OHDSI Collaborator Spotlight: Kristin Kostka

Kristin Kostka is an Associate Director at IQVIA running the OMOP Data Network and a perennial collaborator in the OHDSI community. In her work, Kristin partners with hospitals, payers and healthcare providers to help organizations unlock the power of institutional data and connect with the world’s largest observational health data network.

Kristin has over 10 years of experience leading real-world evidence generation studies, designing and implementing enterprise patient data lakes, conducting large-scale multinational clinical trials and preparing regularly submissions. Within OHDSI, Kristin sits on the OHDSI Steering Committee, the US Symposium Scientific Committee, the Women of OHDSI group, the OHDSI Study Nurture Committee and regularly leads OHDSI network studies. Kristin co-authored three chapters of the Book of OHDSI (Where to Begin, Defining Cohorts and OHDSI Network Research). Her OHDSI passion project is the idea of “studies on studies” — evaluating the best way to disseminate evidence once its generated. Kristin currently serves as a member of the OHDSI COVID-19 Study-a-thon Core Team facilitating follow-on work from the recent virtual study-a-thon. She is also a Co-Principal Investigator on Project CHARYBDIS (Characterizing Health Associated Risks, and Your Baseline Disease In SARS-COV-2).

Kristin is a recipient of many industry awards, including the 2020 Elon University Young Alumni Council “Top 10 Under 10” Alumni Award, a 2018 OHDSI Titan Award for Community Collaboration, a 3-time recipient of Deloitte Outstanding Performance Award and an 8-time recipient of the Deloitte Applause Award for exceptional client service. She holds a Bachelor’s degree in Exercise Science from Elon University and a Master’s in Public Health in Epidemiology from Boston University School of Public Health.

You were recently honored by your alma mater as one of Elon’s Top 10 Under 10, so can you describe your rapid journey from graduation to your current role at OHDSI?

I have a tendency for moving quickly. My journey began with an ending. I graduated from undergrad a semester early (December 2010) and went home for the holidays. I was already accepted to a MPH program at Boston University School of Public Health. I decided to give myself a break and took the spring off from school, deferring my admission to Fall 2011. I came back to Boston on December 15, 2010. Within a couple of days, I landed a research assistantship at Beth Israel Deaconess Medical Center in Boston.

What I didn’t know at the time was that I inadvertently landed a gig with one of the most prestigious interventional cardiologists in the country. It was a really fortunate accident. In that core lab, I was trained in reading angiograms (aka the imaging we order when you have a blocked artery) and learned all about data management. Over time, I began running phase I-IV multi-national clinical trials for a number of popular anticoagulants.

I would end up working there for 3 years full-time while I got my MPH at night. It wasn’t easy but it was worth it. I got incredible hands-on experience. I became a wizard at SAS – which was extremely lucky because one day a biostatistician quit and we needed Steering Committee reports for a Phase III trial. The biostatistician was rather disgruntled and left the existing code with a bunch of ‘booby traps’ so no one could run it unless you were savvy enough to debug his macros. I’d like to credit this as my first experience in learning how to reproduce someone else’s code. ? I ended up getting experience as a biostatistician on that clinical trial from that work. It made some of my intermediate and advanced biostats classes a lot easier.

After I finished my MPH in December 2013, I transitioned to a role in health policy working as a Medicare Risk Adjustment Specialist for a Medicare Advantage Organization. I would travel to clinics and hospital sites to train on their local Epic, Meditech and eClinicalWorks instances so I could pull reports from the data warehouse for our risk adjustment monitoring reports. It was the first time I really got hands-on exposure to EHR data and linking it to claims. I did this role for 9 months before I ended up moving into consulting. From there, things started to snowball. I spent the next 5 years traveling the world to work on a variety of real-world data projects. Another lucky accident in there: my Chief Administrative Officer at the time sent me a link to a free symposium in DC. He approved my expenses to go to DC to this “O-H-D-S-I” thing we’d never heard about. By the end of that day in September 2015, I was converted. I made every excuse I could to hang out with the community.

I spent a lot of nights and weekends getting exposure to everything OHDSI. I wore out my good graces asking 200 questions and incessantly showing up for calls. I caught on fire and so did OHDSI. The community continues to expand in new and amazing ways every year. Last year I got the opportunity to join Christian’s team and turn my OMOP passion into a full-time gig. This particular role is a fortuitous intersection of my love of data, my ability to debug and my excitement to bring more folks into the community. With Christian’s support, I’ve been able to dedicate more time to OHDSI and take on more leadership roles. I definitely wouldn’t be where I am today without the help of some great OHDSI mentors behind me.

While you take part in many OHDSI working groups, you are clearly passionate about running network studies. Can you discuss this passion, and specifically why you believe OHDSI fosters the right environment for this work?

