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First Plenary SessionTAKING STOCK OF THE LEARNINGHEALTH CARE SYSTEM: WHAT HAVEWE ACHIEVED AND WHY DOES ITMATTER?
Moderator
Penny Mohr, MAPatient-Centered
Outcomes ResearchInstitute (PCORI)
Washington, DC, USA
Taking Stock of the Learning Healthcare System:What Have We Achieved and Why Does It Matter?
Penny Mohr, MASenior Program Officer, Improving Healthcare Systems, Patient-Centered Outcomes Research InstituteMay 18, 2015
Caught Between Scylla and Charybdis
$2.6 Billion Cost toBring a New MolecularEntity to Market
Tufts Center for DrugDevelopment, 2014
Increaseddemand forPhase IVStudies andReal-worldEvidence
The Learning Healthcare System
Efforts aremade to learnfrom everyclinical
encounter*
Findings areimplementedto improvepatient care * Accomplished by closely
integrating observational andexperimental clinical research into
clinical practice
Evidence based Draw on the best evidence to provide care Learn through the delivery of care Discovery is a natural outgrowth of care
Value-driven Deliver the most value Retain incentives for innovation Emphasize prevention and health promotion
Patient-centered Provide the care most appropriate for each patient Facilitate collaborative choices between patient and provider
The Vision
The Building Blocks
Investment and Incentives
BD2K
Electronic Health Record Adoption byPhysicians Offices in the United States, 2001-13
>
The Optimists
Evidence BasePoint of care clinicaltrials represent apromising newmethod forconducting clinicalresearch.DAvolio et al. J Am MedInform Assoc. 2012
Value-drivenResults from thePioneer ACO Modeldemonstrationevaluation areencouragingNyweide et al., JAMA 2015
Patient-centerednessPatients are engaged andwant to participate.Martin Coulter CEO,PatientsLikeMe, iHealthbeat 2014
The healthcare system isnow positioned to finallyjoin other industries as anenterprise of continuouslearningVictor Dzau, CEO, Duke UniversityHealth System, IOM 2015
The Critics
Evidence-Basedthe aggregateresearch capacity isvery thin, and theproducts fallsubstantially short ofthe need.IOM, Learning What Works:Infrastructure Required forCER 2010
Value-drivenOne persons waste isanother persons income
Brent James, InterMountainHealthcare, Managed Care 2013
Patient-centerednessPatients frequentlypreferred restrictingprovider access to theirEHRs.Tierney et al. JGIM 2015
How do you learn ina formal, defensibleway?
SpeakersTAKING STOCK OF THE LEARNING HEALTH CARESYSTEM: WHAT HAVE WE ACHIEVED AND WHY DOES ITMATTER?
Sarah Greene, MPHPatient-Centered
Outcomes ResearchInstitute (PCORI)
Washington, DC, USA
Lewis G. Sandy, MD,FACP
UnitedHealth GroupMinneapolis, MN,
USA
Sachin H. Jain, MD,MBA
CareMore/AnthemCerritos, CA, USA
Moderator
Penny Mohr, MAPatient-Centered
Outcomes ResearchInstitute (PCORI)
Washington, DC, USA