Dr. Huguet is a health services researcher and implementation scientist with extensive experience studying care delivery to vulnerable populations. She has been with OHSU Family Medicine since 2014.
What type of research do you do?
My research focuses on evaluating the implementation of federal, state, and local policy/practice changes impacting access to and delivery of care.
In the federal policy realm, I’m doing a lot of work on the Affordable Care Act and its impacts. Some policies in general can be really good, but have negative effects, so our goal is to understand the policies better so that we can try to improve them. You can think of it as epidemiology-type work. We’re trying to positively impact the lives of people by guiding policy makers.
At the practice level, the goal is to understand “How can we make the work easier? How can we facilitate your patients coming in and getting their screenings?” It feels like you’re making a difference because you’re working with practices trying to figure out solutions. The hope is that the science being conducted will become the infrastructure for others to be able to pilot studies and test some changes, whether it’s a new workflow or EHR tool – identifying some barriers patients have to getting care. Once you identify that you can really try to make a change.
What are the projects you’re working on now?
The new grant that we just got funded from the CDC [The Natural Experiments for Translation in Diabetes (NEXT-D3)] is part of a collaborative of six institutions that studies health policies in general – not just the ACA. This CDC initiative has been going on for 10 years already, and will continue for the next 15 years. Being part of this group has been really rewarding, because we collaborate with others studying different policies and how they interact with each other. I feel very privileged to be the co-chair NEXT-D3 for the next 5 years. We have stakeholder meetings throughout the study period with insurance policy makers and insurance companies, so it’s possible to scratch the surface and really make a change.
I am also involved in the BRIDGE-C2 Center. This center is about cancer control, and we’re looking specifically at cancer prevention and primary care. With the COVID pandemic, we received a supplement for the BRIDGE-C2 Center team to understand how the clinics are dealing with this, whether they had to stop delivering care or switch completely to telemedicine. How do you deliver cancer prevention during a pandemic? Some of it just doesn’t work with video screening, so how do you deal with that? And now clinics have a backlog of patients due for screenings. So we’re going into the clinics and trying to understand how they’re adapting and making changes – that’s what implementation science is. As researchers we’re spanning years trying to make a change, and here you have COVID that shows up, and within two days practices have made a complete flip. What can we learn from that? How did you get that kind of adoption? We can do a favor to the clinics by being better in our science.
What got you into this work?
I come from France where health care is a right, not a privilege. When I came to the U.S., I was looking at statistics on the health of Americans versus Canadians, and what you see is the Canadians are just healthier. You can determine that they are also happier. And one of the things that makes a difference is that when Canadians have issues with care, it's about maybe waiting time to access specific types of care, but in the U.S., it's always cost. People just can't pay for the care. Even if you have health insurance, paying 20% of your surgery is not accessible for everyone.
I’m curious why care is such a privilege here – that people don't have health insurance is just amazing to me. Don't you want your fellow Americans to be healthy so that they can participate in the economy? I would love to see this country get a grip on what matters in terms of health care access.
What drew you to OHSU Family Medicine?
I find that our department and Family Medicine in general is really innovative and at the cutting edge of care. I love how our clinic teams develop all these different ways to focus on equitable care. You can tell they really care about helping the patients, and my line of research aligns very well with that because it’s all about delivering care to all.
From a researcher point of view, it’s great to be able to communicate directly with clinicians about their motivations and ideas. Having clinician researchers – and having a Chair (Jen DeVoe) who is a clinician researcher – is so helpful. You can see how your research is actually helping.
And, this really is a family. Our providers care for our patients at a family level, and I get to feel like part of that family.