Message from the Director
No Ideas But in Things
The daughter of good friends has a master’s degree in mathematics, but is currently in a graduate program in art. She is a ceramicist, and when I asked her recently what she likes the most about her art, she replied, “I like to sit in the studio and make things.” Her seemingly simple response made me think about what I like most in research. My answer is the same as hers – I like making things.
One of the most common misperceptions about research is that it is all about grand ideas and sweeping hypotheses. Seeing the big picture and asking the right question are certainly part of the research process, but conducting research requires us to move back and forth between big ideas and fine details. The best researchers are both thinkers and doers, an uncommon combination of skills. And they spend most of their time doing.
Researchers in the IHR have many crafts. They construct visual models of complex biological and organizational processes. They develop and test surveys. They create apps and websites. They write code to assemble data files. They build statistical models. They complete IRB applications. They prepare timelines and budgets. They write and they write and they write – grant applications, public presentations, final reports, research papers. Few non-researchers realize the importance of good writing in a research career. They assume that research is all about the numbers, when in fact, writing is the craft we must master to describe our ideas persuasively and interpret those numbers for others.
People who lead research departments create spaces where other researchers can think great thoughts and make things, where they can practice the art and craft of research. To continue the art analogy, research leaders build studios. Similar to other organizational leaders, they must focus more on the process by which things are made than on the products themselves. They act as “meta-leaders” who replicate the planning and execution of individual research projects on a broad scale. They identify common themes in the ideas of their researchers and administrators, and develop the capacity to enact them. They build teams, establish work processes, manage office space, integrate project budgets into departmental budgets, write annual reports, and represent their departments to others.
Almost all of them wish they could do more “hands-on” research.
Having been (to my great surprise) a research leader for most of my career, I decided over two years ago that I would soon be ready to return to the craft of research, to inhabit research spaces rather than build them. As I described it to friends, I realized that I was finally ready to have the career that I anticipated when I began my research training over 30 years ago. Accordingly, I stepped down as the Senior Director of the IHR at the end of October 2016. With executive sponsorship from Dr. Jandel Allen-Davis and Dr. Wendee Gozansky, Dr. Marsha Raebel and Julie James, our director of research administration, have led the search for my successor over the last year. We're all delighted that Dr. Claudia Steiner will be the new Executive Director of the IHR.
Leading the IHR has been the best job I ever had, yet I leave it without regret to return to a role as a Senior Investigator in our department. The IHR is in great hands, with Dr. Liz Bayliss as Interim Director, with amazing investigators and staff, and with an experienced and skilled leadership team. Our scientific and financial foundation is strong, even in a “soft-money” research world. As a department, we are poised for opportunity and growth. We are prepared to contribute to scientific discovery, collaborate in organizational change within KP, and inform health policy in our community.
I am grateful beyond words for the relationships I have built in the last eight years in the IHR, in KP, and with our broad community of research partners. You all are why I’m staying. Thank you.
So I’m ready to make things again. I take inspiration from the words of William Carlos Williams, a great physician-writer whose poems and short stories celebrate both complexity and specificity:
Say it, no ideas but in things–
MacGowan, Christopher, and William Carlos Williams. The Collected Poems of William Carlos Williams. Carcanet, 1988.
