Career Pathways—Explore the Possibilities, Health Outcomes Researcher

Interview With Dr. Brenna Brady, Health Outcomes Researcher  

Interviewed by Brandon Walling, Ph.D., NIAID Postdoctoral Fellow

What are you going to do after your postdoc or Ph.D. research at NIH? 

The “Career Pathways – Explore the Possibilities” series highlights different professions pursued by scientists like you. This interview focuses on a health outcomes researcher, someone who performs post-market health studies. Dr. Brady works directly with pharmaceutical clients to perform retrospective studies on drugs currently available to the public. This work is primarily centered around the analysis of large databases and interacting with pharmaceutical clients.

Dr. Brady was a postdoc at NIAID for one and a half years, where she worked in the Laboratory of Immune System Biology. Prior to her current position, she worked as the project director at Health Analytics, LLC, performing similar work to her current position with a large healthcare consulting company. Read this interview with Dr. Brady to learn more about her journey to becoming a health outcomes researcher.

Can you tell us a little about your role as a health outcomes researcher?

I work in the health outcomes group where we primarily do post-market research studies for the pharmaceutical industry. We perform post-market phase (after it has been approved and is being used by patients) studies for a wide variety of pharmaceutical companies. These companies continue to do research studies for a whole variety of different reasons such as drug effectiveness, safety, and cost of care; much of the research is tied to supporting their products. The overarching goal is usually to establish a benefit for their product, which may be tied to cost, efficacy, or a number of other outcomes; we also do other more general knowledge analyses (quality measurement, that sort of thing), but those are a bit less common. Performing the research studies includes working with clients to develop the study design, developing a protocol, and doing all of the analysis. The analyses that I do primarily consist of insurance claims database studies. These are databases composed of healthcare billing claims. Think about when you go to the doctor and later get an explanation of benefits in the mail—it includes a description of the services performed (for example an office visit or immunization) and the associated costs—that is what we analyze. In my role, I am the person who interfaces with the client and works with them to design the study. I usually start working with the client at the proposal stage, where they have a broad idea of their topic of interest. I would then put together a proposal that outlines the general study design including eligibility criteria, time periods, outcomes of interest, and analyses. If we win the bid, then we go on to do the study and work with the team of analysts and programmers to perform the study. It is usually quite a collaborative environment. You don’t go into a hole and come back months later with data; it is quite a bit of back and forth. Additionally, our studies go on to get published, and we go to conferences and submit abstracts and posters just like biomedical research. We primarily attend specific health outcome conferences, but there is some presence at more clinical conferences as well.

What is currently on your to do list, both short-term and long-term?

A lot of client meetings. In my history in this field, I’ve usually had between 4 and 13 projects on my plate at any one time. Just prior to this meeting, I got off an hour-and-a-half-long call with a client about their project. Sometimes the meetings are super short and just a check-in; other times they tend to be quite involved. When you get into results, you sometimes tend to be on the phone for a little while longer to explain and interpret the findings. Other than the time in client meetings, I do a lot of proposal writing. The way that my current company is set up, there is a team of analysts who get involved once the study is contracted; they draft the protocols and other study materials based off the proposal. The team of analysts does a lot of the initial drafts of these things, and [I] review those. I also spend a lot of time reviewing and interpreting the results. About half of my time is sales related, which consists of all the proposal writing and looking for new business. The other half is doing the business that [I] previously received. There is also some project management sort of work, but that is minimal.

What kinds of skills, technical or otherwise, do you think are important to have as a research leader?

The ability to organize and many of the same sort of skills that you gain in the lab. You need to be able to understand what questions you are asking and how to address those questions with the resources at hand. In the lab, that may be literally the reagents or the mice that you have. In this particular context, it is what database we are working with, what are the data fields, and how large is the cohort. I think a lot of those skills absolutely transfer. In a position where you are interacting with the client, you need to be able to explain things to clients, listen to what they are saying, and understand, interpret, and come up with a response. Sometimes this is very easy and sometimes it may not be. We have some clients who are not familiar with the data. I also work with a lot of international clients who are not familiar with the U.S. healthcare system. It really comes down to being able to shape the work that you are doing to make it relevant to the client. Sometimes you have a very experienced and savvy client and sometimes you are working with someone who is doing this for the first time. Another skill is troubleshooting, which you also learn at the bench. You get into a study and think it is going to be great and then maybe hit a couple of barriers and have to find a way around them. You need to keep your mind open and be able to interpret the results. Maybe the result you hoped to find isn’t necessarily what you found; however there may be a positive message that you didn’t necessarily anticipate once you review the findings. Other times you may not be able to exactly assess things as planned or there may be something unique in the dataset, so you need to revise and adapt.

What are your favorite aspects of being a research leader?

The work-life balance is pretty fantastic. I am actually currently working from home, which can be great. I like that I get to work with a bunch of different clients, and I get to work across a variety of disciplines, which keeps things interesting. I also kind of like working with retrospective data—there is something about it. I loved being in the lab, but being able to play around within a database and get your data back, maybe not instantly, but very quickly is nice and very rewarding.

What do you find most challenging?

