Nathan Brajer

DIHI 2016, 2017 & 2018 Innovation Scholar

I’m very thankful to have had the opportunity to be a part of the DIHI team over the past three years. After my second year of medical school, I joined the team for my first “3rd year” of medical school, and continued to work with DIHI in various capacities over my 2nd and 3rd “3rd years” as I completed an MBA at Fuqua.

During my first year at DIHI, I built a CKD Population Health economic model to help healthcare organizations better understand major cost drivers in their CKD population, and to forecast the financial impact of more effectively deploying evidence based-interventions over time. During that year, I also contributed to the early stages of a project to develop a machine learning model to predict the onset of sepsis in the hospital, and integrate this model into a clinical workflow designed to improve the delivery of evidence-based interventions for these patients. During my 2nd year at DIHI, most of my time was devoted to my MBA coursework, but DIHI was incredibly supportive in helping identify real problems the health system faces that I could help solve by applying what I was learning in school. I applied what I learned in my finance and operations courses to help service line leaders understand the impact an eConsults service model would have on department finances and wait times for outpatient appointments.

During my 3rd year at DIHI, I completed my official medical school thesis while finishing my MBA coursework. My main project was developing, implementing, and evaluating a machine learning model designed to predict in-hospital mortality at the time of admission. I also contributed to various other projects related to lowering mortality rates, including building a mortality review dashboard for operational leaders, conducting service line and patient sub- population mortality analyses, and developing methods for improving the quality of out-of-hospital death outcomes data used for operational initiatives and clinical research.

My time with DIHI has been an incredible learning experience. Through working directly with the clinical leaders, statisticians, software developers, and front- line staff, I’ve learned to speak different “languages”—clinical, technical, and operational—that have enabled me to work more effectively in multidisciplinary teams doing new and challenging work. I’ve learned basic coding, and developed the skills to explore and analyze complex EHR data and to share insights in a clear and actionable way. I’ve learned about the massive barriers associated with integrating new technologies into clinical care, how to anticipate problems, how to ask the right questions, and how to test critical assumptions early on. Beyond this, I’ve learned about challenges facing all teams doing innovative work in healthcare, and how good teams meet challenges.

Working with DIHI has been highly influential on my future career aspirations. One day, as a clinician, I hope to lead efforts at the intersection of clinical medicine, technology development, and business model innovation, with the aim of driving system-level improvements in how we help people achieve their health goals. In the short-term, I’m looking forward to pursuing residency training with the ability to view healthcare delivery through different lenses, and hopefully continuing to contribute to innovative health system work as a resident!

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