Improving Healthcare Delivery and Population Health
Current research programs and grants:
Future of Health Partnership
Future of Health, Stanford Department of Health Policy, Primary Care and Population Health, and the Clinical Excellence Research Center are partnering to create an evidence-based health policy agenda that will provide strategic guidance and support to its members. Sara Singer will serve as project laed and guide FOH's annual research agenda, expert engagement, and publication process.
Understanding Integration in Oncology Care and Association with Quality and Outcomes
In a partnership with Harvard Medical School, HELIOS labs is focused on improving cancer care. Learning how organizations engage in various forms of integration is critical to understanding how different types of integration influence care. In this Program Project, we propose a novel research effort with four interrelated Projects reflecting different types of organizations that deliver cancer care. The organizations include health systems, independent oncology practices, post-acute care and hospice entities, and specialty pharmacies. Project teams will collect primary data from case studies and surveys and use administrative data from public and commercial insurers to (1) adapt an existing conceptual framework and define key forms of care integration beyond structural integration (i.e., functional, normative, interpersonal, process) for oncology care that are most relevant for integrated patient care experiences; (2) Measure and compare oncology care integration across settings and assess how these key forms of integration are associated with one another and practice and market factors, and (3) Assess the association of integration with spending, utilization, and quality care within and across care settings, including health care systems, independent oncology practices, post-acute care and hospice, and specialty pharmacies and understand mechanisms by which care integration improves or worsens the delivery of high-quality care for groups with different demographic characteristics, residence (rural versus urban areas), and socioeconomics.
Advancing our understanding of team science
AI-READI is one of four data generation projects of the National Institutes of Health (NIH)- funded Bridge2AI Program. AI-READI seeks to create and share a flagship ethically-sourced dataset for type 2 diabetes. The data will be optimized for future artificial intelligence/machine learning (AI/ML) analysis that could provide critical insights into the salutogenic pathways from diabetes to return to health. Dr. Singer leads the AI-READI Teaming Milestone, which aims to apply and advance team science in order to develop an effective multi-team system, capable of achieving individual milestone, AI-READI, and Bridge2AI goals.
The Teaming Milestone will support the AI-READI project by applying team science to promote transdisciplinary collaboration across disciplinary, hierarchical, demographic, and other boundaries. In doing so, we aim to advance our understanding of teaming in the context of multi-team systems involving multidisciplinary scientists, trainees, and communities.
Implementing Scalable, PAtient-centered Team-based Care for Adults with Type 2 Diabetes (iPATH)
More than 37 million people in the United States have type 2 diabetes, and federally qualified health centers (FQHCs) shoulder a high prevalence of diabetes (21% in FQHCs vs 11% overall), offering a promising venue for innovating in diabetes care. The iPATH project will refine and implement an approach to practice transformation originally conceived to support FQHCs’ pursuit of National Committee for Quality Assurance recognition as patient-centered medical homes. A pilot study demonstrated significant decreases (average 31% reduction) in poorly controlled diabetes among patients at 7 clinics affiliated with 1 FQHC in 2017 to 2020. Improvements in patients’ diabetes control were sustained. For aim 1 of the iPATH project, the study team will refine the iPATH implementation approach by identifying organizational conditions and processes at FQHCs that promoted or impeded the effectiveness of type 2 diabetes care. They will conduct 12 in-depth regional case studies to differentiate between high-performing and low-performing FQHCs for diabetes control. Employing an innovative Rapid Data Collection and Reporting methodology, the study team will rapidly collect, analyze, and share data to accelerate dissemination of customized feedback to FQHC leaders and to inform adaptation and implementation of the iPATH practice transformation. For aim 2, the study team will implement a multilevel, multicomponent, technology-enabled practice transformation strategy to improve type 2 diabetes for patients at 8 multi-clinic FQHCs in California, Massachusetts, Ohio, and Puerto Rico. The implementation approach will be modularized and customizable to accommodate organizational readiness, patient needs, and social and environmental factors affecting patients’ health (such as transportation, employment, and nutrition), tailoring practice transformation efforts to each unique FQHC. For aim 3, the study team will evaluate the implementation approach using a stepped-wedge, cluster randomized, hybrid type 2 effectiveness-implementation trial. Using formative, process, and summative evaluation elements guided by the Exploration-Preparation-Implementation-Sustainment model, the trial will evaluate the impact of practice transformation and identify process elements affecting implementation effectiveness.
Stanford Health Policy News Update
Previous research programs and grants:
Establishing a Culture of Health as Business Imperative
Every business, knowingly or not, is in the health business. Business, together with health and community partners, can promote a culture of health through four distinct, but interrlated, pillars: consumer health, employee health, community health, and environmental health. This research explores opportunities for making health a business imperative.
Learn More About Our Work in Culture of Health
Culture of Health - Harvard T.H. Chan School of Public Health
Building a Culture of Health - Robert Wood Johnson Foundation
Identifying Bright Spots in Patient Care Delivery
This program identifies and spreads organizational attributes associated with better value care.
Promoting Integrated Patient Care
For over a decade, Dr. Singer's research has re-conceptualized the meaning of integrated patient care and care integration in ways that emphasize patient's perspectives, including social as well as organizational forms of integrating, to ensure that patients don't get lost in the health system.
RAND Center of Excellence on Health System Performance
Patient Perceptions of Integrated Care (PPIC) - Harvard T.H. Chan School of Public Health
Tech-enabled Future of Work
Engineering High Reliability Learning Lab
The goal of this learning lab is to enhance capacity for innovation and develop highly reliable systems that address communication and coordination challenges that pose patient safety risks at the intersection of primary and specialty care. A five-stage innovation cycle, including problem analysis, design, development, implementation, and evaluation, drives learning lab efforts to develop highly reliable systems within 19 Harvard-affiliated primary care practices and their specialty care partners.
Learn more about Engineering High Reliability Learning Lab (EHRLL)
Overview of Patient Safety Learning Laboratory (PSLL) Projects