2019 Project Archive

Population Health Projects

Pop. Health 1

Advancements in Social Determinants of Health

 

Description
Research has consistently shown that where and how people live is equally, if not more, influential than clinical care on individuals’ lives. Therefore, it is vital to understand where research stands with regard to key social factors and the efficacy of related interventions. This project will review the literature around identified social determinants of health to uncover evidence-based best practices, assess population health base-line data, and conduct initial social network analyses in funded project
communities.

How this is different than related research?
While numerous studies have examined the many social determinants of health, this project will systematically review the literature in areas of social connection, food security, asset security, and post-secondary success and sustainable employment. In addition, a social network analysis will be conducted within each of the Humana-foundation funded communities to understand existing inter-agency relationships
that address one or more of the aforementioned social determinants of health.

Value Proposition

  • While numerous studies have examined the many social determinants of health, this project will systematically review the literature in areas of social connection, food security, asset security, and post-secondary success and sustainable employment. In addition, a social network analysis will be conducted within each of the Humana-foundation funded communities to  understand existing inter-agency relationships that address one or more of the aforementioned social determinants of health.

Pop. Health 2

Culturally-Responsive Approaches for Caregiving Innovation Care Coordination

 

Description
This project will seek insights into
(1) what ways culturally-responsive approaches might strengthen psycho-social resources for employees;
(2) how executives can teach their employees hope and build strategies that instill it in the organization;
(3) incorporate culturally responsive communication around hope to build trust between management and employees; and
(4) explore ways in which hope can become a strategic framework for business growth.

How this is different than related research?
Many studies have noted the advantages of positive psychology in the workplace, and researchers have developed measurement tools that assess levels of hope as well as agency and pathway thoughts. However, few studies have examined the explicit-development of culturally-responsive approaches to hope as a strategic business framework.

Value Proposition

  • Many studies have noted the advantages of positive psychology in the workplace, and researchers have developed measurement tools that assess levels of hope as well as agency and pathway thoughts. However, few studies have examined the explicit-development of culturally-responsive approaches to hope as a strategic business framework.

Pop. Health 3

Smoketown Hopebox

 

Description
This project is a socially and culturally responsive innovation comprised of a laundromat, compassion clinic (to provide training to University of Louisville medicine, nursing, and dental students), arts & culture program to celebrate Black heritage, digital learning lab, and business incubator for multiple employee-owned cooperatives and sole proprietorships. It will use the Center for Creative Placehealing’s (CCP) cultural solutions method for health-related community development.

How this is different than related research?
Well-being is fundamentally influenced by the cultural contexts from which we make meaning. It is the interaction of the cultural relationships between the different levels of the social-ecological model that reveals new ways of understanding cultural assets/opportunities, and how they can be reimagined to support improved public health outcomes. This “re-imagining” is a culturally responsive process to innovation. Evidence shows that this innovation process itself, if well designed and understood,
can yield health-protective factors.

Value Proposition

  • Advance knowledge of inclusive community development models using a co-innovation approach, grounded in culture. Advance knowledge of a university-wide anchor institution’s approach to community engagement.

Pop. Health 4

Utilize Culture/Creative Industry to Impact Obesity Prevention: a Value-based Reimbursement Perspective

 

Description
Engaging culture as a social determinant of health using the Center for Creative
Placehealing’s (CCP) cultural-solutions method for health-related community development supports the CDC funded obesity funded project (SPAN) in Kentucky by offering culturally-responsive innovation trainings in collaboration with IDEAS x Lab. The purpose of the training is to build capacity in state-level staff and stakeholders by improving the understanding on how culture intersects with health equity including how it applies to people in rural/urban settings.

How this is different than related research?
(1) Understand how culture intersects with health equity including how it applies to people in rural settings, those with disabilities, and other groups.
(2) Combine principles and approaches rooted in health equity, hope and heritage in creating an innovative project design/community engagement strategy that goes beyond traditional methods that rely on predominantly on behavior change.
(3) Think expansively about how to leverage the power of local arts, faith, and sports communities in trust building, qualitative data collection, and community participation.