John F. Steiner, MD, MPH
Kind Words & Best Wishes for John
Thank you for leading a department with the most professional, friendly, and collaborative culture I could imagine. Your gestures of kindness are so much appreciated and bring out the best in all of us. There are many examples including the generous credit that you give to individuals and teams at All Hands, and for coming by my desk my first day back from maternity leave with my first child to thank me for my input in a project meeting and welcome me back. - Liza Reifler, MA, Biostatistician, IHR
John's leadership came at a crucial moment for the IHR, and went a very long ways toward ensuring our department's sustainability. I will always appreciate his practicality, his ability to move between the serious and the silly in the same conversation, and his early and enthusiastic endorsement for the practice of engaging patients on our research teams. My career has benefitted immeasurably from this commitment to improving research by partnering with our stakeholders, as John has given me support for expanding the role of the IHR in broader efforts to improve engagement methods and build the capacity for patient and stakeholder engagement both within the IHR and the HCSRN. My most sincere thanks for your vision, and your ability to translate so much of it into action. - Sarah Madrid, MA, ABD, PhD, Sr. Program Manager, IHR
John, you have been very instrumental in representing and advancing the efforts of the IHR in the last eight years. We want to thank you for putting the IHR on the KP map and for standing up for the IHR in what we believe in, and keeping our mission and vision alive on the home front as well as sharing it with everyone that had an interested ear. You have kept us on course and encouraged us to persevere when times have been lean and you have celebrated with us when the bounty has been great. You have contributed greatly to the IHR legacy, and for that we are thankful. - Sharma Cummings, Administrative Assistant, IHR
Ode to Steiner
We worked on the Collaboratory
A challenging grant with a story.
The stakes were dauntingly high.
And I learned quickly, John’s a great guy
We went to DC for a meeting
In a wild downpour—some greeting!
We were grilled, while bedraggled and soaked,
By NIH leaders—no joke!
I learned he’s afraid of umbrellas.
But otherwise, he’s a great fella.
The project did not manifest,
But we soldiered on, nonetheless.
We collaborate still
And I hope that we will
Even after he hands the baton.
John Steiner, you’re awesome. Rock on!
To tie a bow around it, I have the deepest regard for John’s intellect, mentorship, and generosity of spirit. I’ve benefited tremendously from the opportunity to work with him, and feel lucky to be in his orbit. Cheers to a fun and fruitful new chapter in his distinguished career. - Sarah Greene, MPH, Executive Director, HCSRN
IHR Welcomes New Executive Director, Claudia Steiner, MD, MPH
Dr. Claudia Steiner currently serves as Director for the Division of Healthcare Delivery Data, Measures and Research, in the Center for Delivery, Organization, and Markets within the Agency for Healthcare Research and Quality (AHRQ). Dr. Steiner leads the division’s development, production, and improvement of data and software tools for use in research, policy analysis, quality improvement, and public reporting, with a particular focus on Healthcare Cost and Utilization Project (HCUP), the AHRQ Quality Indicators, MONAHRQ® and the All Payer Claims Database project. As the Director, she also serves as a representative and liaison to both intra-Agency and inter-Departmental healthcare initiatives.
Her research interests include the influence of ambulatory surgery on standards of care, utilization, and clinical outcomes; the epidemiology of infectious diseases, including healthcare associated infections; the prevalence and factors associated with readmissions to the acute care setting; and the use and impact of new medical technologies. She has examined the process and considerations used by private indemnity and managed care insurers when determining coverage for new medical technology.
Dr. Steiner received her medical degree and completed residency training in Internal Medicine at the University of Colorado Health Sciences Center (now the University of Colorado Anschutz Medical Campus). Subsequently, she obtained a Masters of Public Health at the Johns Hopkins School of Hygiene and Public Health (now the Johns Hopkins Bloomberg School of Public Health) while completing a research fellowship through the Department of Medicine at Johns Hopkins University.
The vast majority of her time will be devoted to internal and external responsibilities for the Institute for Health Research. She also will have a modest time commitment as an internal medicine clinician with the Colorado Permanente Medical Group (CPMG).
IHR Project Manager Mike Shainline Retires
Please join us in extending best wishes to Project Manager, Mike Shainline MS, MBA, who is retiring from Kaiser Permanente at the start of the new year. Mike has been a member of the Institute for Health Research for 6 years, first joining the IHR in 2010 as Project Manager to work on the AHRQ's ARRA-funded projects: Scalable PArtnering Network for Comparative Effectiveness Research (SPAN) and SUveillance, PREvention, and ManagEment of Diabetes Mellitus (SUPREME-DM). After working on SPAN and SUPREME-DM, Mike became the project manager for the Interactive Voice Recognition (IVR) System. As the IVR project manager, Mike utilized his many skills to act as the front-end business consultant on numerous projects, analyze effectiveness data, and manage IVR member communications.
