Overview of My Research

My research is based at the University of Colorado’s Adult and Child Consortium for Health Outcomes (ACCORDS), a multidisciplinary research center that focuses on the entire life spectrum as well as on “delivery science,” encompassing comparative effectiveness, patient-centered outcomes and implementation and dissemination research.research

My work has focused on using electronic health data methods to define and model systems- and patient-level factors associated with process and outcome measures of health care quality.  This work has assessed variation in quality of care for various conditions, and has demonstrated the importance of rigorous methods in selecting and implementing quality metrics. These publications have highlighted the importance of the following in quality measurement:

  1. selecting process measures only when they have demonstrated association with outcomes of value;
  2. using risk-adjustment that extends beyond adjustment for the severity of the acute condition to encompass chronic medical complexity and social determinants of health; and
  3. incorporating adjustment for structural measures of quality, including crowding and occupancy measures.

These publications document the importance of addressing these issues from a policy standpoint, particularly in light of public reporting and pay for performance tied to such measures.StructureProcessAndHealthOutcomes

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