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Harlan Krumholz, MD, SM

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About

Titles

Harold H. Hines, Jr. Professor of Medicine (Cardiology) and Professor in the Institute for Social and Policy Studies, of Investigative Medicine and of Public Health (Health Policy)

Founder, Center for Outcomes Research and Evaluation (CORE)

Biography

Harlan Krumholz is a cardiologist and scientist at Yale University and Yale New Haven Hospital. He is the Harold H. Hines, Jr. Professor of Medicine. He is a leading expert in the science to improve the quality and efficiency of care, eliminate disparities and promote equity, improve integrity and transparency in medical research, engage patients in their care, and avoid wasteful practices. Recent efforts are focused on harnessing the digital transformation in healthcare to accelerate knowledge generation and facilitate the delivery of care aligned with each patient’s needs and preferences.

Dr. Krumholz is director of the Yale New Haven Hospital Center for Outcomes Research and Evaluation (CORE), an organization dedicated to improving health and health care through research, tools, and practices that produce discovery, heighten accountability, and promote better public health and clinical care. He co-founded and co-leads the Yale University Open Data Access (YODA) Project, designed to increase access to clinical research data and promote their use to generate new knowledge. He also co-founded and co-leads medRxiv, a non-profit preprint server for the medical and health sciences. He was a founding faculty co-director of the Yale Center for Research Computing.

Dr. Krumholz has been honored by membership in the National Academy of Medicine, the Association of American Physicians, and the American Society for Clinical Investigation. He was named a Distinguished Scientist of the American Heart Association and received their Award of Meritorious Achievement and their Clinical Research Prize. He served as a member of the Advisory Committee to the Director of the National Institutes of Health. Dr. Krumholz received the Friendship Award from the People’s Republic of China in recognition of his collaborative efforts to develop a national cardiovascular research network and was named by the Chinese Society of Cardiology as a Top-10 Distinguished International Cardiologist for his contributions to the development of cardiovascular medicine in China. He founded the American Heart Association’s Quality of Care and Outcomes Research Council and co-founded their annual conference. He was the founding editor of Circulation: Cardiovascular Quality and Outcomes; founding editor of CardioExchange, a social media site of the publisher of the New England Journal of Medicine; and editor of Journal Watch Cardiology of the New England Journal of Medicine. He was a founding Governor of the Patient-Centered Outcomes Research Institute. He is the incoming Editor-in-Chief of JACC, a pre-eminent cardiovascular medical journal.

He co-founded HugoHealth, a patient-centric platform to engage people as partners in research and clinical care, facilitate the secure acquisition and movement of digital health data, and promote learning health communities. He co-founded Refactor Health, an enterprise healthcare AI-augmented health data management company.

Before joining the Yale faculty in 1992, Dr. Krumholz received a BS (Biology) from Yale, an MD from Harvard Medical School, and a Masters in Health Policy and Management (SM) from the Harvard University School of Public Health. At Yale, he directed the Robert Wood Johnson Foundation Clinical Scholars Program from 1996-2017 and serves as Director Emeritus of the Yale National Clinician Scholars Program. Dr. Krumholz has published over 1500 articles and three books with an h-index of more than 230.

Appointments

Education & Training

Fellow
Beth Israel Hospital/Harvard Medical School (1992)
SM
Harvard, Health Policy and Management (SM) (1992)
Chief Resident
Moffitt Hospital/University of California, San Francisco (1989)
Resident
University of California, San Francisco (1988)
MD
Harvard University (1985)
BS
Yale College, Biology (1980)

Research

Overview

The research team at the Yale Center for Outcomes Research and Evaluation (CORE), which Dr. Krumholz has directed since 1995, continues to expand its role as the chief architect of the national public reporting of hospital performance. The group has pioneered new approaches to measurement that are now widely accepted and publicly reported by the Centers for Medicare & Medicaid Services. The CORE team has also focused on harnessing the digital transformation in healthcare to accelerate knowledge generation and facilitate the delivery of care aligned with each patient’s unique needs and preferences. International initiatives include a decade-long collaboration with the Chinese National Center for Cardiovascular Diseases Data serving as a foundation for health reform and quality improvement efforts across China. Dr. Krumholz pioneered strategies to improve healthcare quality and health equity, promote open science and transform research processes, support patient empowerment, and apply digital technologies and computational approaches to accelerate progress in clinical care and research.

Other selected grants and projects, completed and ongoing at CORE, are detailed below.

Johnson & Johnson: Yale Open Data Access (YODA) Project and Janssen Research and Development Collaboration [Krumholz (PI): 01/06/14–01/06/2021]. This project addresses the problem of unpublished and selectively published clinical trial research, and is enabling scientists to gain access to clinical trial data assets. It establishes an independent process that promotes open science and seeks to leverage prior research investments to produce new knowledge.

National Institute of Biomedical Imaging Bioengineering (Texas A&M): SCH:INT: A Contextaware Cuffless Wearable Ambulatory Blood Pressure Monitor using BioImpedance Sensor Array [Jafari/Krumholz (Subaward Co-PI)/Spatz (PIs): 09/24/2018–06/30/2022]. This grant is developing and evaluating a new ambulatory blood pressure monitoring device for diagnosis of hypertension.

