Institute on Healthcare Systems

Research

IHS probes key questions facing today's health systems on topics ranging from healthcare financing, provider interactions, workforce trends, and more. Below, find a selection of recent and ongoing work from our researchers. 

Older Adults

Supporting Practices in Respecting Elders (SPIRE) Comparative Effectiveness Trial

An evaluation of two models of primary care for older adults with complex health needs.

Our Team: Jennifer Perloff (Dual Principal Investigator), Karen Donelan (Co-Investigator), Mike Vetter (Project Director), Carie Michael (Project Manager),  Kathy Cook (Program Administrator), Benjamin Koethe (Research Assistant)

Colleagues: Christine Ritchie (Dual Principal Investigator), Steve Bartels (Co-Investigator), Jocelyn Carter (Co-Investigator), Kathryn Corelli (Co-Investigator), and team.

Partners: Massachusetts General Brigham, AtriumHealth Wake Forest Baptist, BaylorScott & White, Griffin Health, Indiana University, Vanderbilt University

Contract awarded by the Patient-Centered Outcomes Research Institute (PCORI).

Evaluating Novel Healthcare Approaches to Nurturing and Caring for Hospitalized Elders (ENHANCE) Comparative Effectiveness Trial

A stepped wedge comparison of delirium prevention protocols among hospitalized older adults.

Our Team: Karen Donelan (Stakeholder Engagement Core Leader), Carie Michael (Project Director), Bella Cameron (Research Assistant)

Colleagues: Sharon Inouye (Dual Principal Investigator), Phil Vlisides (Dual Principal Investigator), Eva Schmitt (Overall Project Director), and team.

Partners: Hebrew SeniorLife Marcus Institute For Aging Research, Allegheny General Hospital, Maine Medical Center, Saddleback Memorial Hospital, Meriter Hospital, University of Michigan Hospital, Hospital of the University of Pensylvania, University of Utah Hospital

Contract Awarded by the Patient-Centered Outcomes Research Institute (PCORI).

Advancing Gender and Income Equity in Long-Term Services and Supports

An examination of gendered barriers to healthy aging in the US.

Related events include the Brandeis Forum on Long Term Services and Supports: Personal Crises, Private Payments, Social Policy.

Our Team: Christine Bishop, Karen Donelan, Jennifer Perloff, Melissa Brown

Grant awarded by the Jewish Healthcare Foundation.

Champion-Led Deprescribing for Persons with Dementia in Primary Care: A Qualitative Study in Accountable Care Organizations

Clinician perspectives on factors affecting implementation of dementia-friendly prescribing practices.

Our Team: Jennifer Perloff, Masami Tabata-Kelly1

Colleagues: Lorella Palazzo2, Linda Kiel2, Michael Parchman3, Robert Penfold2.

Partners: 1Center for Surgery and Public Health, Mass General Brigham; 2Kaiser Permanente Washington Health Research Institute; 3Community Health Worker Coalition for Migrants & Refugees.

Funded by the National Institute on Aging.

Published in Journal of General Internal Medicine.

Social Drivers of Healthcare Outcomes

US and Massachusetts Social and Health Policy Datasets

A collection of resources designed to provide information about policies and empirical indicators across four domains: Public Health, Healthcare Delivery, Social Welfare and Economics.

Our Team: Rajan Sonik (Principal Investigator), Kimberley Nicholson (Research Associate), Bianca Porneala (Senior Statistical Programmer), Natalie Moresco (Senior Statistical Programmer), Bella Cameron (Research Assistant), Onyx Allen (Graduate Research Assistant), Maya Stantchev (Undergraduate Research Assistant), Sydney Duncan (Atkins Fellow).

Partners: Cambridge Health Alliance, AltaMed Health Services.

Grants awarded by the National Institute on Minority Health and Health Disparities and the National Institute of Nursing Research.

Growth and Decline in SNAP Generosity: Outcome and Equity Implications

An investigation into the health and health equity impacts of fluctuating SNAP benefits resulting from the implementation and rollback of the Families First Coronavirus Response Act.

Our Team: Rajan Sonik (Principal Investigator).

Partners: Altamed Health Services Corporation.

Grant awarded by the National Institute on Minority Health and Health Disparities.

Effects of the Supplemental Nutrition Assistance Program On Racial/Ethnic and Disability Based Healthcare Disparities

An inquiry into the connection between SNAP access, health outcomes, and patterns of healthcare utilization with an eye toward racial, ethnic, and disability equity. 

Our Team: Rajan Sonik (Principal Investigator).

Partners: Altamed Health Services Corporation.

Grant awarded by the National Institutes of Health.

Eliciting Patient Past Experiences of Healthcare Discrimination as a Potential Pathway to Reduce Health Disparities: A Qualitative Study of Primary Care Staff

A study of primary care providers' perceptions of and openness to engaging patients around past experiences of bias and discrimination in healthcare settings.

Our Team: Rajan Sonik

Colleagues: Dharma Cortes, Ana Progovac, Frederick Lu, Esther Lee and team.

Partners: Harvard Medical School, Cambridge Health Alliance Health Equity Lab, Warren Alpert Medical School at Brown University, and team.

Contract awarded by the Patient Centered Outcomes Research Institute.

Published in Health Services Research.

 Legal Aid Is Essential to Effective Social Care Integration

An analysis of the role of legal aid organizations in identifying health-related social needs.

Our Team: Rajan Sonik

Colleagues: Breena Taira, Sorto Gerson.

Partners: UCLA Medical Center; Neighborhood Legal Services of Los Angeles County.