Value Proposition

-Expands opportunities for investing in prevention science
-Makes cultural-impacts on health measurable
-Strengthens leadership
-Promotes cross-culture innovation
-Creates cultural markets for health

Pop. Health 5

Linked Social Determinants to Healthcare Delivery for At-Risk Pediatric Populations

 

Description
Many factors contribute to health & health outcomes of patients including social and environmental determinants, such as economic stability, housing & physical environment, food access, community support, & available healthcare systems. The degree of change as well as the emergent set of changes that might occur in concert can often have health consequences for at-risk populations. In this proposed study,
we intend to investigate and quantify opportunities for improving pediatric population health, patience experience and costs—the Triple Aim—by aligning social determinant events with timely (rapid) healthcare delivery.

How this is different than related research?
This proposed research focuses on at-risk, asthmatic pediatric populations & examines the potential to improve the time-until-response for care & the reduction in total cost of care. Using simulation modeling, the research intends to demonstrate the value of responding to individual social determinant events as well as multiple events occurring within a defined time span. The research has the potential to impact other chronic respiratory diseases affected by environmental factors. This is phase one of a twopart research program. The second phase will demonstrate the practical application of social determinant response by developing the necessary databases, triggers, & event sources.

Value Proposition

  • Industry partners will be able to investigate anticipated changes in levels of demand when considering at-risk pediatric populations and trigger events. They will use simulation models to examine the complex interdependent consequences of new patient monitoring capabilities.

Pop. Health 6

Our Emotional Wellbeing: Arts & Youth Leadership

 

Description
This project is aimed to support, guide, and evaluate an arts-based process in Louisville’s smoke town neighborhood designed by IDEAS x Lab to cultivate youth (AA, LGBT, diverse) leadership, hope, and emotional well-being. The multiphase initiative will culminate in 2020 with a “Youth Wellbeing Summit” and launch of a toolkit/curriculum. This project will use the Center for Creative Placehealing’s (CCP) cultural solutions method for health-related community development.

How this is different than related research?
Well-being is fundamentally influenced by the cultural contexts from which we make meaning. It is the interaction of the cultural relationships between the different levels of the socio-ecological model that reveals new ways of understanding cultural assets/opportunities, and how they can be reimagined to support improved public health outcomes. This “re-imagining” is a culturally-responsive process to innovation. Evidence shows that this innovation process, itself, if well designed and understood,
can yield health-protective factors. system design and human-device interaction technologies to offer real-time decision support providers.

Value Proposition

-Expands opportunities for investing in prevention science
-Makes cultural-impacts on health measurable
-Strengthens leadership
-Promotes cross culture innovation
-Creates cultural markets for health

Care Coordination Projects

Care Coordination                 1

Evaluation and Optimization of Inter-unit Efficiency and Workflow within Departments/Systems

 

Description
Magnetic Resonance Imaging (MRI) is an important diagnostic tool for the detection and monitoring of specific diseases and conditions. However, the equipment cost and maintenance and the specialty training of the technologists makes the examination expensive. This project will focus on the evaluation of work and patient flow inefficiencies between hospital departments of involved health systems and use this
to determine common bottlenecks effecting efficiency in delivery of care, including the MRI imaging process. The researchers will use their findings to identify and realize areas of cost savings and a more timely delivery of care for involved IAB members.

How this is different than related research?
Efficiency has been studied extensively in healthcare as a measure of quality in task performance and resource utilization. However, the studies tend to be isolated to particular healthcare processes, and there is a lack of general analyses that investigate efficiency improvement efforts across a broader platform. The identification of common bottlenecks can inform key areas of concern and potential improvement across the care industry. Additionally, related care and research has focused on teleradiology benefits and processes, cognitive load of reading radiologists, and scheduling improvements of MRI exams. There are opportunities to increase efficiency of administrative tasks.

Value Proposition

  • CHOT IAB members will benefit by the broad sharing of challenges (to work on with collaborative research) and best practices (that are implementable) in maintaining efficiencies across measures of value to the member operations (patient flow, resource utilization, etc.)

Care Coordination                 2

Developing a Risk Prediction Model for Hospital Acquired Clostridium Difficile Infection (CDI)

 

Description
Hospital Acquired Infections (HAI), infections acquired after admissions to the hospital, consume about $25 to $31 billion. Clostridium Difficile Infection (CDI) is the most common cause of infectious diarrhea occurring in hospitals. Treatment costs
per patient is approximately $8,911 to $30,049. The goal of this research is to improve patient outcomes in CDI by testing our findings in earlier phases by using Cerner Health Facts data warehouse. There is a need for better predictive models that allow the development of patient-specific risk scoring.

