Assistant Professor of Health Management and Policy
Saint Louis University
Kimberly R. Enard, PhD, MBA, MSHA, FACHE, is a health services researcher with academic- and community-based experience in engaging stakeholders across multiple disciplines and settings in planning, implementing and evaluating patient-centered programs. She received her PhD in health services with a specialization in health policy from the University of California-Los Angeles School of Public Health. Prior to that, she earned Master of Business Administration and Master of Science in Health Administration degrees from Georgia State University’s J. Mack Robinson College of Business. Dr. Enard completed postdoctoral fellowship training in the Kellogg Health Scholars Program at the University of Texas (UT) MD Anderson Cancer Center-Dorothy I. Height Center for Health Equity and Evaluation Research and the National Cancer Institute Cancer Education and Career Development Program at the UT-Houston Health Sciences Center. Dr. Enard is board-certified in healthcare management and has more than 15 years of management and consulting experience with organizations that include Emory Healthcare in Atlanta, Providence Health & Services, UCLA Health and Keck Medicine of USC in Los Angeles and Memorial Hermann Healthcare System in Houston. Prior to that, Dr. Enard worked as a journalist in national and local media markets, and earned an award from the Georgia Associated Press for her efforts. Dr. Enard has participated in aspects of the healthcare delivery continuum that encompassed strategic planning and business development, service line management, quality improvement, patient education, community outreach, government relations and media relations and is able to communicate and collaborate effectively with stakeholders ranging from patients, caregivers and community leaders to physicians, hospital administrators and policymakers. Dr. Enard is committed to addressing health inequities by employing community-engaged strategies to gain a more comprehensive understanding of how socially disadvantaged populations interact with the health system and, subsequently, to design and translate innovative research into evidence-based policies and practices that enhance those interactions.
Despite measureable progress in the U.S. health system toward achieving the Triple Aim of better care, better health, and lower costs, safety-net patients continue to experience substantial barriers to accessing coordinated, high-value healthcare and often rely on emergency departments (EDs) to address their unmet healthcare needs. The patient navigation (PN) model has been advocated as a strategy to coordinate better integration of healthcare and related support services for safety-net patients. This study will evaluate a PN program sponsored by Houston-based Memorial Hermann Community Benefit Corporation (MHCBC) that utilizes ED-based community health workers (CHWs) to connect safety-net patients with primary care, social and community services. The findings from this study can inform the design and implementation of new models that incorporate PN or similar programs to transform health systems. For example, the scope, timing, duration and location of PN services, in addition to predisposing health conditions and other needs of patients most likely to benefit from PN, are all understudied areas that warrant further investigation. This study is significant because it will be among the first to report findings from a large-scale, PN program that attempts to fill critical healthcare and social needs for safety-net patients in Texas, where Medicaid eligibility is among the most stringent in the nation and high uninsured rates persist. MHCBC’s program is innovative because it incorporates best practices from the cancer care PN model and engages patients early in the delivery continuum, before low acuity health conditions become serious health crises. Importantly, MHCBC is a part of a large, integrated health system committed to continuous quality improvement. MHCBC is uniquely positioned to model for other health systems how to leverage community benefit and other financing to support strategies that engage multilevel stakeholders in developing sustainable models of care that meet the needs of safety-net populations.
Why did you apply to New Connections
I strongly believe that diverse perspectives and approaches are needed to provide the context that can drive relevant and sustainable changes in our health systems and communities. The diversity of my experience and the strength of my commitment to underserved communities uniquely position me to build partnerships and teams that can develop and implement solutions to help those most in need. I applied to New Connections because I realize the power of plugging in to this incredible network of multidisciplinary researchers who share a similar commitment to uplifting underserved communities in novel, meaningful ways. The ability to reach out to another New Connections scholar who has extensive knowledge and expertise in an area that I am exploring is a powerful connection.
Dr. Enard’s overarching research goal is to address health inequities using community-engaged, patient-centered approaches that recognize the complex, multilevel factors that influence each person’s health and well-being over their life course. She investigates community-level (hospitals, physicians, community-based organizations, etc.) and patient-level (knowledge, satisfaction, perceptions, attitudes, etc.) characteristics that interact to shape processes and outcomes of care for socially disadvantaged patients. She also examines shared decision-making mechanisms that may influence disparities related to delivery context (when and where socially disadvantaged patients seek and receive care) and quality (unwarranted variations in care), with the goal of contributing to the development of policies, practices and tools that empower patients and strengthen patient-provider relationships. Most recently, Dr. Enard has focused on examining patient navigation (PN) as a strategy to address health inequities through the coordination integrated healthcare, social and community services for safety-net and other underserved populations. Grounded in the cancer care continuum, PN facilitates the timely movement of individuals across the entire healthcare delivery system by providing education and/or counseling, care coordination/logistical support (e.g., scheduling appointments, completing paperwork, managing financial/insurance issues, intervening with food insecurity) and individualized psychosocial support (e.g., addressing issues of fear/mistrust and language/cultural barriers to effective healthcare interactions). Dr. Enard’s next steps in this line of research are: 1) to examine how to better target PN to those subgroups that will gain the most benefit; and 2) to investigate patient-centered strategies that effectively engage safety-net and other underserved patients in primary care medical homes.
Enard, K.R., Dolan Mullen, P., Kamath, G.R., Dixon, N.M., & Volk, R.J. (2016). Are cancer-related decision aids appropriate for socially disadvantaged patients? A systematic review of US randomized controlled trials. BMC Med Inform Decis Mak, 16(64), doi: 10.1186/s12911-016-0303-6
Enard, K.R., Nevarez, L., Hernandez, M., Hovick, S.R., Moguel, M.R., Hajek, R.A., . . .Torres-Vigil, I. (2015). Patient navigation to increase colorectal cancer screening among Latino Medicare enrollees: a randomized controlled trial. Cancer Causes Control, 26(9), 1351-1359. doi: 10.1007/s10552-015-0620-6
Lunstroth, J., Jones, L.A., & Enard, K.R. (2015). Eliminating Cancer Disparities Through Legislative Action. In J Phillips (Ed.), Cancer and Health Policy: Advancements and Opportunities. Oncology Nursing Society: Pittsburgh, PA
Enard, K.R., & Ganelin, D.M. (2013). Reducing preventable emergency department utilization and costs by using community health workers as patient navigators. J Healthc Manag, 58(6), 412-427; discussion 428.
Natale-Pereira, A., Enard, K. R., Nevarez, L., & Jones, L. A. (2011). The role of patient navigators in eliminating health disparities. Cancer, 117(15 Suppl), 3543-3552. doi: 10.1002/cncr.26264
- New Connections Status: Junior Investigator
- Award Year: 2017
- RWJF Team/Portfolio: Strengthening Integration of Health Services and Systems
- Project Name: Examining the Role of Community Health Workers in Navigating Safety-Net Patients from Emergency Departments to Primary Care Medical Homes