Like many other medical researchers across the country, Malaz Boustani, M.D., was ready to move on to something different once his findings were written up in a well-known medical journal.
“I thought, ‘My job, it’s over,’ ” Boustani says. Clinicians could read the article, published in the Journal of the American Medical Association, and decide for themselves whether to implement the new model of dementia care he developed.
But an unexpected challenge from health system executives at Eskenazi Health, Indianapolis, set Boustani on a new path. Now, as chief operating officer of the Center for Health Innovation & Implementation Science at Indiana University School of Medicine, he is part of a growing movement to accelerate the rate at which advances discovered through medical research are implemented in the real world. Currently, “it takes a solution 17 years to make it as an actual standard of care,” he notes.
It was a need for quick results that led executives at what is now called Eskenazi Health to push Boustani to bring the research into reality, and in a short time — three months. Lee Livin, executive vice president of strategy and business development for Eskenazi, saw an opportunity to improve care quickly by reducing the incidence of dementia as a comorbidity and save money. Livin at the time was chief financial officer and Eskenazi was known as Wishard Health Services. Boustani also notes that the three-month time frame coincided with the start of the calendar year, a logical time.
Lisa Harris, M.D., Eskenazi’s CEO, says the hospital has a long tradition of working to bring research quickly into practice, borne of necessity as a safety-net provider that serves large numbers of uninsured patients. Since a lot of the cost of the hospital’s care was beingwritten off as charity care, the hospital had greater incentive to improve the efficiency of its care, Harris says. “Everyone is accustomed to a culture of innovation and testing,” Harris says. Creating the center will help Eskenazi and the other institutions involved, IU School of Medicine and Richard L. Roudebush VA Medical Center, to share their successes and learn from others on a national scale.
The center in Indianapolis is taking on a worthwhile task in joining the effort to make research more useful, says Stuart Guterman, vice president for Medicare and cost control at the Commonwealth Fund. “When you’re trying to improve the way things are done, success depends on a lot. It depends on the system it’s operating in. It depends on the leadership available,” Guterman says. “So it’s appropriate to try to figure out how to get good ideas actually into practice.”