This week’s faculty spotlight shines on Santanu Datta, PhD, MBA, who talks the future of telemedicine, how his two business degrees influence his research, and developing interventions to reduce alcohol consumption in people with hepatitis C.
How long have you been at Duke? How long have you been at the Division?
I joined the Center for Clinical Health Policy Research at Duke in 1997 and joined the Division of General Internal Medicine in 2003.
What does a typical day for you at the Division look like?
As with everyone, my day starts with checking and responding to emails. I try to devote three 2-hour blocks of time each day to concentrating on a specific research project, be it writing a grant proposal or manuscript, or data analysis and modeling. I fit these blocks of time around research meetings and conference calls.
In addition to your doctorate in health policy and administration, you have a master’s degree in economics and a MBA in finance. How have these degrees influenced your health research?
My varied educational background allows me to apply both state-of-the-art research methods and a practical approach to the presentation of the results so that they are useful to decision-makers. When considering implementation of a medical intervention the first question asked is regarding its effectiveness. But if it is deemed effective, follow-up questions are often economic or financial in nature: how much will the intervention cost, is it potentially cost saving or cost-effective, what is the likely budget impact, and so on.
You’re a recipient of a NIH grant to examine integrated treatments for people dealing with both hepatitis C and alcohol abuse. What sorts of issues do people facing these problems face? What is your research examining?
Alcohol use in patients with hepatitis C virus (HCV) increases the risk of cirrhosis and hepatocellular carcinoma, and also decrease the response to HCV antiviral therapy. HCV is the leading cause of liver transplantation in the U.S. Yet adults with HCV are also eight times more likely than adults without HCV to consume three or more drinks daily. Therefore it is imperative to reduce alcohol consumption in the HCV patient population.
Dr. Rae Jean Proeschold-Bell at the Duke Global Health Institute developed a pilot study that showed great promise to identify and treat patients with HCV who consume alcohol. Based on its results we were able to receive grant funding to compare the intervention to usual care, which is brief alcohol counseling.
We hope the primary outcome of the intervention is a significant improvement in alcohol abstinence rate and decrease in relapse rates. Our research also includes a thorough examination of the costs to implement the intervention, the economic burdens of having HCV and engaging in alcohol and substance abuse and potential cost savings from quitting, and whether the intervention is cost-effective by conventional standards.
Do you have any other research projects at the moment?
I am involved in several other projects but the one I would highlight is an evaluation of the use of low-dose CT (LDCT) for lung cancer screening among people with a history of smoking. The U.S. Preventive Services Task Force has recommended health care systems implement a program for annual LDCT screening of people aged 55-80 who are current or former smokers who quit within 15 years and has at least a 30 pack-year history. However, there is scant guidance for how to implement such programs.
Thus, we have undertaken an eight-site evaluation project to assess the implementation of a LDCT lung cancer screening program. An important component of the evaluation will be to assess intervention cost, to estimate the increased amount of health care resources that will be needed to examine the lung cancer screening patients, and the potential budget impact of implementing LDCT screening.
You’re also heavily involved in telemedicine research. How far along is this field? What are some of the advantages and potential pitfalls of this type of health care delivery?
Telemedicine is in its infancy but there is an extraordinary amount of activity in this field. Telemedicine has the potential to improve access to care to rural areas, extend care to outside of the clinic/hospital setting, provide care in a continuous rather than acute manner, improve adherence, and provide care with more efficient utilization of health care resources.
The main pitfall that I see is a rush to implement telemedicine without understanding what needs patients want addressed, what the barriers and facilitators to sustainability of telemedicine are, ensuring that services provided by telemedicine will be adequately reimbursed, and the unavailability of a telehealth network that allows for communication and transfer of information between various electronic medical record systems of different health care systems.
What passion or hobbies do you have outside of the Division?
I love to play golf and tennis—although I don’t get to play nearly as much as I’d like. Growing up in Tallahassee and attending FSU, I enjoy cheering on the Seminoles in football. I’m so happy they brought the national championship trophy to the ACC where it belongs!
My two older sons will be graduating high school in the next couple of years so I mostly try to spend time building memories with them before they leave for college and start their own lives.