Advancing Health is pleased to welcome our newest scientist, Dr. Logan Trenaman. Dr. Trenaman holds a PhD in Population and Public Health with a concentration in Health Economics from UBC. Following graduation, Dr. Trenaman completed two sequential CIHR-funded postdoctoral fellowships. The first was at the University of California, Davis, and the second saw him return to UBC in the Faculty of Pharmaceutical Sciences. Throughout his training, Dr. Trenaman has held multiple affiliations with Advancing Health, collaborating across programs as a patient-oriented health services researcher.
“My approach is driven by a commitment to develop evidence with and for patients, and to ensure that patient values, needs, and perspectives are included in health service decision-making and delivery,” he explained. In practice, Dr. Trenaman’s work aims to generate evidence to support health systems in implementing patient-centred care: “This includes supporting decision-making at all levels of health system, ranging from clinical decision-making between patients and providers, to health system or policy decisions.”
With experience in the Canadian, U.K., and U.S. health systems and expertise in a range of health economics and patient-oriented research methodologies, Dr. Trenaman brings a unique perspective to Advancing Health. This includes developing and evaluating patient-oriented knowledge translation interventions to support clinical decision-making and using large administrative and patient-centred measurement datasets to improve patient outcomes, experience, and efficiency of care. He is also an expert in measuring patient, provider, and societal preferences to ensure that policies, programs, and interventions are valued by key stakeholders.
Value in health care: Trade-offs, complexities, and competing priorities
With funding support from the Agency for Healthcare Research and Quality, Dr. Trenaman recently completed a study on the role of integrating patient perspectives in value-based payment models in the U.S. “This project asked Medicare patients about what aspects of hospital quality matter most to them, and determined how incorporating patient preferences in the program would impact incentive payments,” he explained. “Ultimately, it’s about trying to ensure that hospitals that are providing care that is most important to patients are rewarded.”
Dr. Trenaman acknowledges that one of the fundamental challenges of this work is considering and integrating the perspectives of patients, providers, and payers. “A policy-maker might be concerned about efficiency, whereas a patient might be more concerned with outcomes or safety,” explained Dr. Trenaman. “It’s not about either one being right or wrong, it’s about recognizing the different perspectives and competing priorities, and thinking about how to reconcile and balance them.”
Ultimately, his results demonstrate that the current incentive structure in this value-based payment program does not reflect the preferences of Medicare patients, and that considering patient preferences might come with some trade-offs. “We found that aligning incentives with patient preferences would actually disadvantage smaller, rural hospitals,” he said. “Highlighting these trade-offs is important to inform discussions about value-based payment reforms.”
Using patient-reported data to improve outcomes and the efficiency of care
Dr. Trenaman’s work at home leverages administrative and patient survey data in B.C. to understand and predict who may be at risk of high health care costs, with the aim of improve care and outcomes for high-cost users.
“Over the last ten years, there’s been an explosion in what are called patient-centred measurement surveys,” he said. “For example, people who leave the hospital or emergency department are often followed up with and asked to provide their perspectives on their experience of care and information on their health outcomes.”
Dr. Trenaman explains how researchers in B.C. are very fortunate to have access to patient-centred measurement datasets which can be linked to large administrative databases. “Routinely collected administrative data can be really helpful and a rich source of information on resource use and cost, which is half the health economic coin. But the patient-centred measurement data add information on outcomes and consequences,” he said. “I am interested in how these linked data can be used to improve patient outcomes, experience, and the efficiency of care,” he explained.
While the goal of Dr. Trenaman’s research program is to collect and use data that matters to patients and other stakeholders, he says it all starts with engaging patients from the very beginning: “Working with patients fundamentally changes how we approach research,” he said.
Through his collaboration with the province’s Patient-Centred Measurement Data Analysis Group, which is led by Advancing Health Program Head of Patient-Reported Outcomes Dr. Rick Sawatzky, Dr. Trenaman engages with the Ministry of Health to discuss priorities, provide feedback, and share knowledge on different applications of this type of data.
Dr. Trenaman also has a number of ongoing and new projects in collaboration with researchers at the Centre. He is co-leading a project with Advancing Health Program Head of Health Economics Dr. Wei Zhang to understand the impact of health status on work productivity for people with specific chronic conditions. Alongside Advancing Health Program Head of Knowledge Translation Dr. Sarah Munro, Dr. Trenaman is co-leading a project funded by the Society of Family Planning Research Fund to understand what matters most to people seeking access to family planning services in Texas.
Join us on March 8 for our Work in Progress Seminar Series to learn more about Dr. Trenaman’s ongoing work.