UCSF Comparative Effectiveness Research - PCORI Funding (2013 Symposium)
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Transcript of UCSF Comparative Effectiveness Research - PCORI Funding (2013 Symposium)
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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
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Goo-Goos & Pinky-Ringers?
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Today’s Conversation
• What is PCORI funding and why
• What are challenges & opportunities now and in the future
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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?
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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?
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And What Did NOT Get Funded
• Objective is to advance observational data approaches for reflecting patient variability and 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)
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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
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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
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1. Prevention, dx, tx2. Healthcare systems3. Communication & dissemination4. Disparities5. Methods
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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 •
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Methodology RFA
• Patient centeredness‐• Systematic reviews• Inclusion of stakeholders: topics, peer-
review• Methods for CER• Data sources• Reproducibility• Training in PCOR methods
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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
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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
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There’s a wonderful rule of thumb for American health care:
Shift happens
Uwe Reinhardt