Placement: Dell Medical School, The University of Texas at Austin
Mentor: Kevin Bozic, M.D., M.B.A. (Chair of the Department of Surgery and Perioperative Care, Professor of Orthopaedic Surgery, Dell Medical School, University of Texas at Austin)
Co-mentors: Elisabeth Teisberg, Ph.D. (Executive Director, Value Institute for Health and Care; Professor, Department of Medical Education, Dell Medical School, University of Texas at Austin)
Thomas Lee, M.D., M.Sc. (Chief Medical Officer, Press Ganey)
Project: Transforming Musculoskeletal Health Care through Integrated Care: The Impact of Integrated Musculoskeletal Care Delivery Models on Health Outcomes and Costs
Prakash Jayakumar, M.B.B.S., MRCS, FSEM, DPhil, is a 2018–19 U.K. Harkness Fellow in Health Care Policy and Practice. He is an orthopaedic specialist registrar and honorary researcher at the University of Oxford where he was awarded his Doctor of Philosophy assessing the impact of musculoskeletal trauma on quality of life. This followed a scholarship from the Harvard T.H. Chan School of Public Health and fellowship at Massachusetts General Hospital studying health-related outcomes. Jayakumar is a principal investigator in a 5-year global project on patient outcomes following injury, funded by the AO Foundation in Switzerland. He has a special interest in design-led innovation in health and been a clinical advisor for medical design teams at NASA. He is currently exploring design-led approaches to enhance population health through artificial intelligence and deep learning from outcomes data in a Masters in Research in Health Care Design program developed by Prof Lord Ara Darzi at the Royal College of Art/Imperial College London. Jayakumar consults for the University of Oxford and medical device companies on high-value health and health technologies. He completed his medical degree at Kings College London, holds a 1st class honors bachelor’s degree from University College London, and is a member of the Royal College of Surgeons of England.
Project Abstract: Musculoskeletal conditions are the most commonly reported health conditions in the U.S. and a leading cause of years lived with disability in the U.K. Health care systems are contending with high spending, utilization and variable outcomes in this specialty and falling short in relation to coordination, continuity and access to care. The concept of integrated care has been designed to contend with these issues and defined as “care that is coordinated across professionals, facilities and support systems; continuous over time and between visits; tailored to a patients’ needs and preferences; and based on shared responsibility between patients and caregivers.” While this concept is well-recognized, one or more of these aspects remain a challenge for health care delivery systems and policymakers to implement.
The purpose of this project is to investigate current U.S. and European models of integrated care for patients with musculoskeletal conditions through an assessment of patient and provider experiences, an evaluation of outcomes and cost, and an appraisal of patient engagement solutions. This will involve qualitative (thematic) analysis across institutions focused on structural, functional, normative, interpersonal and process-related aspects of integrated care. The project will also assess clinical, process and patient reported outcomes, and time-driven activity-based costings at the Musculoskeletal Institute, Dell Medical School at The University of Texas at Austin, an integrated practice unit focused on managing patients with joint pain, and the Orthopaedic Unit at Schön Klinik, Germany, a quality-oriented, high-volume joint replacement center. Innovative patient engagement solutions, including a risk factor modification program and predictive analytics decision aid for joint replacement, will be assessed using decision-quality indices and patient outcome measures. The findings of this project will inform health care delivery systems and policymakers about the value of integrated care delivery models, and drive transformational strategies around episodes of musculoskeletal care.
Current Positions:
- Assistant Professor of Surgery & Perioperative Care and Director of Value Based Health Care and Outcome Measurement, Dell Medical School, The University of Texas at Austin
- Senior Advisor, Practice Transformation Unit, Duke University Health System
- Visiting Professor of Orthopedic Survey, Duke University
Select Harkness-Related Publications:
P. Jayakumar, M. Grogan Moore, A. Hill, K. Koenig. Integrated Practice Units: What are they and how can they be applied to Orthopaedic Trauma? Journal of Ortopedic Trauma. 2019.
A. Alokozai, P. Jayakumar, K. Bozic. Value-based Healthcare: Improving Outcomes through Patient Activation and Risk Factor Modification. Clinical Orthopaedics and Related Research. 2019.
P. Jayakumar, M. Grogan Moore, K. Bozic. Value-based Health Care: Can Artificial Intelligence Provide Value in Orthopaedic Surgery? Clinical Orthopaedics and Related Research. 2019.
P. Jayakumar, M. Grogan Moore, K. Bozic. Team Approach: A multi-disciplinary approach to the management of hip and knee osteoarthritis. The Journal of Bone and Joint Surgery. 2019.
P. Jayakumar, K. Bozic. Reduced spending with mandatory bundled payments for joint replacements. JAMA Internal Medicine. 2019.
S. Pathak, D. Snyder, T. Kroshus, A. Keswani, P. Jayakumar, K. Esposito, K. Koenig ,D. Jevsevar, K. Bozic, C. Moucha. What are the uses and limitations of Time-driven Activity-based Costing in Total Joint Replacement? Clinical Orthopaedics and Related Research. 2019.
P. Jayakumar, T. Lee, K. Bozic. Information Asymmetry: The Untapped Value of the Patient. NEJM Catalyst. 2019.
M. Grogan Moore, P. Jayakumar, K. Koenig. Not Just for Research Anymore: The Usefulness of PROMs in Clinical Practice. AAOS Now. 2019.
P. Jayakumar, K. Bozic. Advanced decision-making using patient-reported outcome measures in total joint replacement. Journal of Orthopaedic Research. 2020.
P. Jayakumar, J. O’Donnell, O. Manickas-Hill, M. Japinga, C. Mather, M. McClellan, K. Bozic. Critical Considerations For Condition-Based Alternative Payment Models: A Multi-stakeholder Perspective. Health Affairs Blog. 2020.