How this is different than related research?
Healthcare providers are vulnerable to penalties for Healthcare Associated Infections (such as CDI) by the payers. CDI risk prevention model is important for providers to develop more targeted prevention strategies. Patients would benefit from better informed clinical care through the CDI risk prevention model. CDI risk prevention models would lead to potential interventions such as:
(1) developing intervention strategies targeted at high-risk patients that may reduce the risk of contracting CDI,
(2) diagnosing preexisting CDI resulting in quicker treatment for
patient & prevent HAI penalty for hospitals, and
(3) potentially reducing the length of stay thereby potentially
reducing hospital costs. to formal healthcare providers.

For older adults with complex multiple chronic conditions and cognitive impairment, the individual who may be best able to assess baseline cognitive function is the family caregiver. A modification of CAM, FAM-CAM, allows family caregivers to report their observations of symptoms of delirium in a standardized method. The FAM-CAM shows potential to improve recognition, and therefore, management of delirium in the acute care setting.

Value Proposition

  • Hospitals would be able to develop more targeted testing strategies for CDI and deploy patient-specific interventions through decision support systems.

 

Care Coordination                 3

Evaluation of Interventions Related to Workers Compensation Injuries

 

Description
The goal of this project is to evaluate the effects of a set of case management services on outcomes of interest to workers’ compensation insurers, employers, and injured employees. In particular, we will be looking at the outcomes claims cost and return to work time.

How this is different than related research?
There is a large body of evidence examining the impact of case management in the context of health insurance and health care delivery. However, there is far less literature available to describe the effects of care management in the context of employment injury.

Value Proposition

  • Our results will inform employer decisions about whether or not to purchase case management services for their employees. Similarly, our results may help refine current case management programs serving injured workers.

 

Care Coordination                 4

Developing an Inpatient to Community Transition of Care Model for Spinal Cord Injuries (SCI)

 

Description
UAB investigators are collaborating with officials from Spain Rehabilitation Center to develop a hospital to community care transition model for individuals living with SCI. Key activities during the past year included conducting in-depth interviews with individuals living with SCI and healthcare providers to identify key components of the transition of care model. Activities for the upcoming year will involve identifying and describing organizational barriers to community integration.

How this is different than related research?
Health systems have developed transition of care models for patients with acute health conditions. Most of these models focus on the general population and do not address the specific and unique needs of individuals newly diagnosed with SCI. Earlier phases of this project focused on identifying key components of a transition model. This phase will focus explicitly on understanding the barriers organizations face in integrating individuals with disabilities into their operations.

Value Proposition

  • A framework for a care integration model that is generalizable to other communities

Analytics & Innovative Technology Projects

Analytics & Innovative Tech.                 1

Risk and Predictive Modeling for Improving and Advancing Quality of Care Delivery

 

Description
Risk and predicative modeling can assist in early detection, assess and monitor disease progression, assess risk of patients in different disease settings and populations among participatory IAB organizations. Such models can help early diagnosis and intervention, cost-effective and timely treatment, and critical
intervention to prevent avoidable death. It will facilitate better clinical decision and care delivery. This study will build upon foundations previously addressed in projects by the CHOT university sites.

How this is different than related research?
Many attempts have been carried out to analyze risks. Not much has been performed by a diverse team with difference expertise mining over a diverse set of data from multiple sites and multiple diseases. Lack of understanding on how different models behave under different data source. Lack of return on investment analysis to support actual implementation. Opportunity for cross-disciplinary fertilization.

Value Proposition

-Facilitate early diagnosis and intervention
-Deliver cost-effective and timely treatment
-Perform critical and timely intervention to prevent avoidable death
-Facilitate better clinical decision and care delivery

Analytics & Innovative Tech                2

Building Heterogeneous Health Data Banks: Costs, Limitations, Benefits, and Best Practices

 

Description
This effort will involve identifying challenges to creating and maintaining a successful database that includes expanded heterogeneous sources, as well as the benefits available to accessing such a database. Our work not only includes health data commonly stored in EHR systems, but also integrates new types (qualitative, descriptive) and sources (socioeconomic, demographic, mental health) of data. The researchers will analyze and compare costs and benefits for multiple populations, and provide foundation of best practices for integrating heterogeneous data for greater patient acuity and improved modeling of patient risk.

