Keeneland 2013 Q&A: William Roper
Today’s plenary speaker at the 2013 Keeneland Conference is William Roper, MD, MPH, dean of the school of medicine, vice chancellor for medical affairs and CEO of the UNC Health Care System at the University of North Carolina at Chapel Hill. Earlier in his career, Dr. Roper was senior vice president of Prudential HealthCare, president of the Prudential Center for Health Care Research, director of the Centers for Disease Control and Prevention and administrator of the Health Care Financing System, the precursor to the Center for Medicare and Medicaid Services.
NewPublicHealth spoke with Dr. Roper on his way to the Keeneland Conference about the drive to better use data, instead of anecdotes and personal beliefs, to drive decision-making.
NewPublicHealth: What were some of the early efforts you were involved in that set the stage for the field of public health services and systems research we know today?
Dr. Roper: I didn’t do this by myself; I did it with a lot of other people, but one of the critical early efforts was the publication of Medicare mortality information on all American hospitals beginning in 1986 and continuing for a number of years thereafter. Another was creation of the Agency for Healthcare Policy and Research in 1989, which has since been renamed the Agency for Healthcare Research and Quality. Another was the launching of the Prevention Effectiveness Initiative at CDC in the early 90s. And then subsequently, work that I’ve done at the University of North Carolina, first at the School of Public Health and then at the School of Medicine using the tools of health services research broadly in health care and in public health.
NPH: What are some of the fruits of those efforts?
Dr. Roper: We now have much more than just personal beliefs and anecdotes driving decision making. We now have data driven decision making ranging from the way we organize and deliver health care and public health services to individual decisions that we ask patients and their families to make. In a whole variety of areas we now have a better framework and process for making key decisions in health and health care.
NPH: How critical was that early work to the creation of the Affordable Care Act?
Dr. Roper: There’s a whole notion that we can do better, that we can make smarter decisions individually and collectively as a nation. It’s one of the things that have driven us to the Affordable Care Act. It’s not all implemented; 2014 will be an important milestone, but even then, there are many other things that need further to be done. For example PCORI, the Patient- Centered Outcomes Research Institute will give us information and insights over the coming years that will further shape health care. This is not a finished effort.
>>Read more on the Patient-Centered Outcomes Research Institute in an interview with Joe Selby.
NPH: What population health research questions would you point young investigators to that need answers?
Dr. Roper: I think one research question is how do we go from the rhetoric of population health, which everybody thinks is a very nice idea—I sure do—to something practical that organized systems of care like mine can use to do practical work that actually does improve population health. I think we are at the slogan stage right now, not the operational stage.
NPH: What research questions are you working on yourself?
Dr. Roper: Increasingly, statewide, we are asking not how public health just survives, but also thrives in this turbulent time in health care, and that’s the challenge that we are daily working on. Those challenges include resource constraints, but also how to form constructive relationships between doctors and hospitals to help bring about the integration of health care in public health in America.