Probably the interpersonal skills and relationships. Like anything else, you can get challenging individuals on the team; sometimes people want to do it their way even if it doesn’t work well. Working from home can be great, but it can sometimes be challenging to get everybody on the same page; although honestly that can be an issue face to face. Since it’s a consulting service, the remote thing will always be there even if you work from an office, as you may never meet your clients face to face. Also, with all the technology we have, it’s really not a big deal; you just need to consider it when drafting emails, presenting an idea, or explaining results.

Some of these skills may not be necessarily things you get in traditional graduate studies or postdoctoral work. Was there anything in particular you did to prepare for this job?

I agree to a certain extent. However, in your graduate or postdoctoral work, you are working with others and don’t necessarily know every assay as well as you might like. You don’t have every reagent, so you need to make friends across floors and figure out who the expert is in the technique you are doing. I think that is very much a part of what I am doing now. I was never formally trained in non-experimental study design, but my bench training did teach me how to properly design a study, and certainly, my knowledge of non-experimental design has increased as I have gained more and more experience. Conceptually, however, it is a lot of the same stuff you do at the bench: You are looking at data, interpreting, writing, and figuring out to how to explain precisely what that finding means. I do think a lot of the skills translate over. As far as how to prepare, I would say get out and talk to people, even if you are not comfortable talking to somebody or explaining your work. Do it as much as you can—get comfortable talking to other people. Asking questions and just accepting that you are not the expert in everything can be very helpful.

Many postdocs appear to stay in their position for close to the full five years. What made you decide to leave early?

I liked the lab, I liked being in the lab, I liked the research, but I also started to look around and say, ‘I don’t want to be here all the time, and I would like a personal life.’ At the time I was living southern Maryland, so I was commuting an hour and a half every day. I loved what I was doing, but I also looked at the sort of research I enjoyed. It was more basic science and less translational. I saw the funding landscape, the difficulty to get your own lab, and what you had to put in to get to that point. I thought, ‘I love it, but I don’t know that I love it that much.’ To compete with everyone else, you have to give up a lot. With that realization, I started using some of the resources at the NIH and looking around and seeing what was available and trying to understand how I could use my skills. It just so happened that somebody else in one of the labs next door knew someone who had a small consulting company that was looking for a health outcomes researcher. I interviewed, and actually the guy said that he didn’t think it was going to work out. It was great in retrospect because I ended up being hired there and became a really core member of that team. 

What was the application/hiring process like? For people considering this career, how much time might they expect to be job searching?

It depends on your experience; when I started in this field, I really didn’t have any. For my first position, the interview consisted of going in and talking to the head of the company and discussing the job a little bit. I went into the interview really not understanding what the job was or what the area was – and not for lack of trying. It is a weird area if you are not aware of it, and it is a little bit difficult to explain. It is easier to learn more about this job when you talk to someone on the phone, but on a website, it is very difficult. I went in and talked about what I can do, what my skills are, how [I] think [my] skills are going to translate over. Then, honestly, you just hope it works out.

Was the application process different when you were applying for your current position?

It was totally different during my application [for my current position]. I had been in the industry for three [or] four years at that point. I had a clear expectation of what they wanted. They knew what they needed, and my resume really matched up well with the job description compared to when I applied for my first position. Understandably, I could see how, during the hiring process for my first position, there would be questions about me doing the job. My resume didn’t really say anything for [a health outcomes researcher] other than that I had research experience, but that was really it and was more of an over-arching skill. I think it would have been more difficult to get my current job without that prior experience. When moving to a new field I think just getting a foot in the door, even if it maybe isn’t the exact position that you want, is important. It gives you a chance to build skills and prove yourself, which is important for moving your career forward. 

What activities or resources at the NIH, or within NIAID specifically, helped prepare you for your career transition?

I don’t remember what it was called, but they did have a number of seminars about other job options or workshops to work on skills like working with others. None of them were earth-shattering, I didn’t go in, listen to someone talk, and think, ‘I never knew that before,’ but I do think there is some value when you are looking for something new. Hearing people say things out loud can help to reinforce them. That was helpful, and anything that you can do to boost your resume or any sort of resume development is obviously very helpful. But in terms of skills to get my first job, I hate to say it, but I got it because of who I knew; I had to prove myself once there, but knowing someone got me in the door. Again, one of the biggest benefits at the NIH is the community. You never know when an opportunity might come up, so making those networks is important.

Do you have any advice for fellows who are thinking about entering a similar career field? What do you think would make them a competitive candidate?

I would say in this particular field and any sort of retrospective database field: If you know how to program or know a programming language, that is beneficial. I don’t, but it would be nice. Gaining an understanding of databases because as bench scientists you work with data but, barring bioinformatics, you don’t work with large databases, and recognizing the difference between data and large data. Also, you would be amazed how many people I’ve worked with over the years who could not make a position work because they could not think through an issue clearly or were not okay talking with a client. Those are important abilities. Skills like writing and study design are really crucial too, but they aren’t everything.

Is it okay if current NIAID fellows contact you with questions?

Yeah! My email is brenna.brady@gmail.com.

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