become commonplace in policy debates and trust in science and institutions has eroded. Polarization in our political and public discourse has further weakened our ability to come together and develop solutions. It is in this environment that AcademyHealth’s nonpartisan stance is essential. We advocate for our field and its ability to do its work effectively through more funding and better research policies but do not take political positions on critical health policy topics (e.g. the Dobbs decision reversing Roe v Wade, the Medicaid unwinding). I’ll admit that distinction has been difficult to hold at times, particularly as policy decisions exacerbate existing inequities and challenge our mission to improve health and health care for all. Into this challenge, AcademyHealth and the field it represents must continue to lead with evidence, educate for understanding, and strive to inform policy debates in nonpartisan, mission-aligned ways. 

Finally, I want to thank all of you for being part of this ride. The membership, sponsors, supporters, and most importantly, our staff have made the last 13 years among the most fulfilling of my career. Working together with you has been an honor and a privilege. 

I leave AcademyHealth proud of the work we have done together and confident in its future. You can always find me on LinkedIn. Please stay in touch!

Blog comments are restricted to AcademyHealth members only. To add comments, please sign-in.