Our expert answers 3 Questions
One area of my research focuses on the interface between primary and specialty care, including aspects of patient-sharing relationships between physicians. In particular, I am looking at how patterns of connection among surgeons, referring primary care physicians, and consultants affect the quality, cost, and efficiency of care delivered around the surgical episode. Our group within the Dow Division of Health Services Research is also examining connections between local health systems and non-institutional providers like freestanding ambulatory surgery centers to better understand the impact of different delivery system and payment reforms on surgical care.
This line of inquiry uses “big data” methods such as network analytical tools that were developed in other fields - including the computational sciences, physics, sociology, and engineering - and applies them to problems in health care. It’s the general idea that tons of data are being collected in health care but are largely ignored. We can take these data and learn more about how physicians relate to one another, what their interactions look like, and how these interactions can be taken advantage of to help transform the care that individuals receive. I come at this from the perspective of being a surgical subspecialist myself, where I frequently curbside other medical and surgical specialists, as well as primary care physicians. I also see the large number of medical encounters that patients have throughout their healthcare continuum - It would be great if we could better shepherd patients through this complex system of ours.
Many of the themes that I'm exploring in terms of physician connectedness are directly relevant to efforts to enhance care coordination and communication among physicians that are central to the Affordable Care Act. Some of our recent work examining differences in patient-sharing networks that serve racially segregated communities has practical implications for addressing disparities in health care.