How this is different than related research?
To the knowledge of CHOT workers, there does not exist any published work that documents and seeks to define patterns among challenges and best practices in healthcare database curation, integration, and providing access to health
data at the point of care. Furthermore, this research attempts to integrate multi-site, multisource, and multi-type medical data into a database that will be accessible to the healthcare industry. This effort will bring together perspectives on this process from several members of industry in healthcare systems that are varied in geographic location and population demographics.

Value Proposition

-IAB members benefit from the sharing of challenges and best practices that are implementable in the building/management of heterogeneous health data banks.

-Initial steps can be taken towards shared data banks that combine input across several entities/health data sources.

Analytics & Innovative Tech.                 3

Developing a Globally-Scalable B-C-B Data Sharing Program

 

Description
Project participants will participate in research to design a novel, globally scalable business-to-consumer-to-business (B-C-B) data sharing platform design to support use cases for health, pharma, population health, personalized services, and other domains. The research will focus on designing collaborative governance, scalable financing, and a technical architecture for this effort. Research will include consideration of data needed for next generation research and care of people living
with type 2 diabetes.

How this is different than related research?
The CHIN project will continue research on a new paradigm of health information sharing in which consumers own and control their own data, gain access to it using new individual right of access laws, and authorize its sharing wherever they go for services, including non-traditional organizations such as grocery stores, community service agencies and retail stores. This is the so called “Business to Consumer to
Business” (B-C-B) data sharing method.

Value Proposition

-Advance knowledge of B-C-B data sharing methods
-Advance knowledge of potential strategies for organizing governance, financing and technology for an international “VISA-like” platform for B-C-B data sharing
-Advance knowledge of this approach for T2D use cases

Patient Experience Projects

Patient Experience                 1

Effective Genetic Test Authorization and Coordination for Improved Patient Care

 

Description
Genetic testing is a laboratory method that detects changes in human deoxyribonucleic acid (DNA), chromosomes, genes, or gene products (e.g., proteins). DNA for genetic testing may be extracted from a variety of samples, including
blood, tissue, buccal swabs, and saliva. There are many thousands of active genetic tests, and a continuous evolution of additions and replacements as genetics research and development is translated to clinical practice. Genetic testing is generally expensive and so greater attention to the objectives of the proposed tests and their justification are required by the insurance providers, before they will authorize
payments for the procedures.

How this is different than related research?
This research focuses on improving the processes involved in insurance authorization & coordination of clinically appropriate genetic tests for pediatric patients. While much attention has been on the challenges confronting care providers in aligning tests & diagnoses, the financial aspects of genetic testing contribute to the complexity of the system of decisions: the constraints of the 3rd party payers should be acknowledged as potentially influencing the diagnosis & treatment of delivery processes. The complexity & dynamics of the system lead to delays in decisions about genetic testing that may waste resources, postpone patient care & create unnecessary stress for patients and families.

Value Proposition

  • Industry partners will have comprehensive system models identifying the common processes & activities undertaken to select evaluate, authorize, and order genetic test for pediatric patients. The models will be used in subsequent research efforts to design industry standards.

Access to Care Projects

Access to Care                 1

Prediction and Intervention Models for Combatting the Opioid Epidemic

 

Description
Each day, more than 115 Americans die as a result of overdosing on opioids. The objective of this project is to develop a prediction, prevention, and intervention model that seeks to combat the opioid epidemic. This project seeks to connect the multiple facets of the opioid epidemic into a unifying decision support system
that not only predicts the risks of opioid addiction, but also proposes reliable, safe, and effective prevention and mitigation strategies.

How this is different than related research?
Current approaches to mitigating the effects of the opioid epidemic typically focus on population health perspectives and model the epidemic at a macro-level. However, these models often fail to prevent individual patients from succumbing to the harmful effects of opioid addiction. The proposed project seeks to develop
individually-customized predictive models aimed at either preventing opioid addiction or intervening to mitigate the effects of opioid addiction.

Value Proposition

-Decision support system that can be integrated into clinical workflows
-Insights into effective prevention and intervention treatments and strategies