Agency for Healthcare Research and Quality through NYU School of Medicine: Understanding Hospital Value: Provider, Hospital and Community Effects [Horwitz/Krumholz (Subaward PI): 09/30/2019–07/31/2024]. This grant is exploring provider, hospital and community factors affecting the value (quality and cost) of inpatient care. A better understanding of what drives high-value care will help hospitals across the country to more rapidly transform to a value-based healthcare system, improving healthcare quality and cost for all Americans.

State of CT Department of Public Health: Surveillance Project to Estimate the Prevalence of SARS-CoV-2 in Connecticut [Krumholz (PI): 05/01/2020–04/30/2021]. The primary aim of this project is to determine the seroprevalence of SARS-CoV-2 among adults aged 18 and older in Connecticut to provide the information to the Connecticut Department of Health to inform public policy, support mitigation strategies, and assist in plans for future surveillance activities.

Foundation for a Smoke-Free World: Insights about the COVID Pandemic Using Public Data [Krumholz (PI): 06/01/2020–11/30/2020]. This project is building a platform that collects online chatter relating to COVID-19, integrates this unstructured data for trends analysis, and monitors early warning signals of COVID-19 outbreaks in the population.

Agency for Healthcare Research and Quality: Yale-CORE Career Development Program in Patient-Centered Outcomes Research [Krumholz (PI): 08/01/14–07/31/19]. This K12 training program developed scientists with the skills to become independent PCOR investigators and generate practical knowledge poised for application.

The Commonwealth Fund: Evaluating the STAAR Collaborative’s Impact on Hospitals’ Care Transition Practices and Ability to Reduce Readmissions [Krumholz/Curry/Bradley (Co-PIs): 01/01/13–06/30/15]. This project identified changes in the use of recommended practices for reducing readmissions; assessed the impact of hospital practices on readmission rates; and explored how STAAR may have led to changes in care transition practices and readmission rates.

United States Food and Drug Administration: Optimizing Medical Device Post-Market Surveillance for Public Value [Krumholz (PI): 09/30/12–09/29/17]. This project engaged experts in device safety and effectiveness surveillance, industry, academics, government, clinicians, and patients to develop critical methods to monitor medical devices as well as the policies that define roles/responsibilities of expert parties engaged in the device surveillance ecosystem.

Medtronic: Developing an Independent Program to Evaluate the Efficacy and Safety of Drugs and Devices [Krumholz (PI): 08/01/11–01/31/15]. This project developed a model to facilitate independent evaluation of the benefits and harms of drugs and devices, promoting a rigorous review of all available clinical trial and post-market surveillance data.

The Patrick and Catherine Weldon Donaghue Medical Research Foundation: Hospitalomics: A System-based Approach to Hospital Performance [Krumholz (PI): 01/01/11–12/31/14]. This project developed a multi-disciplinary, data-intensive, system-based approach to characterizing patterns of hospital care, linked patterns with performance, and identified targets for interventions to improve hospital performance.

National Heart, Lung, and Blood Institute: Center for Cardiovascular Outcomes Research at Yale University [Krumholz/Curtis (Co-PIs): 09/30/10– 07/31/15]. The focus of this Center was on research to promote hospital and regional excellence in patient outcomes and healthcare value, and to promote inter-institutional collaboration and development of early-stage investigators.

National Heart, Lung, and Blood Institute: Variation in Recovery: Role of Gender on Outcomes in Young AMI Patients (VIRGO/NCT00597922) [Krumholz (PI): 09/01/07–05/31/13]. The VIRGO study characterized sex differences in outcomes following acute myocardial infarction (including mortality, hospitalization and health status); determined sex differences in the prevalence of demographic, clinical and psychosocial risk factors; determined sex differences in quality of care; and determined sex differences in the prevalence of biological factors (including sex hormones, biomarkers and genetic variations).

National Heart, Lung, and Blood Institute: Telemonitoring to Improve Heart Failure Outcomes/NCT00303212 [Krumholz (PI): 04/01/05–10/31/10]. This multi-center, randomized controlled trial compared the effectiveness of telemonitoring with usual care in reducing re-hospitalizations and mortality among patients recently hospitalized for heart failure.

Robert Wood Johnson Foundation: Clinical Scholars Program [Krumholz (PI): 07/01/1996–06/30/16]. This fellowship, the flagship program of the Robert Wood Johnson Foundation for more than 40 years, prepared physicians dedicated to leading efforts toward positive change by addressing challenges and opportunities in the rapidly evolving healthcare system. Dr. Krumholz served as PI/Co-Director of the Yale site from 1996 until the Program's closure in 2016, and now serves as Director Emeritus of the Yale National Clinician Scholars Program.

Medical Subject Headings (MeSH)

Access to Information; Cardiology; Decision Making; Health Care Quality, Access, and Evaluation; Health Information Systems; Health Policy; Heart Failure; Machine Learning; Myocardial Infarction

Research at a Glance

Publications Timeline

A big-picture view of Harlan Krumholz's research output by year.

Publications

Clinical Trials

Current Trials

Academic Achievements and Community Involvement

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Clinical Care

Overview

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.

Clinical Specialties

Cardiovascular Medicine

Board Certifications

  • Internal Medicine

    Certification Organization
    AB of Internal Medicine
    Original Certification Date
    1989

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