Harlan Krumholz, MD, SM, is the director of the Yale New Haven Hospital Center for Outcomes Research and Evaluation (CORE), one of the nation’s first research units dedicated to improving patient outcomes and promoting better population health. While he is a cardiologist who still cares for heart patients at Yale New Haven Hospital, Dr. Krumholz is also well known for pursuing research that involves gathering, measuring, and analyzing data, often from billing records or existing databases. The results have been used to improve care on a national scale.
Dr. Krumholz became interested in medicine as a child, when his father, a pulmonologist, brought him on patient rounds. Years later, as an intern for a health service in rural North Carolina, the younger Dr. Krumholz studied ways to help people not served adequately by the health care system. “I was sort of drawn in this way to the practical aspects of medicine,” he says. “What I do now is called ‘outcomes research.’ It's asking, at the end of the day, how have we helped people? What have we actually done for them?”
One of Dr. Krumholz’s most notable projects showed that while doctors were increasingly successful at developing innovative tools and techniques to treat heart attacks, patients weren’t always getting those treatments quickly enough. “When we looked around the country and at our own experience, we saw that too often people would come into the emergency room with a heart attack and delays would occur—delays in diagnosis, transport, communication, and preparation for the cath lab,” he says.
Working with the American College of Cardiology and the American Heart Association, Dr. Krumholz analyzed the problems and worked with people at hospitals around the country to make research-based improvements. Some of the changes were as simple as requiring paramedics to transmit electrocardiogram readings from the ambulance to the emergency room to reduce door-to-treatment time once the patient arrived. As a result of the changes, “Many patients who would have waited two or three hours for care for a heart attack are now treated in the hospital within 15 minutes,” Dr. Krumholz says. “At our own institution, we've seen many patients come in with a heart attack and get treatment so fast that there was no discernible damage. That's what research enabled.”
Dr. Krumholz says much of his inspiration for changing care came from his own work over the years with patients. “Caring for patients is very important to me, because it reminds me of the distance we need to go. Personally, I also very much enjoy the connection with patients. It's one of the most gratifying things ever. You walk into a room where people trust you without knowing you, and then you show them that you're worthy of the trust,” says Dr. Krumholz. Currently, he is exploring a number of research avenues, including the best ways to use the growing bodies of data that are becoming available in medicine from electronic medical records and other sources. “We believe that medicine is going to be entirely different in 10 years. It has the potential to be much better,” he says.
In addition to his clinical work and research, Dr. Krumholz was the director of the Robert Wood Johnson Foundation Clinical Scholars Program for more than 20 years, which prepared talented physicians to become future health care leaders. He is the author of books on smoking cessation and on reducing the risk of heart disease. He publishes a blog on Forbes.com and is an occasional contributor to both the New York Times and National Public Radio. He has a podcast, Never Delegate Understanding, that is dedicated to stories of patient empowerment.
Years In Practice