Grants awarded by California Health Care Foundation, National Institute on Minority Health and Health Disparities, and National Institute of Nursing Research.

Published in JAMA Internal Medicine.

Uncovering Household Tuberculosis Infection Testing and Care Patterns Using a Novel Bioinformatics Linkage Strategy

An examination of TB testing and treatment pathways in households with sentinel patients.

Our Team: Cynthia Tschampl

Colleagues: Jeffrey Campbell, Meredith Brooks, Jessica Haberer, Rachel Epstein, and team.

Partners: Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston University School of Public Health, Harvard Medical School.

Published in Clinical Infectious Diseases.

Workforce

Reducing NP Barriers to Value-Based Care

A pilot of risk readiness tools in primary care offices owned by nurse practitioners.

How Can We Grow The Nurse Supply?

An assessment of a federal incentive program addressing healthcare professional shortage areas.

Burnout to Balance

A comparative effectiveness study of two models to reduce turnover and enhance resilience in the group home workforce.

Key-Informant Perspectives On Pharmacy-Based Methadone Treatment For Opioid Use Disorder In The US

A qualitative investigation into perceptions of pharmacy access to methadone medication  among opioid treatment program leadership, pharmacy administrators, policymakers, and insurers.

Our Team: Cynthia Tschampl (Dual PI), Traci Green (Dual PI, IBH).

Colleagues: Maureen Stewart, Sage Feltus, Jeffrey Bratberg.

Partners: Boston University, University of Rhode Island College of Pharmacy.

Funded by Pew Charitable Trusts, Brandeis-Harvard Center to Improve System Performance of Substance Use Disorder Treatment.

Published in Health Affairs.

Relational Coordination Collaborative (RCC)

A research community promoting relationship-based task integration. RCC programs include Relating Across Difference, a coaching protocol for clinical units.

 

The Influence of Premed Curriculum on Physician Specialty Choice

An inquiry into the role of interdisciplinary undergraduate education in shaping the physician workforce.

Our Team: Darren Zinner.

Colleagues: Victoria Lesser.

Partners: Norton College of Medicine, SUNY Upstate Medical University.

Published in Journal of General Internal Medicine.

Changes in Mental Health Services Use Under the ACA in One State: Role of Mental Health Provider Shortages

A study examining how mental health care use changed under Affordable Care Act provisions in the state of California.

 

Economic Evaluations

Cost-Effectiveness of Case Management and Financial Incentives to Increase Participation in Cardiac Rehabilitation

A comparison of approaches to increasing utilization of cost-effective cardiac care.

Our Team: Donald Shapard, Jiaye Shen.

Colleagues: Blair Yant, Deborah Denkmann, Patrick Savage, Robin Collier,  Bryan Katz, Philip Ades, Diann Gaalema.

Primary Partner: University of Vermont

Additional Partner: University of Texas Medical Branch

Grant awarded by National Institutes of Health.

Published in Journal of Cardiopulmonary Rehabilitation and Prevention

Economic Evaluation of Wolbachia Deployment in Colombia: A Modeling Study

A cost-effectiveness study of dengue fever prevention in 11 target cities in Colombia.

Our Team: Donald Shepard (Principal Investigator), Yara A. Halasa-Rappel, Samantha R. Lee.

Colleagues:  Carlos William Rincon Perez, Arturo Harker Roa.

Partners: University of the Andes.

Funded by Wellcome Trust via Monash University's World Mosquito Program; Bill and Melinda Gates Foundation.

Published in PLos One.

Cost-Effectiveness of Human Papillomavirus Vaccination for Adolescent Girls in Moscow, Russia

An examination of the economic and health implications of expanding HPV vaccination coverage in Russia.

Our Team: Daria Nefedova, Shiji Valsan, Donald Shepard. This publication evolved from course papers written by Nefedva and Valsan while earning Master's degrees at the Heller School.

Published in Public Health Challenges.

Cost of introducing human papilloma virus vaccination into Nigeria’s expanded program on immunization: Lessons from two Nigerian states

An evaluation of procurement, operations, service delivery, and other expenses tied to establishing an augmented vaccine program in geographically challenging areas. 

Our Team: Shafik Sekitto,  Ismail Ndalami Salihu1, Donald Shepard. This publication evolved from course papers written by Sekitto and Salihu while earning Master's degrees at the Heller School.

Colleagues: Benjamin Mari Aya1, Ahmed Rufai Garba1, Sulaiman Etamesor1, Binta Aduke Ismail1, Adaugo Nneoma Chidubem2, Mohammed Yahaya3.

Partners: 1National Primary Health Care Development Agency, 2Sydani Group, 3Usmani Danfodiyo University.

Published in Vaccine: X.

Finance and Payment

The Financial Sustainability of Programs to Initiate Medications for Opioid Use Disorder in Emergency Department Settings

A qualitative investigation into factors shaping the feasibility of an ED-based response to the widespread underuse of opioid use disorder treatment.

Dominic Hodgkin, Cindy Parks Thomas, Margot T. Davis (IBH), Jennifer J. Wicks (IBH), Constance M. Horgan (IBH).

Colleagues: Shelly F. Greenfield1,2, Zachary F. Meisel3

Partners: 1Harvard Medical School, 2Mclean Psychiatric Hospital; 3University of Pennsylvania Perelman School of Medicine.

Published in Academic Emergency Medicine.

Hospital–Skilled Nursing Facility Integration and Participation in a Bundled Payment Initiative

An original investigation into whether hospitals integrated with skilled nursing facilities are more likely to adopt Medicare bundled payment initiatives.