Associate professor Jessica Keim-Malpass has been named a Costs of Care fellow, the first nurse ever to assume such a role.
Costs of Care is a non-governmental organization that curates, sources, and disseminates knowledge from patients and frontline clinicians to help health systems deliver better care at a lower cost.
In her early research, Keim-Malpass – a pediatric and oncology nurse and researcher who teaches in both the Schools of Nursing and Medicine – studied how and why young people with advanced cancer shared their stories on social media. At the heart of their complex dilemmas, she noted, lurked the ever-present stress of healthcare costs.
“Many in my study ranked their financial toxicity worse than their symptom experience with cancer treatment,” said Keim-Malpass. “I remember stories of women at the end of life considering divorce so they wouldn’t be left with the medical debt. I also became acutely aware of the information imbalance and lack of transparency in costs, and how infrequently the topic would come up during clinical consultations. Additionally, I began to understand the cumulative stress of financial uncertainty in shared medical decision-making. [As an oncology nurse], I felt helpless when I could not provide patients adequate responses to straightforward questions like, ‘What will this surgery cost me?’”
As a member of the Costs of Care team, she will develop educational materials, establish implementation frameworks and lead workshops that aim to improve care and reduce costs. In addition to this work, Keim-Malpass also studies HPV vaccine compliance, how families of children with disabilities cope and connect, and is co-investigator of CoMET, with Randall Moorman, MD, a newly developed software that uses big data to predict acutely ill patients’ decompensation before it happens.
“We are actively engaged in shared decision-making with patients,” adds Keim-Malpass, “and there is immense potential to modify our own practices in clinical settings to deliver the most effective, family-centered, quality care for our patients. We often want to engage in cost of care conversations with our patients, or with our clinician colleagues, but don’t have enough information to know where to start ourselves . . . I hope to translate these new perspectives to my future research, clinical practice, and in the classroom where I am educating the next generation of nurses.”