The Patient-Centered Outcomes Research Institute (PCORI)—an independent nonprofit that funds comparative clinical effectiveness research—has tapped UW Health and 41 other major health systems nationwide to participate in its new multi-year, $50 million Health Systems Implementation Initiative (HSII).

Through this initiative, UW Health—and the other participating health systems—can leverage their health care delivery experience and expertise to develop and deploy viable strategies to accelerate the implementation of evidence-based practice improvements. “The work this initiative funds benefits our patients and our larger community, and helps UW Health fulfill our mission as an academic health center,” says Elizabeth (Betsy) Trowbridge, MD, Kenneth D. Skaar, MD, Chair of Primary Care and chief, General Internal Medicine, who helped write UW Health’s application to join HSII. “What it represents is the opportunity to champion better quality improvement and implementation processes at UW Health.”

Robin Lankton, MPH, CHES, vice president for population health, UW Health, co-principal investigator (PI), reinforces that perspective.

“We want to apply clinical knowledge more quickly,” she says. “We want to learn by doing, evaluate what we’re doing, and then disseminate the findings. PCORI is providing us an opportunity to jump start that process with an infusion of funding.”

Building capacity and bringing change

In addition to becoming part of an HSII Learning Network, all participating health systems have the opportunity to prepare proposals for at least two funding opportunities through the initiative. The first will support initial capacity-building projects—each system can receive up to $500,000 for projects that support preparation for future implementation strategies. The second will support practical and innovative projects that promote uptake of specific evidence from PCORI-funded research studies within the health systems, with funds ranging from $500,000 to $5 million per implementation project.

Lankton and co-PI Kirsten Rindfleisch, MD, senior medical director of primary care, UW Health, and associate professor, Department of Family Medicine and Community Health, will work with select UW Health service councils to decide whether to pursue the funding opportunities PCORI offers based on how well the evidence to be implemented fits with ongoing priorities and previous work at UW Health.

“The capacity-building stage will allow us to speed our response to future project calls and enable success across all future projects,” explains Lankton. “We’ll start with a readiness assessment and the creation of an administrative team and a mobile implementation team.”

The latter would be tasked with working on the ground with clinical teams on continuous quality improvement during implementation. For example: if a specific project is focused on improving cancer screening, the mobile implementation team might partner with medical oncology faculty and staff from clinical departments and UW Health to assist with refinement, dissemination and change management.

Findings made during implementations will be shared with other HSII participants through the HSII Learning Network.

Collaborating across SMPH

The work will also leverage ongoing collaborations between UW Health and the University of Wisconsin School of Medicine and Public Health (SMPH), centered around four key organizations:

• The Health Innovation Program (HIP), which brings together SMPH investigators and UW Health staff to build and test new ways of thinking about healthcare delivery. HIP is led by Maureen Smith, MD, MPH, PhD, professor of population health sciences and family medicine.
• Primary Care Academics Transforming Healthcare (PATH), a multidisciplinary coalition of primary care physicians and change leaders who write about UW Health system redesign efforts. PATH is led by Dr. Trowbridge.
• UW Health’s Office of Population Health (OPH), which develops care model programs that emphasize populations of patients with complex health and social needs. OPH is led by Lankton.
• The Primary Care Leadership Committee (PCLC), which coordinates the operational work of UW Health primary care clinics. The PCLC is led by Dr. Rindfleisch and Wendy Adams, MA, MBA, vice president of primary care, UW Health.

Looking to the future

“The dream,” says Dr. Trowbridge, “is that this is also the beginning of us becoming what’s called a learning health system and a leader in healthcare design improvement.”

A learning health system, as defined by the U.S. Department of Health and Human Service’s Agency for Healthcare Research and Quality, integrates internal data and experience with external evidence and puts those pieces into practice. This results in higher quality, more efficient care and makes health care delivery organizations better places to work overall.

UW Health’s inclusion in the PCORI initiative—in addition to its size, scope and academic affiliation—is a testament to how well it has already begun assuming the characteristics of a learning health system.

“UW Health’s nearly 300,000 medically homed patients represent an enormous, powerful learning lab that’s just waiting for the right moment to be harnessed,” Dr. Trowbridge says. “Now that moment might be around the corner.”

Learn more about PCORI’s Health Systems Implementation Initiative.

Banner: UW Health and environs. Credit: Clint Thayer/Department of Medicine.