“Patrick … is intense,” says Dr. Keren, laughing. “But not in an obvious way. He’s very mild-mannered and polite and easy going on the outside. But when he starts a project, he is pretty aggressive as far as setting a very ambitious timeline, pushing things forward, and working as hard as possible. I just had to point him in the right direction every now and then, and he got the job done.”
Dr. Conway, lead author of the JAMA study, also contributed to a video news release and podcasts about its results. He impressed some of Dr. Clancy’s colleagues at the AHRQ with his ability to make the information easy to understand for people without a clinical medical background, Dr. Clancy says. That skill made him a good candidate for the fellowship.
“My goal is that he would get a lot of exposure to how healthcare policy is made, and that he would go back to Cincinnati Children’s understanding how physicians can play a more vital role in making sure that we get health policy right,” Dr. Clancy says. “To do that, you’ve got to be bilingual both in policy and in medicine—and there aren’t enough people who have that skill.”
And there’s something else to look forward to. “Supposedly we get the opportunity to ride mountain bikes with the president if we’re good enough,” Dr. Conway says. “I bike, but not extensively, so I’m working up to that. I need to make sure I don’t embarrass myself.”
Hospitalist Goals
Dr. Conway says one of his focuses is on the implementation of health information technology that better serves physicians and patients.
“We are interested in the alignment of incentive payments to physicians who use information technology to improve the care delivered to patients,” including electronic medical records and interoperability of data, he says. “In the last five years or so, there’s been increased interest in pay for performance, and now we’re moving toward thinking about how to structure these programs to pay for and enable quality improvement and the effective utilization of information technology.
“From a hospitalist perspective, I think one of the important issues is that many of these quality measures are directly related to the care delivered in hospitals by, primarily, hospitalists, so therefore it’s important for hospitalists to be involved in these processes.”
He’s also working with HHS on a value-driven healthcare initiative, intended “to bring transparency around quality and cost in healthcare and to enable quality improvement,” Dr. Conway says. “In this case, transparency for all stakeholders, so for consumers, for providers, for payers. We can criticize the process from the outside or we can get involved. We need to get involved.”
He has had a clearer idea than most about his career plan from the start, said Chris Landrigan, MD, MPH, research and fellowship director, inpatient pediatrics service, and assistant professor of pediatrics at Children’s Hospital Boston, where Dr. Conway interned. The two found they had a lot in common: Both were interested in the operations of the health system and in finding ways to improve it through clinical work, research, and policy, Dr. Landrigan says.
“Most of our work together has revolved around looking at the variations in care in hospital systems,” Dr. Landrigan says. “Some of my work has been in trying to set up a research network for pediatric hospitalists, and to try and improve the care of hospitalized children.”
Dr. Landrigan was surveying pediatric hospitalists about how they treat several common conditions, looking for variations, when Dr. Conway arrived at Children’s.