NUTORC-a transdisciplinary health services and outcomes research team in transplantation

Hepatology in a changing health care landscape: A call for health services research

With the passage of the Affordable Care Act followed by the physician payment reform, there is an urgent need to better understand the complex relationships between structure (including incentives), processes, and outcomes of health care and, based on this understanding, identify interventions that can ensure delivery of high-value care to patients with liver disease. As hepatologists, how do we systematically address these issues and ensure that we provide high-value care to our patients? These factors combine in the burgeoning field of health services research. This article seeks to describe how health services research influences the practice of hepatology, the tools and technologies it utilizes, as well as how interested individuals can seek to acquire knowledge and methodological training in health services research. Finally, we summarize the current state of health services research in hepatology and liver transplantation. (Hepatology 2018).

Expanding transplant outcomes research opportunities through the use of a common data model

The volume of solid organ transplant in the United States is increasing, providing improved quality of life and survival for patients with organ failure. The growth of transplant requires a systematized management of transplant outcomes assessment, especially with the movement toward value-based care. However, there are several challenges to analyzing outcomes in the current registry-based, transplant reporting system: (1) longitudinal data points are difficult to capture in outcomes models; (2) data elements are restricted to those that already exist in the registry data; and (3) there is a delay in the release of outcomes report. In this article, we propose an informatics approach to solve these problems by using a "common data model" to integrate disparate data sources, data elements, and temporal data points. Adopting such a framework can enable multicenter outcomes analyses among transplant centers, nationally and internationally.