We conduct research on the structures, processes, and outcomes of the health care and public health systems. Our work blends a population and public health focus, is anchored in health care delivery, and leverages unprecedented data resources derived from health care delivery systems along with methodologic expertise in analyzing those resources.
Our research portfolio continues to grow and evolve along with the changing health needs of the population. Underlying this dynamic body of work are four longstanding projects that are pillars of our department:
MDPHnet: Infectious and Chronic Disease Surveillance
Institute researchers have partnered with the Massachusetts Department of Public Health (MDPH) for almost two decades to operate and enhance a distributed data network that uses electronic health record data to support real-time detection and reporting of notifiable diseases including hepatitis, HIV, and tuberculosis; weekly assessment of respiratory virus like illness; and monitoring for chronic conditions such as obesity, hypertension, smoking, and diabetes. The network currently covers approximately 50% of the Massachusetts population at 16 partner sites, with 4 new sites currently being onboarded.
2023 highlights include:
- Development of statistical models to improve estimates at both the state and local levels. These models adjust for differences between the people included in MDPHnet vs. the rest of the state. These ongoing, prospective estimates of conditions such as asthma and hypertension are being used as a complement to existing public health data sources.
- Introduction of a web-based population management tool to support partner practices to promote the uptake of pre-exposure prophylaxis (PrEP) for people at high risk of HIV. This work utilizes an HIV risk model developed at the Institute and provides sites with a list of their at-risk patients to target for PrEP outreach.
- Creation of a novel surveillance tool for monitoring respiratory viral activity that integrates both laboratory tests and diagnosis codes. This tool helps both practices and public health agencies to monitor the full spectrum of respiratory viral illnesses and includes both tested and untested patients.
Year Founded: 2007
Principal Investigators:
Michael Klompas
Noelle Cocoros
Year Founded: 2014
Principal Investigator:
Jason Block
PCORnet
Institute researchers play a key role in PCORnet, the National Patient-Centered Clinical Research Network, an innovative research network that facilitates multi-site clinical and epidemiologic research using electronic health record data from health systems across the United States. The Institute was a Coordinating Center for PCORnet from its inception in 2014 through 2021. Institute researchers continue to lead work within PCORnet for research and population health surveillance.
2023 highlights include:
- A recent paper found that among 1.5 million patients with COVID-19, higher blood pressure and glycated hemoglobin prior to infection were associated with more severe COVID-19 outcomes. Findings suggest that adults with the poorest control of hypertension or diabetes might benefit from efforts to prevent and initiate early treatment of COVID-19.
- Institute researchers are exploring the association of new prescriptions used for varied chronic diseases on weight change over time. Initial findings show that most patients starting antidepressants experience mild weight gain, with bupropion use associated with the least weight gain over a 2-year follow-up period.
- Vanderbilt University Medical Center was awarded an NIH grant to explore the relationship between COVID-19 and diabetes. Jason Block is one of the Principal Investigators of the study, and a team of Institute researchers will provide important contributions in analyzing data from 38 PCORnet sites to assess varied aspects of the relationship between COVID-19 and diabetes.
Project Viva
Led by Institute faculty, Project Viva is a landmark study of lifecourse influences on health and disease. Continuously funded by the NIH since 1998, Viva has followed a cohort of pregnant women and their (now young adult) offspring for more than two decades. Project Viva has expanded its focus to include a wider range of experiences that influence health extending into midlife for the mothers, and young adulthood for their children. Health exposures of interest now include not only diet but also physical activity, sleep, environmental chemicals, air pollution, stressors, mental health, and others.
2023 Project Viva Highlights include:
- Project Viva turned 25! The next era of research kicked off with conducting the Young Adult Visit, the 7th in-person visit with “Viva Kids” since birth. Read more about the history of Project Viva in the birthday report.
- The team launched a new web-based research portal to support data sharing, called the Research Operations and Data Management Platform (Viva ROADMaP).
- A total of 53 publications using Project Viva data were published in 2023, the highest number in any year since the founding of the study.
Year Founded: 1998
Principal Investigators:
Emily Oken
Marie-France Hivert
Year Founded: 2009
Principal Investigator:
Darren Toh
The U.S. Food and Drug Administration (FDA) Sentinel System
The Harvard Pilgrim Health Care Institute led the development, maintenance, and expansion of the FDA Sentinel System, a program that allows the FDA to work with the nation’s leading health care organizations and data partners to monitor the safety and effectiveness of marketed medical products. Sentinel created a distributed electronic health data network. Curated data covering tens of billions of hospital stays, outpatient visits, and pharmacy dispensings remains with the participating organizations to ensure the privacy and security of patients’ health information.
2023 highlights include:
- 11 publications were posted to the Sentinel website, with 13 actively under review by academic journals
- The FDA ran 68 analyses in the Sentinel System
- Analyses conducted within the Sentinel System informed the FDA’s approval of medications, reversal of medication approvals, adjustments to the communication of medication warnings, and reclassification of medications.