Population Health in Otolaryngology
Stephanie Smith, MD, assistant professor of otolaryngology–head and neck surgery at Northwestern Medicine in Chicago, believes that population health is more prevalent within the specialty than many people realize. “I think there is a fair amount of population health research being done within otolaryngology, but it may not be defined as such,” she said. “For instance, over the past decade, we’ve seen a lot of research emerging on HPV and its relationship to oropharyngeal cancer, and that has affected vaccination campaigns,” she said. “I think that over the next few years and decades, we’ll see the impact of vaccination on head and neck cancer rates.”
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October 2019Dr. Smith’s research into antibiotic prescription patterns for sinusitis is an example of population health research that may fuel population health initiatives. “The impetus for my research came from national data that shows we prescribe antibiotics for sinusitis more than [for] any other diagnosis for adult outpatients in this country,” she said. Given the fact that unnecessary antibiotic usage may contribute to the rise of antibiotic-resistant bacteria, minimizing over-prescription is one way to protect public health. Dr. Smith dug more deeply into the data and learned that primary care physicians and otolaryngologists prescribe most of the antibiotics used to treat sinusitis; she also discovered that primary care physicians are more likely to prescribe antibiotics than otolaryngologists. “Whenever you find a disparity, it points to an opportunity for quality improvement,” she said. “Someone is doing it differently and, perhaps, better.”
Because many patients think that antibiotics are the best treatment for sinusitis, and expect their providers to write a prescription, Dr. Smith is currently working to develop a mobile health platform that will tailor information to patient populations. She plans to test whether or not such a platform can effectively shape patient expectations of antibiotics and interactions with primary care providers. If so, routine use of such a tool could decrease antibiotic over-prescription.
At the Henry Ford Health System, Dr. Chang has integrated population health into the clinical care of patients with head and neck cancer. All new patients attend a pretreatment clinic to help them prepare for their upcoming cancer treatments. During this appointment, clinicians also administer some basic screening tests to better understand how well patients will do during treatment,” Dr. Chang said. Clinicians use standardized tools to assess patient health literacy, alcohol and tobacco use, and social determinants of health. The information garnered helps healthcare providers tailor treatment to patients’ specific needs. It also drives additional population health research.
“Because we use standardized tools, we can look across our data and records and compare outcomes for early stage vs. late stage head and neck cancer, socioeconomic status, cognitive status, and type of cancer,” Dr. Chang said.