Who's Who: Jeremy Kahn is Helping to Cross the Quality Chasm
Over the course of his career, Jeremy Kahn, MD, MS, has approached the practice of medicine from two perspectives. As an intensivist caring for patients in the ICU, he sees firsthand how best practices improve people’s health at the point of care. But as an expert in healthcare policy, management and delivery, he also looks at critical care outcomes from a system-wide point of view. He wears both hats at the University of Pittsburgh, where he spends most of his time conducting comparative effectiveness research designed to help clinicians and policymakers make informed decisions.
“I am fascinated with the ways in which healthcare is organized, particularly the complex structural patterns in the ICU,” said Dr. Kahn, who is associate professor of critical care and a core faculty member in the University’s Clinical Research, Investigation and Systems Modeling of Acute Illness (CRISMA) Center. “Pittsburgh is an outstanding environment for health services research and has a long tradition of innovative policy work. Here, I am able to teach and oversee large public health datasets, while at the same time working closely with health economists at Carnegie Mellon University and the Rand Corporation, as well as other international leaders in the field of critical care health policy.”
As a fellow at the University of Washington, Dr. Kahn thought he would become a critical care epidemiologist who specialized in acute lung injury—in fact, this was one of the reasons he decided to train in Seattle under Gordon Rubenfeld and Leonard Hudson shortly after having completed his residency at the University of Chicago Hospitals in 2002.
“I was frustrated to discover that most clinical research does little to change clinical practice,” explained Dr. Kahn, who went on to earn his master’s degree in epidemiology from the University of Washington in 2005. “My eyes really opened when I first read the Institute of Medicine report Crossing the Quality Chasm—it really demonstrated how ineffective we are at providing evidence-based care. I realized that we don’t really need new ways to care for patients; what we need are new ways to effectively deliver the care we already know is good. Health services research is my way of doing just that.”
As director of CRISMA’s Program on Critical Care Health Policy, he oversees junior faculty, fellows and students who are conducting research on a variety of topics, including how economic, behavioral and social factors influence the use and outcomes of critical care. He also directs the University’s Comparative Effectiveness Data Center, which helps researchers throughout the university to better understand the structure, process and outcome of healthcare quality.
“I am particularly interested in the intersection between structure and outcome—the ways in which we can best organize and manage the ICU to deliver evidence-based medicine and increase survival,” said Dr. Kahn, who also serves as associate professor of health policy and management at the Graduate School of Public Health.
He is currently working on three NIH-supported grants, one of which is a career development award that is using a multicenter survey linked to patient-outcome data to determine the organizational practices most associated with quality care. “Lately, I have also become interested in post-acute care for patients recovering from critical illness,” he said. “My most recent NIH grant examines the role of long-term acute care hospitals in patients receiving prolonged mechanical ventilation.”
It is the challenge of generating new knowledge that most excites him about his research. “The health system is always changing and new questions constantly arise about the best way to organize and manage such a complex system,” Dr. Kahn explained. “It is exciting to use the tools of epidemiology and health economics to try and answer these questions.”
Looking forward, Dr. Kahn hopes to focus more on health policy and system design in a way that improves outcomes for critically ill patients. “Lately, I have spent a lot of time on the phone with Medicare staff, talking about what problems they are having and what questions they need answered,” he continued. “Just as clinical researchers want their work translated into practice, I want my work translated into health policy.”
Given his interest in improving patient care, it is no surprise that Dr. Kahn chairs the ATS Quality Improvement Committee, which is now working to position the Society as a leader in developing new guidelines and quality measures and, ultimately, implementing them in large-scale projects.
When he’s not working, Dr. Kahn enjoys gardening, mountain biking and taking walks through Pittsburgh’s East End with his wife, Jennifer Marin, MD, who is assistant professor of pediatrics at the University of Pittsburgh and director of pediatric emergency ultrasound at the Children’s Hospital of Pittsburgh, and their two-year-old son, Aaron. He is also an accomplished “home chef” who is passionate about cooking.