Post on 04-Jul-2015
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What PCORI Wants
Kathryn A. Phillips PhDProfessor of Health Economics &
Health Services ResearchDept Clinical Pharmacy/IHPS/Cancer
Center, UCSF
The Center for Translational and Policy Research on Personalized Medicine
Goo-Goos & Pinky-Ringers?
Today’s Conversation
• What is PCORI funding and why
• What are challenges & opportunities now and in the future
Winner #1: David Thom
• Health Coaches: Health Team Support for Patient Informed Decision Making
• Why Successful?
– Joined academic research w/ stakeholder involvement
• Questions & Challenges?
– How to create meaningful collaboration w/ stakeholders who are not familiar with research process?
– How will collaboration change research process, results, & dissemination/application of research?
Winner #2: Diane Allen
• Disability & Rehabilitation: Mind the Gap—Targeting Differences in Patients’ Current and Preferred Abilities
• Why Successful?
– Focused on patient-reported outcomes, when relevant to patient
• Questions & Challenges?
– What is this institute and what influence will it have in health care research moving forward?
Awards
National Pharmaceutical Council <info@npcnow.org>
And What Did NOT Get Funded
• Objective is to advance observational data approaches for reflecting patient variabilityand subpopulations
– YES: Engaging stakeholders in how to best use health plan data; topics of interest
– NO: Use of health plan data not innovative enough; methods not sufficiently detailed; (health plans not a focus of PCORI)
Others Not Funded
• #1: Problem not important enough –population too small
• May not change practice – little room for patient preferences to change decisions
• #2: A study of how to improve policy decisions did not include patients as stakeholders (now policymakers considered stakeholders?)
• Methods insufficient
What Does PCORI Want?
• Expect to commit $355 million in 2013
• Funding
–Pilots (awarded)
– Five priority areas
– Topic specific areas (early 2013)
–Contracts
– “Challenge”
• Cash awards for prototype of patient/researcher matching system
1. Prevention, dx, tx2. Healthcare systems3. Communication & dissemination4. Disparities5. Methods
AHRQ Grants (2013)
• Patient-Generated Health Outcomes Data and Clinical Decision Support Using Smart Device Technology
• Enhancing Comparative Effectiveness Research (CER) Data Resources • Institutional Mentored Career Development Award Program in PCOR.• Researcher Training and Workforce Development in Methods and
Standards for Conducting Patient-Centered Health Outcomes Research Studies
• Individual Mentored Career Development Award Program in PCOR • Electronic Data Methods (EDM) Forum: Phase II• Bringing Evidence to Stakeholders for Translation (BEST) to Primary
Care• Disseminating Patient Centered Outcomes Research to Improve
Healthcare Delivery Systems• Deliberative Approaches for Patient Involvement in Implementing
Evidence-Based Health Care•
Methodology RFA
• Patient‐centeredness
• Systematic reviews
• Inclusion of stakeholders: topics, peer-review
• Methods for CER
• Data sources
• Reproducibility
• Training in PCOR methods
Challenges & Opportunities
• Real world evidence
• Incorporating stakeholder perspectives
• Focus on patient heterogeneity
• Prohibited from using “cost per QALY as threshold”
• Evolving landscape
• Speed up review process?
• Stakeholder burnout
• Fiscal situation
Understand the Culture
• Goo- goos – good government – CER needed to ensure value
• Pinky-ringers – political realists –“where’s mine?”
• PCORI is compromise – independent, non-profit, no yearly Congressional appropriation (until 2019)
–No longer “CER” and no mention of costs
There’s a wonderful rule of thumb
for American health care:
Shift happens
Uwe Reinhardt