Evidence to Practice: An Interview with Dr. Craig Umscheid

Carrie Patnode, PhD^✉ and Nora Henrikson, PhD, MPH^✉; Evidence-Based Behavioral Medicine SIG

Craig Umscheid, MD, MS
 

Craig Umscheid, MD, MS is a practicing general internist and clinical epidemiologist who was named the new Director of the Agency for Healthcare Research and Quality’s (AHRQ) Evidence-based Practice Center Division (EPC Division) within the Center for Evidence and Practice Improvement, an appointment he will begin in July. Dr. Umscheid is currently faculty at the University of Chicago.

We sat down with Dr. Umscheid to talk about his transition to AHRQ and his thoughts on evidence-based behavioral medicine.
 

Tell us a little bit about yourself.

Clinically I practice general internal medicine in the inpatient setting. Academically, I’ve been trained in clinical epidemiology, and have spent my career building processes to translate research evidence into practice to support quality across hospital systems. That’s what I did at the University of Pennsylvania for about 15 years, where I helped establish and lead Penn Medicine’s Center for Evidence-based Practice, and most recently at the University of Chicago, where I’ve led quality, innovation and medical informatics. Now, moving to AHRQ, I’ll be focused in these areas at a national level.
 

Tell us a bit about the EPC Division.

In 1997, the Agency for Healthcare Research and Quality (AHRQ) launched the Evidence-based Practice Center (EPC) Program to promote evidence-based practice in everyday care. The EPCs develop reviews of the evidence on topics relevant to clinical care and healthcare delivery. Currently, there are 9 EPCs under contract to do this work.
 

What attracted you to make the move to direct the EPC Division?

The potential impact. The EPC Division has had a lot of impact informing guidelines, payer decisions, quality measures, and research agendas. I think the potential to strengthen that impact even further is there—including in the partnerships we build, and methods we innovate to further enhance our responsiveness to stakeholders.
 

What do you see at the intersection of behavioral science and evidence-based medicine? Our SIG’s members have great interest in dissemination and implementation, which is one of the EPC Program’s main efforts.

Evidence-based practice is really about closing the gap between what we know works and what’s actually happening in the real world. That is the implementation science space, which requires behavioral science. For patients, it’s about meeting them where they’re at—trying to understand their needs, their interests, and helping them to achieve their goals.

For providers—the traditional model of thinking that they will read a research paper and then change their practice as a result—it’s a model that in an overwhelmed clinical environment often does not reflect reality. Implementation science can inform approaches to bake that evidence more seamlessly into the systems used to deliver clinical care, including the electronic health record. These systems support the whole care team, not only the physician. Patients are also included through approaches like patient portals.
 

How has recent attention on race and racism in the U.S. shaped your thinking about the EPC Division?  

So many topics being addressed by the EPC Program are relevant to those who have been historically underserved. This needs to continue. But so many of the clinical trials identified by our reviews do not adequately include historically underserved populations. The EPC program has a unique opportunity to spotlight this, particularly in its role informing future research agendas.

Also, more recent EPC projects are specifically related to concerns around structural racism, such as a current review examining the potential for racial bias in predictive algorithms. This is important for healthcare systems making investments in predictive analytics. Lastly, there are opportunities to think through how we prioritize topics, and how we are hearing from all stakeholders across this country.
 

What advice to you have for SBM members who want to get more involved with evidence-based medicine research?

If you are at an institution with an EPC – meet those EPC teams. It’s also helpful to know what organizations are supporting research in evidence-based practice—AHRQ, SAMSHA, NIH—particularly NCI and NIMH—support a lot of implementation science work.
 

What do you do to balance work and life?

I have a son in elementary school, a daughter in middle school, and a wife who is a veterinarian, so we have a busy household, and I spend a lot of time with my family outside of work. We’re also excited to be moving back to the East Coast to be able to spend more time with our extended families, who will all be close by.