David Peiris

Harkness Fellow

Department of Health Policy and Management

David Peiris, M.B.B.S. (hons), M.I.P.H., Ph.D., is the 2015-16 Australian Harkness Fellow in Health Care Policy and Practice, sponsored by the Commonwealth Fund. He is a general practitioner and head of primary health care research at The George Institute for Global Health. He is an associate professor at the University of Sydney and holds a 2013-16 National Health and Medical Research Council (NHMRC) Australian Primary Health Care Research Fellowship.

David works in the field of implementation science- understanding how well research evidence is adopted into routine health care. He is the lead investigator on several primary health care related research grants and government contracts and has conducted large scale trials of mobile health technologies, low cost polypills and workforce re-engineering in Australia, India and China. He has a strong interest in primary health care reform in low resource settings and is the co-chair of the Global Alliance for Chronic Diseases hypertension research network. He is a board member on the Royal Australian College of General Practitioners National Faculty of Aboriginal and Torres Strait Islander Health and sits on several governmental, non-profit, and research advisory committees.

Harkness project

Mentor: Meredith Rosenthal, Ph.D

Title: Identifying Intrinsic Mechanisms Used by Healthcare Systems and Organizations to Increase Healthcare Performance

Abstract: Although much of the focus on the U.S. health care reforms has been related to insurance coverage expansion, several initiatives are also underway to improve quality and efficiency within health care organizations. Despite the breadth of transformation that is taking place through initiatives such as medical homes and accountable care organizations (ACOs), it remains unclear which elements are associated with system improvements. We hypothesize that processes internal to organizations are key determinants of whether innovative practices are successfully implemented. This project aims to identify the financial and non-financial mechanisms that health organizations internally adopt and to determine which of these mechanisms are associated with improved quality and efficiency. This research forms part of a newly funded AHRQ Research Centers for Excellence in Patient Centered Outcomes Research. It will draw on analyses of existing national surveys of ACOs and physician organizations and will inform the development of a new National Survey of Healthcare Organizations and Systems. Outcomes will be assessed based on national claims data and data from the High Value Healthcare Collaborative which comprises over 20 health systems servicing around 70 million patients. Qualitative interviews with health service managers will complement the quantitative analyses. The findings are expected to help inform policy directions in both the U.S. and Australia on how best to support healthcare organizations to deliver efficient, quality health care.