Healthcare Delivery
Research Blog

May 2015

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I recently had the opportunity to attend the annual Surveillance, Epidemiology and End Results (SEER) Managers and Principal Investigators Meeting with my HDRP colleagues Lynne Harlan and Joan Warren; DCCPS Director Bob Croyle; and many colleagues from the Surveillance Research Program.

            The Kentucky Cancer Registry and the NCI-designated Markey Cancer Center at the University of Kentucky hosted the meeting.  The Registry is well-integrated with the Cancer Center’s Cancer Prevention and Control Program, which has led to recent novel collaborations between basic and... Read more


At the recent American Society of Preventive Oncology, the Survivorship Special Interest Group held a breakfast session* in which four speakers gave presentations on innovative survivorship, community-based programs designed to provide cancer survivors with supportive services, both within and outside of the healthcare context.  One such program, the Harvest for Health Project at the University of Alabama, Birmingham (UAB), was presented by Tony Glover, who serves as the Cullman County Extension Coordinator of the Alabama Cooperative Extension System. The program partners master gardeners in the State of Alabama with cancer survivors to create vegetable gardens at the survivors’ homes. Wendy Demark-Wahnefried, PhD, RD, the Associate Director for Cancer Prevention and Control at the UAB Comprehensive Cancer Center and Principal Investigator for Harvest for Health, wanted to see if gardening could help these survivors increase their... Read more


Over the course of my career I have often been frustrated with the gap between the research I was conducting and the clinical operations of the health care delivery systems with which I was affiliated.  As a researcher I often lacked a full understanding of the decisions facing operational leaders and the evidence that would be useful to them.  Operational leaders frequently seemed to find my work esoteric and irrelevant to the challenges they faced. 

The opening plenary* at the recent HMO Research Network meeting was designed to address the topic of cooperation between research and clinical operations.  Much of the discussion centered on how to integrate day-to-day clinical care with research that can improve such care.  Comments from three of the speakers included how their organizations pursue this integration.

In one approach, clinical care processes are established based on available information.  Researchers then develop studies based on their observations of... Read more

clinical careconferences

The first question many people ask about our new Healthcare Delivery Research Program concerns the title. Why was the term “healthcare delivery research” used? Below are some of my personal reflections about this choice of terminology.

I came to NCI to serve as Chief of the Health Services and Economics Branch. There were two other Branches focused on work that could be considered to fall mainly under the rubric of “health services research.” They were the Outcomes Research Branch and the Patterns of Care Research Branch. I was concerned that combining the three groups into a “Health Services Research Program” would fail to indicate the expansion of this field of research within the Division of Cancer Control and Population Sciences (DCCPS).

Throughout the fall of 2015, I and others began to talk about plans to create a new group within the Division of Cancer Control and Population Sciences. We heard from some national research leaders that the term “health... Read more

healthcare delivery

Delayed cancer diagnosis due to breakdowns in the cancer screening process. Incomplete information on benefits and harms provided to patients making treatment decisions. Poor communication and coordination between specialists involved in cancer care. Diminished adherence to oral medication due to patient cost. Inadequate monitoring of cancer survivors for cancer recurrence. Lack of attention to caregiver needs. Disparities in cancer care due to age, gender, race, ethnicity, sexual orientation, rural residence, education, and income. Purchase and promotion of new and costly, but unproven, technologies by medical facilities. Shifting reimbursement strategies. Minimal integration of patient-reported outcomes into clinical care. Failure to communicate and act on advance directives. Continued increases in the societal costs of cancer care.

Understanding the many challenges of cancer care is the focus of the new Healthcare Delivery Research Program in the Division of... Read more