Ariadne Labs expands into new clinical areas, with an emphasis on system-level solutions.
By Erin Lawler and Stephanie Schorow
Soon after its founding, Ariadne Labs began to expand its work, with an eye for system-level solutions that would make health care safer, more integrated, and more equitable for patients around the world.
In 2013, Asaf Bitton, a primary care doctor in Boston, received a call from Atul Gawande, asking him to lead a primary care program for Ariadne Labs. Under Bitton’s guidance, Ariadne’s Primary Health Care Program developed partnerships with more than 40 countries including Estonia, Costa Rica, Rwanda, and Ghana. The lab partnered with the Bill & Melinda Gates Foundation, the World Health Organization, the World Bank Group, UNICEF, and Results for Development to launch the Primary Health Care Performance Initiative (PHCPI).
Through work with PHCPI, Ariande’s primary health care team set out to define the building blocks of successful primary health care systems, and later developed the Vital Signs Profiles, a first-of-its-kind measurement tool to assess the functioning of a country’s health care system and help leaders pinpoint strengths and weaknesses. Countries can then access Improvement Strategies to identify actionable opportunities to improve their system. As of February 2023, nearly 30 countries have completed profiles.
In 2019, Bitton succeeded Gawande as the Executive Director of Ariadne Labs. Gawande continued to serve on the Ariadne Governance Board until 2021 when he became Assistant Administrator of USAID’s Bureau for Global Health. Now under the direction of June-Ho Kim, MD, MPH, the Primary Health Care program continues to expand its impact in creating more integrated, equitable health care systems, most recently launching work to inform equitable use of telehealth services in federally qualified health care centers.
Another example of emphasis on a whole system approach is the Delivery Decisions Initiative, launched in 2013 by Neel Shah, MD, MPP. The program is now led by Amber Weiseth, DNP, MSN, RN. “DDI really started by focusing on the notable increase and variation in C-section rates. And when you see that type of variation, you know that there’s a system problem underneath,” said Weiseth. DDI soon evolved into a more expansive approach to improving childbirth and maternal health and supporting growing families.
DDI’s work includes TeamBirth, launched in 2018, a system-level solution to improve teamwork and communication during childbirth. Their solution, the use of white boards, team huddles, and other communication tools, contribute to a culture that places the birthing person at the center of their care. DDI has rigorously tested this method and is spreading it across the U.S. and even internationally. To date, TeamBirth has been implemented in more than 50 hospitals across the U.S., including every birthing hospital in Tulsa, Oklahoma, and continues to grow. DDI’s work extends beyond the hospital walls, with efforts underway to improve equity and access to maternal health services for all people growing their families.
Rebecca Weintraub, MD, who leads Better Evidence and Vaccine Delivery at Ariadne Labs, also speaks of the need for system-level solutions to connect every patient, everywhere with safe, reliable health care. During her clinical work in Rwanda, Weintraub practiced medicine with Rwandan trainees who were eager to integrate the evidence-based information and digital tools that are regularly available in Harvard teaching hospitals. With this insight, she launched Better Evidence at Harvard Medical School in 2009. The program became part of Ariadne Labs in 2016. In partnership with Wolters Kluwer, the program has facilitated the donation of more than 100,000 UpToDate® subscriptions for frontline health care providers in 159 countries across the globe. In addition, the team has published their novel methods and will continue to analyze the click stream data from these evidence based resources. Better Evidence is also exploring ways to build a culture of use for these tools.
Weintraub believes the need has never been greater to connect clinicians, regardless of their locations or resources, to the latest medical evidence so as to provide high-quality care equitably to all patients.
“The COVID-19 pandemic has revealed structural inequities so deeply embedded in how health care is delivered that it needs Ariadne’s prowess,” she said. “We need even better, more robust decision making and planning to ensure we are caring for the vulnerable, and this includes data-driven tools. For example, how do we prepare for equitable distribution of a new vaccine? How do we design and test new access points for vital diagnostics and therapeutics products?“
But it’s not enough to pose these questions. Ariadne researchers seek to answer them through a process unique to the lab.