Application Number: 1 U01 MH103018-01 (Formerly: 1U01AG046691-01) HUSKAMP, HAIDEN A. PHD NORMAND, SHARON-LISE TERESA PHD (Contact) Technology Diffusion Pathways DESCRIPTION: Over the past several years, there has been increasing focus on provider organizations as the locus of responsibility for the cost and quality of health care that is delivered. A number of new strategies to contain spending growth and improve quality of care encourage provider organizations to meet these goals through delivery system changes. Adoption of new medical technology is a primary driver of health care spending growth. Physicians and the organizations in which they practice have various options to adopt and use new and existing technologies. Their choices can potentially improve efficiency of care, but might not prove optimal depending on which technologies are adopted more quickly versus more slowly, and the impact of such strategies will likely vary across organizations. Using a rich collection of data for the period 2005-2015, we propose to examine the relationship between organization traits and diffusion of technology.
In Aim 1 we will study the diffusion of selected new technologies, including technologies we designate to be of higher and lower value, in 4 disease categories - cancer, depression, cardiac, and hip degeneration - as a function of organization characteristics. Our statistical methods include properties of diffusion curves, and provide new approaches to characterize the path of technology adoption. These approaches enable determination of whether decisions to use new technologies are correlated among different technology types, or within and between disease conditions.
In Aim 2, using quality measures promulgated by professional societies, technology characteristics, and FDA alerts, we will distinguish higher from lower value services, identify organizational factors predictive of their use, and determine if decisions to adopt higher vs. lower value services are correlated.
In Aim 3, we will identify organizational characteristics, adjusting for physician and patient factors, associated with spending for new technologies and for lower vs. higher value services. Most research on technological adoption and diffusion consists of case studies of single technologies. Our study will compare rates of adoption and use across types of technologies (medications, devices, and biologics) within disease areas, across lower and higher value technologies, and across organizational forms.

Public Health Relevance

This study will conduct an in-depth investigation of the patterns of diffusion of new technologies, including drugs, biologics, and devices, across organizations of different types. The study will provide information about factors that drive organizations to adopt and expand their use of new technologies.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01MH103018-03
Application #
8916466
Study Section
Special Emphasis Panel (ZRG1-HDM-R (51))
Program Officer
Rupp, Agnes
Project Start
2013-09-26
Project End
2018-06-30
Budget Start
2015-09-01
Budget End
2016-06-30
Support Year
3
Fiscal Year
2015
Total Cost
$580,395
Indirect Cost
$237,979
Name
Harvard Medical School
Department
Administration
Type
Schools of Medicine
DUNS #
047006379
City
Boston
State
MA
Country
United States
Zip Code
02115
Gilstrap, Lauren G; DeFilippis, Ersilia M; Stevenson, Lynne W (2017) An Unintended Consequence of the 21st-Century Cures Act for Patients With Heart Failure. Circulation 136:123-125
Schwartz, Aaron L; Chernew, Michael E; Landon, Bruce E et al. (2015) Changes in Low-Value Services in Year 1 of the Medicare Pioneer Accountable Care Organization Program. JAMA Intern Med 175:1815-25