In addition to his many work-related talents, Mike is a singer/songwriter and guitar player. He is an avid bike rider and has participated in many regional rides like the Santa Fe Century as well as riding into the office most days of the week (barring inclement weather!) We know you all join us in wishing Mike well as he starts this new chapter in life.
Now in its third year, the ARISE (Accountability, Research, Innovation, Service, Excellence) Award was given out at this year's holiday luncheon on December 8th. The ARISE Award recognizes IHR staff for outstanding service and contributions to the department. Peer nominations are reviewed by a committee comprised of IHR staff to determine six finalists. Congratulations to all of the nominees, Ted Palen, PhD, MD, MSPH, FACP, Sophia Newcomer, MPH, Hilda Medina, and Dave Powers, MS and to finalists Kris Wain, Sharma Cummings, Cheryl Kelly, PhD, MPH, MA, and Courtney Kraus, MSPH--and to our 2016 winner Jennifer Boggs, MSW!
Marsha A. Raebel, PharmD, BCPS, FCCP won the Best Poster Award at the American College of Clinical Pharmacy Annual Meeting, October 24, 2016, in Hollywood, Florida. Poster authors included Marsha A. Raebel, PharmD (KPCO), Gregory A. Nichols, PhD (KPNW), Wendy Dyer, MS (KPNC), and Julie A. Schmittdiel, PhD (KPNC). The poster was entitled "Relationships between antihypertensive medication adherence, age, comorbidities, and blood pressure control in elderly patients with diabetes." The results presented in the poster were part of a project funded through grant 5R21DK103146 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) .
In late September, Andrea Burnett-Hartman PhD, MPH, presented at the American Association for Cancer Research National Colorectal Cancer Meeting. The presentation focused on the use of medical informatics to evaluate the risk of colorectal cancer in patients with clinically diagnosed sessile serrated polyps (SSPs). Together with Chan Zeng, PhD, Dr. Burnett-Hartman found that the risk of colorectal cancer in patients with clinically-diagnosed sessile serrated polyps is similar to the risk of colorectal cancer in those with non-advanced adenomas. These results run counter to recent evidence that SSPs may be important, aggressive precursors for proximal colon cancer and suggests the need for additional longitudinal studies of SSPs diagnosed through usual care to inform guidelines for the surveillance of patients with SSPs.
Ted Palen, PhD, MD, MSPH, FACP, gave a presentation on “Point of care radiology decision support embedded in electronic health records” in early November at the American Medical Informatics Association Annual Symposium. The presentation revolved around the value of adding radiology decision support software to the electronic healthcare system at Kaiser Permanente Colorado. The decision support software aids physicians and non-physician clinicians in ordering appropriate cross-sectional imaging tests for their patients via the American College of Radiology (ACR) Appropriateness Criteria. Collaborating with radiologist Dr. Richard Sharpe, specialty and primary care departments at KPCO, Dr. Palen and Susan Shetterly, MS, found that Kaiser Permanente CO physicians and non-physician clinicians already ordered appropriate tests for their patients at high rates prior to implementing the decision support software. However, the decision support software did decrease the ordering volume of high-cost exams like MRIs and CT scans, potentially increasing access to patients that need these tests.
Matthew Daley, MD, Jennifer Barrow, MSPH, David Tabano, MA, LeeAnn Rohm, MSW and Liza Reifler, MPH, are excited to announce that the Colorado Health and Environment Data (CHED) website now hosts the maps and data tables from the Colorado BMI Monitoring System. On this web page, users can do the following:
Check out the most recent IHR Publications here.