OHDSI is a rare place where everyone really rolls up their sleeves. It’s easy to talk, but doing takes energy and dedication. Time and again I’ve seen the community rally around supporting a need and turn it into something amazing. I think what makes OHDSI the right environment is the mission. We all want to be part of something bigger than ourselves. We all want to see healthcare change for the better. A lot of us will never get the opportunity to be at bedside treating patients. We’re removed from that piece of the equation. OHDSI provides us with a way to collaborate and share our talents to generate evidence that promotes better health decisions and better care. It’s that commitment to doing things together, not separately, and sharing the bumps and bruises that come with the hard work that makes this the right environment for this work. Nobody in this community sugarcoats it, but that’s the fun. We know that this is hard work. We know that some days we’ll get rejected from mainstream peer-reviewed journals because we’re a little too new for them. It can be defeating yet we have this incredible energy and resilience to preserve no matter what. This is what makes OHDSI unique and an incredible thing to be part of.

Kristin Kostka

Can you discuss the current growth of OHDSI within Latin America, and where you feel some of the biggest gains have been made recently?

You know, we started 2020 with big plans and COVID-19 has definitely turned things upside down. The COVID-19 study-a-thon helped bring in some of our collaboration partners from Argentina, Colombia and Brazil, which is invaluable. We’re extremely lucky to have Talita Duarte-Salles, from SIDIAP in Spain, wearing many hats in the OHDSI community – including being a part-time local ambassador to the Brazilian OHDSI community, having many professional connections with institutions in the area. Her work in reaching out to Latin American sites has brought renewed energy to interest in finding ways to get these sites engaged. I recently got an email asking myself and Jose Posada if we wanted to be part of referees for someone’s grant application to do an OMOP conversion for a Latin American institution. There are lots of little things like that that are happening quietly behind the scenes. Many of us are a little split in our focus but the passion of Latin American OHDSI is fiery and it finds its own way, even when we neglect it. I’m excited to see how we can continue to foster this budding region into converting more data and collaborating in studies. ¡Muchas gracias a Gerardo y Jose y Juan y Talita!

OHDSI is based on tenets of open science and collaboration. How do those enhance the work you do, and what do you enjoy most about the concept of ‘team science’?

“Team Science” is like Steve Kerr playing with Michael Jordan on the 1998 Bulls. All boats rise with the rising tide. I know for me personally, having the energy of other collaborators and the shared expertise brings me to another level. I struggle with imposter syndrome and feel like I’m not qualified to be doing this work but being around this community reminds me that there’s a place for each of us in this process and our unique contributions can really make an impact. Plus, it’s kind of awesome to have a phone a friend list of 300+ people who are so diverse in their skills that I always have “a guy” to help. ?

You are part of the original Women of OHDSI working group. While your work on the breast cancer prediction study is obviously impactful, what do you hope your fellow ‘WoO’ collaborators can get from this group?

I really admire that Maura [Beaton] started this group. It’s important to create a community that fosters a constructive conversation on how we can do a better job of mentoring and empowering those who are historically underrepresented in STEM. My hope for my fellow ‘WoO’ collaborators is that they find access to mentorship and sponsorship. They’re not the same thing. It’s important to have mentors who advise you on what to do. It’s even more important to develop relationships with sponsors who advocate for you. You want to cultivate connections that are helping open and expand your impact. The power of the WoO collaboration is that we each have access to different doors and different views. What I have may not be useful to everyone but it could be a game-changer for someone looking for access to that opportunity. I hope that we can help create in-roads and make it easier to find these connections and build these bonds. It’s a learned skill and it takes a lot of practice. It’s important we foster this openly and give avenues for this to thrive.

You are one of the most active people in giving tutorials, and you took part in writing the Book of OHDSI. How much do you enjoy teaching/sharing information, and is there a particular tutorial or educational moment that brings forth some truly memorable moments?

Teaching tutorials is a bit like running a marathon. It’s totally an endurance game. I’ve had the privilege to travel the world getting to teach in a variety of universities and companies. It’s never the same experience but it’s always a learning opportunity of how we can continue to improve and expand how we make the methods and tools accessible to everyone.

My favorite memory of teaching was last summer in Shanghai. Patrick, Mui and I were teaching a week-long boot camp for 100+ students at Fudan University. Up until this point, I actually had never run a network study myself from end-to-end. It was the most exhilarating thing to go from years of talking about the theoretical to actually seeing it come to life in my own analytics environment and then having the opportunity to train others on this new skill I’d developed. I get so excited when a data partner finishes ETL and is ready to run their first study package because I know what that joy feels like when they cross over that threshold. It’s why I keep teaching. I want everyone to experience the excitement of how this amazing engine works.

What are some of your hobbies, and what is one interesting thing that most community members might not know about you?

I’m a yogi. I’ve run four marathons. I’m obsessed with mid-century modern design.

I often forget to say this because it’s so obvious to me and yet, very few people would know this if you haven’t met my sister: I’m an identical twin. I have my own counterfactual. We look different now but our voices are the same (and it still really freaks my husband out).

Growing up, my mom enrolled us in twin studies so I guess you could say I’ve been involved in research for decades. ?