Research Spotlight: Dr. Debbie Pestka

Tell us about your research

M Health Fairview began a population health-focused primary care transformation in May 2019. As part of the primary care transformation, every M Health Fairview primary care patient is placed into one of five strata (called service bundles) based on their complexity of care. Appointment lengths and care team resources are then tailored to each service bundle. Through my research, I am examining how clinical pharmacists providing comprehensive medication management are implemented into this new model of care and the transformation efforts overall.

What is the partnership you have developed with M Health Fairview?

I am a learning health systems researcher, so I have partnered with M Health Fairview to better understand the challenges and opportunities presented by the primary care transformation. My research is then focused on generating data from practice, using the data to identify where and how care and care delivery could be improved, and then implementing those changes into practice.

Do you have any partners in your research?

I am funded through the Minnesota Learning Health System (MN-LHS) K12 program, which is a career development program. With my project, I have mentors both at the University and at M Health Fairview. The MN-LHS program is a collaboration between the School of Public Health, Mayo Clinic, Hennepin Healthcare, and M Health Fairview, so I also have a lot of great partners and mentors through the MN-LHS program. In addition, through the program I have been able to connect and work with learning health system researchers not only across M Health Fairview, but in other health systems across the state.

What did you find?

While my research is ongoing, through my initial qualitative work, I have identified several implementation barriers and facilitators that have occurred with the initial roll-out of the primary care transformation and integration of comprehensive medication management services. In addition, I examined how comprehensive medication management delivery changed in the primary care transformation compared to before it began. I also worked with the care team providing care to the most complex patients in the primary care transformation to examine key insights they have learned in providing care to high-cost, high-need patients, through a highly integrated team-based model.

Why do your findings matter?

Learning health system research is all about generating data from practice, learning from the data, and then putting that knowledge back into practice to improve care and care delivery. Evaluating implementation barriers and facilitators in the early stages of implementation is important for health system initiatives because they can illustrate where adaptations may need to be made or what barriers may need to be addressed to ensure successful implementation.

What do you hope people will take away from this research?

My hope is that health systems and funders recognize the value of learning health system research. Health care is a discipline that is driven by evidence-based practice. Embedding researchers into practice can help health systems ensure that they are providing evidence-based care delivery, and the highest quality and most cost-effective care.