Harkness Project Title: Hard to Reach: Delivering Continuity of Care Without Continuity of Provider
Mentor: Arnold Milstein, M.D., M.P.H. (Stanford University)
Co-Mentor: Julie A. Schmittdiel, Ph.D. (Kaiser Permanente)
Placement: Stanford Clinical Excellence Research Center
Biography at time of Harkness Fellowship: Scott Robertson, M.Econ., R.N., a 2014–15 Canadian Harkness Fellow in Health Care Policy and Practice, is senior project manager for medical travel in the Department of Health and Social Services in the Government of the Northwest Territories, where he leads development of policy and program frameworks, as well as models program costs. His past positions have included chief nursing officer and senior nursing consultant for the Government of the Northwest Territories’ Department of Health and Social Services, nursing researcher for the Inuit Health Survey at McGill University, and as a registered nurse with Stanton Territorial Health Authority. Robertson’s research interests include indigenous populations, rural health, primary health care, nursing, continuity of care, and health economics. He was a Canadian Foundation for Healthcare Improvement from 2013–14, participated in the Governor General’s Canadian Leadership Program in 2012, and held an Action Canada Fellowship from 2010–11. He earned a master’s degree in specialized economic analysis from the Barcelona Graduate School of Economics.
Project: People with a chronic illness have better outcomes when they have the same health care provider over time. Scott aims to analyze the practices in providing continuity of care for isolated populations—geographic, social, or financial—that can be applied regardless of provider continuity. First, observational and interview data collected in the AIM (American Idol in Medicine) study that examines the features of high-performing, low-cost healthcare systems will be examined. Common themes will be identified related to the relationship and activities with the patient and how it is specifically translated into activities that improve outcomes. Second, using a patient data set from a large HMO in Northern California, various factors related to continuity and patient outcome will be examined to see if there are quantitative measures that help better understand this relationship. For example, patients with higher measures of continuity of care are more likely to take their prescription medication, which leads to better health outcomes. If this is found to be the case with this population, can we understand more about the characteristics that lead to better medication adherence, and should that be a focus of efforts? The outcome of this research will be to provide evidence-based policy recommendations that apply both intra-organizational and extra-organizational approaches to improve care through improving continuity. The application of the proposed research is of particular importance to isolated populations, and has broader applications toward improving the delivery of primary care in all settings.
Career Activity since Fellowship:
- Lead for Specialty Care Site Visits, Stanford Clinical Excellence Research Center, 2015 – 2016
Current Position: Senior Clinical Research Advisor, Verily Life Sciences (updated 11/2016)
Email: [email protected]