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What I Learned as a Value-Based Health Care Research Fellow

Nov. 7, 2017

Tiffany Liu, a former value-based health care research fellow at Dell Medical School, wrote the following blog post about her experience in the program.

As a third-year medical student at the University of Pennsylvania rotating on an orthopaedic trauma elective, I had just decided orthopaedic surgery was the specialty for me when I received a fortuitous email with the subject line “FW: Dell Medical School Value-Based Care Fellowship Award.” It came from a classmate with a connection to someone at a gutsy institution in Austin, Texas seeking to “rethink everything” about health care. The timing was perfect. Despite the surety of my specialty, I was considering my future career and wondering how I could combine my dedication to clinical care with my interest in quality and policy to have a broader impact on health care.

The fellowship captured my attention because it combines strategy and operations work with value-based care research, a unique blend that stood out from the other research postings floating around on the internet and through my inbox. Reading through the online materials about how Dell Med seeks to improve value by restructuring health care to be patient-centered, I was struck by how deeply the mission and vision resonated with me. Moreover, I knew I would have a chance to work with leading orthopaedic surgeons — role models I aspired to learn from.

When I arrived at Dell Med, I received the flexibility to pursue the projects of most interest to me, and indeed, my projects have touched upon research, clinical care and operations, and policy. I’ve been most deeply immersed in the realm of patient-reported outcomes and even had the opportunity to lead the implementation of routine patient-reported outcomes measures (PROM) collection across two clinics. This experience led me to design and carry out a qualitative research study seeking to understand the barriers and challenges that patients face in completing PROMs. From a research perspective, learning how to design and conduct a study was interesting and challenging enough. However, the operational aspect yielded understanding of even more nuances. To be successful, I had to consider the provider, patient, organizational, and administrative perspectives, and combine them all into a cohesive workflow.

My experience in patient-reported outcomes offered me lessons that I plan to incorporate into my future practice: assessing the appropriateness of treatment options, offering shared decision-making to bring the patients’ goals and preferences into the treatment plan, and routinely measuring outcomes to constantly improve the care I provide. And above all, asking my patients how they are doing and how their health is affecting their life.

This chance to get elbows deep into value-based care design and work with health care leaders was truly unique. From this year, I’ll carry away the principles of value-based care and patient-centered care delivery. But beyond the learnings I gleaned from my job-related tasks, I had the opportunity to collaborate with energetic, innovative, and passionate people who truly care about health rather than simply offering more health care. As a colleague said to me my first week, “this place is like lightning in a bottle,” and he couldn’t have been more right. It’s this blend of passion, energy, and dedication that will stick with me long after I leave Austin.