The MedStar Health Economics and Aging Research (H.E.A.R.) Institute is part of the MedStar Health Research Institute, located at MedStar Good Samaritan Hospital. The mission of H.E.A.R. is to support MedStar Health as a laboratory for innovation and best practices in quality geriatric care. The H.E.A.R. Institute facilitates and fosters collaboration with MedStar Health practice sites to develop, implement, evaluate, and disseminate innovative models of geriatric care delivery.
Research at the H.E.A.R. Institute falls into three strategic focus areas.
Putting the patient at the center
Three out of four older adults are managing two or more chronic conditions and this population accounts for 93% of Medicare spending. Older adults with multiple chronic conditions and their family caregivers face the most challenges navigating the complex health care system of multiple clinicians, medications, and care settings. We leverage the diverse patient population and rich data infrastructure at MedStar Health to study how innovations in treatment and management of multiple chronic conditions can be most effectively deployed across a wide variety of care settings. The H.E.A.R. Institute research also focuses on how shared decision making and goal-setting can be used to improve the quality of care provided to older adults ensuring that health care addresses what matters most to them. Notable programs include:
- Collaborative Care Center at MedStar Good Samaritan Hospital: This center will open in 2020 and provide integrated specialty and behavioral health care to patients with multiple complex chronic conditions such as congestive heart failure, diabetes, and chronic obstructive pulmonary disease. The center will aim to reduce hospital length of stay and readmissions by providing intensive chronic disease management and education as patients make the transition from the hospital back to the community. The H.E.A.R. Institute is helping to develop and evaluate this new approach to delivering care.
- Demonstration of Person-Driven Outcomes for an Age-Friendly Health System: In partnership with the National Committee for Quality Assurance, the H.E.A.R. Institute is engaged in a national, multi-site demonstration of goal-based outcome measurement. This health care intervention allows older adults and their family members to set goals with clinicians based on their own priorities and measure progress on those goals. Click here to learn more.
Economic analysis on the “total cost of care”
Costs for patients and families are rising and more family members are dropping out of the workforce to care for aged loved ones. Spending for Medicare alone, in the absence of change, will account for 8 percent of gross domestic product by 2035. Radical health care reform is required to counter these trends, including a deeper analysis of inefficiencies in our health care system and the economic impact on patients and family members. H.E.A.R. is engaged in several multi-year research programs that seek to reduce not just Medicare costs but also the costs to patients and family members. Notable programs include:
- MedStar House Call Program: This innovative model of providing at-home care to housebound older adults is part of a Centers for Medicare and Medicaid National Independence at Home Demonstration and early results show substantial savings to Medicare. Learn more about this program here.
- Center for Successful Aging at MedStar Good Samaritan Hospital: This interdisciplinary geriatric care program uses a risk stratification model to identify and predict high-risk patients, as well as prioritize the management of their care in order to prevent worse outcomes. The H.E.A.R. Institute is engaged in an evaluation of the Center’s model of care and enhancing this model for dissemination across the wider MedStar Health network and beyond. Learn more about this program here.
Delivering equitable care that addresses the social determinants of health
Located in the greater Washington, D.C., and Baltimore areas, MedStar Health serves one of the most culturally diverse populations of the United States, and our award-winning researchers have successfully conducted numerous studies involving underserved and minority populations. We know that addressing health disparities involves understanding the needs of the community beyond those typically addressed in the medical care system, such as housing, nutrition, transportation, and safety. The H.E.A.R. Institute will facilitate partnerships with health equity and community-based participatory research experts to advance our understanding of how to best to deliver cost-effective, high-quality, and equitable care to all aging patients in community-based settings.
H.E.A.R. Institute Team Members
- Erin Giovannetti, PhD, Scientific Director
- Jason Brown
- Derek DeLia, PhD
- Dana Frank, MD, FACP
- Jessica E. Galarraga, MD, MPH
- Gongliang Zhang
Standardised approach to measuring goal-based outcomes among older disabled adults: results from a multisite pilot, BMJ Quality and Safety. DOI: 10.1136/bmjqs-2019-010742
A prospective cohort study of feasibility in seven sites (33 clinicians) of the two approaches with 229 individuals. We calculated performance on a measure of achievement of individually identified goals.
Refining a Taxonomy of Goals for Older Adults With Functional Limitations and Their Caregivers to Inform Care Planning, Journal of Applied Gerontology. DOI: 10.1177/0733464820944326
Through focus groups and interviews, 76 older adults with ≥1 activity of daily living limitation and 28 family/friend caregivers were asked about what mattered most to them and their goals for care.
Ways to Support Us
Sustainability is the key to success. Communities need sustainable health in order to thrive. Health systems need sustainable models of care in order to effectively serve their patients. MedStar Health believes that the H.E.A.R. Institute community-based research will help achieve both of these goals, as well as identify opportunities to lower costs while achieving better health outcomes.
The missing link is bringing the community, research, and expert health care resources together to identify these solutions and ways to sustain them over time. The synergy of these diverse partners will spark opportunities and resources we could not have imagined otherwise. This work will pay for itself in the long run. Please consider “paying it forward” to make this vision, in honor of Dr. Dana Frank, a reality. Learn more about philanthropy at MedStar Health here.
MedStar Health seeks to raise $2 million in philanthropic investments to build the H.E.A.R. Institute. These crucial start-up funds will help build the team with supporting research scientists and analysts with expertise in bioinformatics, biostatistics, community-based research, health economics, and implementation science. The start-up funds are necessary both to begin this critical work and secure additional grant funding for the future. Join with us to make a difference in the lives of our community!