Health Services and Outcomes Research
Researchers and data analysts in the Health Services and Outcomes Research Program in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery have a wide spectrum of expertise in health care quality, safety, outcomes and costs, as well as in assessing the value and comparative effectiveness of different types of health care interventions.
Team members in the Health Services and Outcomes Research Program are focused on:
- Comparative effectiveness research. The program team evaluates novel therapies or other medical interventions against the standard of care or may compare several similarly effective interventions to each other.
- Economic evaluation. Researchers and data analysts identify and analyze the costs of care and use of health care resources and use simulation modeling to conduct formal cost-effectiveness analyses.
- Outcomes research. Health services and outcomes research experts analyze the impact of current or novel health care delivery systems and processes on patient and population health and wellness. They collaborate across Mayo Clinic's medical practice to develop, implement, evaluate and refine data-driven interventions.
- Patient and provider experience research. Program researchers detect and analyze the drivers of patient satisfaction and provider well-being. They develop new methodologies and interventions and assess the causes and effects of disparities in health care from the perspectives of patients, families and caregivers, health care providers, and the community.
- Quality and safety. The Health Services and Outcomes Research Program team is developing and continually improving a quality data platform that incorporates several hundred public and internal metrics. This effort involves designing, testing and implementing evidence-based, user-friendly artificial intelligence or technology-based solutions to inform and improve patient care and the health care experience.
Advanced care at home
The program team is developing a model of care focused on treating seriously ill patients or those with complex medical conditions at home. This will allow patients to avoid hospital stays or transition from the hospital to their homes faster, while ensuring quality, safety, improved outcomes and reduced cost.
This program was first implemented at Mayo Clinic in Florida and Mayo Clinic Health System in Eau Claire, Wisconsin, and is now available at Mayo Clinic in Arizona.
Xiaoxi Yao, Ph.D. is leading the program's Advanced Care at Home research.
Related news stories:
Tranexamic acid in patients with hip fractures
Tranexamic acid — a blood clotting agent — is considered a safe and effective treatment for use during elective total joint replacement (arthroplasty). This study looked at patients with hip fractures who required hip replacement but were at high risk for thrombotic complications or mortality. It aimed to assess whether giving them tranexamic acid affected their risk levels.
The program team reviewed 1,066 propensity-matched high-risk patients who had hip replacements for displaced femoral neck fractures. The team found that patients who received tranexamic acid did not have an increased risk of mortality, deep venous thrombosis, pulmonary embolism, myocardial infarction or stroke compared with those who did not receive it.
This project was led by Aaron C. Spaulding, Ph.D., with analysis by Shalmali R. Borkar, M.P.H.
Platelet rich plasma for wound care in the Medicare population
Through a systematic review and meta-analyses funded by the Agency for Healthcare Research and Quality and the Centers for Medicare and Medicaid Services (CMS), the Health Services and Outcomes Research Program team collaborated with the Mayo Clinic Department of Pain Medicine and the Center for Regenerative Medicine to evaluate the effectiveness of using patients' own (autologous) platelet-rich plasma in individuals with lower extremity diabetic ulcers, lower extremity venous ulcers or pressure ulcers.
The team found that this plasma increases complete wound healing, shortens healing time and reduces wound size in people with lower extremity diabetic ulcers.
Based on these findings, CMS will cover autologous platelet-rich plasma for the treatment of chronic nonhealing diabetic wounds for a duration of 20 weeks. This is the first time that CMS will provide any coverage for regenerative medicine, which has the potential to dramatically impact Mayo Clinic's practice.
This study was co-led by Zhen Wang, Ph.D., and M. Hassan Murad, M.D., with Wenchun Qu, M.D., Ph.D., as the clinical lead.
Bowel dysfunction after colorectal surgery
The development of major low anterior resection syndrome after low anterior resection is severely detrimental to quality of life, yet awareness and use of treatments for the syndrome is unclear. To improve knowledge of this condition, the Health Services and Outcomes Research Program team surveyed patients who underwent low anterior resection for sigmoid or rectal cancer to assess symptoms and report medications or treatment received for low anterior resection syndrome.
The study team found that major low anterior resection syndrome is underrecognized by clinicians, with less than half of patients who had the condition receiving first line therapy. Long term follow-up of patients after low anterior resection and continued symptom assessment is necessary to improve treatment of this syndrome.
This study was led by the center's deputy director of research, Elizabeth B. Habermann, Ph.D.
Remote patient monitoring after hospitalizations
In this project, the program team evaluated outcomes associated with remote monitoring of patients after they were discharged from the hospital. In particular, the team was interested in emergency department visits and 30-day readmissions.
The study team found that remote patient monitoring was associated with 78% relative risk reduction in hospital admission. Furthermore, we observed that when patients were hospitalized, they experienced shorter stays and had fewer prolonged hospitalizations, intensive care unit admissions and deaths.
This project was a collaboration between the Mayo Clinic Kern Center for the Science of Health Care Delivery and the Mayo Clinic Center for Digital Health. It was led by Bijan J. Borah, Ph.D., from the Health Services and Outcomes Research Program and Joshua C. Pritchett, M.D., and Tufia C. Haddad, M.D., from the Center for Digital Health.
- Pritchett JC, Borah BJ, Desai AP, Xie Z, Saliba AN, Leventakos K, Coffey JD, Pearson KK, Speicher LL, Orenstein R, Virk A, Ganesh R, Paludo J, Halfdanarson TR, Haddad TC. Association of a remote patient monitoring (RPM) program with reduced hospitalizations in cancer patients with COVID-19. JCO Oncology Practice. 2021; doi:10.1200/OP.21.00307.