Primary Health Care Research
The George Institute for Global Health; and
Associate Professor Sydney
University of Sydney
Placement: Harvard School of Public Health
Mentor: Meredith Rosenthal, Ph.D. (Harvard School of Public Health)
Project: Identifying Intrinsic Mechanisms Used by Healthcare Systems and Organizations to Increase Healthcare Performance
David Peiris, M.B.B.S. (hons), M.I.P.H., Ph.D., is a 2015–16 Australian Harkness Fellow in Health Care Policy and Practice. He is a general practitioner and head of primary health care research at The George Institute for Global Health. He has an associate professor appointment at the University of Sydney and a senior research associate appointment at the University of Oxford. He is also a 2013–16 National Health and Medical Research Council (NHMRC) Australian Primary Health Care Early Career Research Fellow. Peiris 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. He has a strong interest in primary health care reform in India and China and is the co-chair of the Global Alliance for Chronic Diseases hypertension research network. Prior to work at the George Institute, Peiris was the sole general practitioner in a remote Aboriginal community, implementing local system changes which led to major changes in service design and performance. 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, nonprofit, and research advisory committees. He has published 38 peer-reviewed journal articles, one national clinical practice guideline, and a chapter for the Australian Commission on Safety and Quality in Health Care annual report.
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. Peiris hypothesizes that certain internal organizational mechanisms, such as leadership, financial incentives, measurement of cost and quality, and use of decision support, are key determinants of whether innovative practices are successfully implemented. He aims to identify these financial and non-financial mechanisms that health organizations internally adopt, and to determine which of these mechanisms are associated with improved system performance. His 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 Australia and the U.S. on how best to support healthcare organizations to deliver efficient, quality health care.
Career Activity since Fellowship: