Keeneland Conference: A Look Ahead with F. Douglas Scutchfield
The annual Keeneland Conference kicked off today, where more than 300 public health services and systems researchers (PHSSR), public health officials and policy-makers have convened to discuss the latest issues in this growing field of research. PHSSR is aimed at establishing an evidence base to allow public health officials to make smarter, more-informed decisions with regard to resource allocation, staffing, operations and service provision.
NewPublicHealth is on the ground in Kentucky to capture the critical conversations and Q&As from leaders in the field. We spoke with F. Douglas Scutchfield, MD, director of the National Coordinating Center for PHSSR and the Peter Bosomworth endowed faculty in the University of Kentucky College of Public Health, to get his take on where the PHSSR field stands and the anticipated highlights of conference.
NewPublicHealth: What are the critical areas for public health as you head into the Keeneland Conference?
Dr. Scutchfield: I think there are several agendas that will be a backdrop against which Keeneland is taking place. One is a reformed healthcare system, with the Affordable Care Act and its implications for public health and public health’s relations with a variety of other service delivery systems, such as primary care and hospitals.
We will also see the rollout of a new research agenda, published as a supplement to the American Journal of Preventive Medicine,that will give us a new direction to pursue in terms of how we’re going to begin to try improving the infrastructure in the public health system.
NPH: What has been your sense in speaking with colleagues in the field about what kind of research is most in demand for public health leaders and decision-makers right now?
Dr. Scutchfield: There are several things that are happening. One is the economic downturn, and a key research issue is its impact on public health service delivery.
I think the second thing that’s going to be very interesting is that this economic change has kind of changed the way we’ve had to do business. I think one of the things we’ll hear at the meeting are some new and interesting ways that we’ve been able to try to cope with organizational and structural changes, including new partnerships, relationships and activities to try to bridge the loss of resources that we’ve seen in public health while maintaining services for the people that we serve.
Another theme that we will see and that I’m excited about is how we take the findings and get those to practitioners and have practitioners adapt those more rapidly.
NPH: What other research do you expect to generate buzz?
Dr. Scutchfield: There has just been a release on the public health nursing research agenda. Public health nursing is a key component of public health and the largest component of the public health workforce.
There’s also a broad movement in quality issues. There’s a growing discussion about how we go about the process of measuring and assuring quality in population services and how we measure population health.
NPH: How does an emphasis on research also help the growing intersection between health and healthcare in the delivery of public health services?
Dr. Scutchfield: We’ve got a new Institute of Medicine report on the relationship between primary care and public health that’s going to be discussed at the meeting, and the president of the American Hospital Association will be talking about how this new paradigm and changes in health reform are going to help form new partnerships and focus between hospitals and health departments. I think that what you’re seeing with this changing healthcare environment is a continued growth in the cost of medical care, and an understanding that we’re going to have to reduce costs; one of the ways to get a handle on that is prevention and public health and getting ahead of some of the issues in chronic disease that are driving a lot of the rising costs.
NPH: Frontiers in PHSSR, the new online PHSSR journal, was also launched here at the conference. What will this new resource add to the field?
Dr. Scutchfield: A key goal of the new journal is to try to speed our research findings to practitioners. The average lifecycle from completion of research study until its adoption in practice is 17 years. We haven’t got time for that. Frontiers will be a rapid-cycle journal, and the analogy I use is CDC’s Morbidity and Mortality Weekly Report. It’s brief, and it’s something that you can use immediately.
There are three articles I think that are especially interesting in the first issue. One of them looks at how the thought leaders in public health are influencing the implementation of research findings. Some work by Jackie Merrill and her colleagues at Columbia and Carnegie Mellon suggests that there are early adopters who are people who very quickly grab research findings and apply them in their particular practice setting and become thought leaders. Those are individuals that we clearly want to try to identify.
There’s a second article by our colleague Betty Bekemeier at the University of Washington who focuses on using the practice-based research networks to be able to track what’s going on with the actual delivery of public health services across the United States and gives us a quick and easy mechanism for finding out what’s hot and what’s not. And a third article, by Scott Hayes at the University of Illinois, focuses on boards of health and what’s most effective in their composition and character.
NPH: What else has to happen for the research to be applied more broadly and quickly?
Dr. Scutchfield: We have to get it out and we have to get it out to the right people. We’ve learned some valuable lessons from our colleagues in agriculture. If you think a little bit about the cooperative extension service [a network that helped disseminate agricultural innovations to widespread adoption] and begin to make that extrapolation to public health, particularly focusing on the thought-leader individuals that Dr. Merrill has identified in her social network research, that tells you some of the ways we can get information there. And we’re involved in a major study funded by the Robert Wood Johnson Foundation, being conducted by Washington University, to identify those factors that influence the rapidity with which research is implemented in public health departments.
We realize that practitioners are busy and frequently don’t have the time to do the kind of research that they would like to do in order to find the evidence that would help them make decisions, so we’re also working with our colleagues at the National Library of Medicine on a new program to help get the evidence in the literature out to practitioners.
NPH: What’s uppermost in your mind as you head into the conference?
Dr. Scutchfield: We think there’s an excitement in the air. We’re seeing some new and exciting things happen: the release three Institute of Medicine reports this year, discussions of new financing, how [the public health field] is going to be relating to hospitals, how we’re going to be relating to primary care centers, the implications of that for research, and how we can provide the information to practitioners and policy-makers to more effectively deal with the kinds of changes that we’re seeing in a rapidly evolving healthcare system. I think the speed with which things are happening in public health has accelerated, and that’s exciting.