Team will study technology used to access primary care surrounding COVID-19 and any related health disparities—and recommend actions to improve access for patients
Columbia, MD—To better understand and address technology-driven U.S. primary care access and health disparities around COVID-19 and beyond, the Agency for Healthcare Research and Quality (AHRQ) has awarded MedStar Health a nearly $1 million grant to create and advance a telehealth research collaboration with Intermountain Healthcare and Stanford Health Care. As the two-year effort launches this month, it establishes one of the largest COVID-19 primary care data sharing and analysis alliances to date, including three systems that have previously delivered 4.5 million primary care appointments in a year.
“Truly tackling pressing health disparity questions requires expansive information about people’s experiences,” said the grant’s co-principal investigator (PI) Raj Ratwani, PhD, vice president of scientific affairs, MedStar Health Research Institute and director, MedStar Health National Center for Human Factors in Healthcare. “We can study access more rigorously—and arrive at results and recommendations that better represent our nation—by combining data and other insights from three incredibly diverse sets of patient populations, primary care access models, and technical, social, and structural environments.”
COVID-19 resulted in a historic shift in the way primary care services are delivered, leading to the rapid adoption of a variety of ways for patients to seek care virtually such as telehealth video-based and phone-based visits, text messages, and patient portal messages. Nationally, it is unclear whether different patient subpopulations can access primary care during the pandemic and which avenues are being used by those accessing care. In response, the team will examine how their different subpopulations got their care during COVID-19; barriers and facilitators to accessing care; and if/how primary care accessibility evolves surrounding the pandemic by following patients’ use of primary care avenues over time.
Anticipated deliverables of this collaboration include journal publications, policy briefings, and other outreach to stakeholders such as patients, providers, policymakers, community groups, trade and research organizations, etc., to further explore and implement meaningful research questions and resources.
Team leadership and assets
The grant work will be co-led by MedStar Health co-PI Ethan Booker, MD, medical director of MedStar Telehealth Innovation Center and MedStar eVisit. MedStar Health’s telehealth and human factors teams will work closely with Intermountain Healthcare site co-PIs Lory Maddox, PhD, RN, Senior Clinical Outcomes Researcher for Intermountain Connect, and Kerry Palakanis, executive director of Connect Care, as well as Stanford University School of Medicine site PI Kevin Schulman, MD, director of industry partnerships and education for the Clinical Excellence Research Center (CERC).
“As the initial surges of COVID-19 have massively disrupted traditional modes of care delivery, telehealth has helped us effectively bridge many potential gaps in care—especially in primary care—and we want to ensure that’s true in as many populations as possible,” Dr. Booker said. “Given the exponential growth of telehealth over this period, we now have an enormous amount of data that can help us inform policy and better invent the future. It will be a far greater opportunity for all if we share, expand, and apply what we’ve learned within the U.S. health system more broadly, which the AHRQ grant will help us achieve.”
Following is preview of what these participating systems bring to this effort:
- MedStar Health is the largest not-for-profit healthcare system in Maryland and Washington, D.C., consisting of 10 hospitals and more than 300 ambulatory care sites in that region plus Virginia. The clinical partner of Georgetown University, MedStar Health is also a microcosm of American medicine with urban, suburban, and rural care facilities serving a diverse patient population with nearly 5 million ambulatory visits a year. Due to COVID-19, outpatient telehealth visits increased from around seven to 4,500 per day at peak, with more than 600,000 telehealth sessions overall and around 30% of primary care visits shifting to video.
- Intermountain Healthcare is a not-for-profit health system based in Salt Lake City, Utah, with 24 hospitals including a “virtual” hospital; 215 clinics; and a broad range of medical services. It is the largest healthcare provider in the Intermountain West, serving the healthcare needs of Utah, Las Vegas, and southeastern Idaho residents. During COVID-19, rapid implementation of existing and alternate video platforms increased telehealth visits from approximately five percent to 40% of scheduled primary care visits.
- Stanford Health Care, located in California, is a leading academic health system delivering world-class clinical services and more via their enterprise virtual care platform, practicing across 150 clinics, and serving as the teaching hospital for the Stanford University School of Medicine. During COVID-19, telehealth visits increased 50x to meet patient needs and grew from less than two percent of ambulatory visits to more than 70%.
This AHRQ grant is a U.S. Department of Health and Human Services’ R01 award, which is among the most prestigious grant types. This marks the seventh R01 award led by the MedStar Health National Center for Human Factors in Healthcare, whose awards to date have focused on improving patient safety. This is the first R01 for the MedStar Telehealth Innovation Center, signifying the extent to which telehealth has become a new and increased research priority due to the COVID-19 pandemic.
About MedStar Health
At MedStar Health, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. Our 30,000 associates and 4,700 affiliated physicians are committed to living this promise through our core SPIRIT values—Service, Patient first, Integrity, Respect, Innovation, and Teamwork—across our more than 300 locations including 10 hospitals, ambulatory, and urgent care centers. As the medical education and clinical partner of Georgetown University, MedStar Health is training future physician leaders to care for the whole person and is advancing care through the MedStar Health Research Institute. From our telemedicine and urgent care services to the region’s largest home health agency, we’re committed to providing high-quality health care that’s also easy and convenient for our patients. At MedStar Health—It’s how we treat people. Learn more at MedStarHealth.org.