At the Patient-Centered Outcomes Research Institute (PCORI), we believe comparative clinical effectiveness research (CER) is important and that we have a critical role to play in establishing the nation’s CER priorities. I’m pleased to say that many respondents to the latest National Pharmaceutical Council (NPC) survey think so as well.
While results of CER studies that we and others are funding have yet to be completed, and CER’s ultimate ability to transform our healthcare system is still years away, nearly all respondents in this fourth annual survey agree that CER is here to stay and that it will become increasingly important in aiding decision making. Respondents also indicated that CER has not yet assessed the broader array of outcomes that matter to patients.
These are important insights. The survey tracks the attitudes of researchers, policymakers, employers, business groups, insurers, and health plans. Engaging with these stakeholders – along with patients, caregivers, clinicians, and other providers – and ensuring that the work we fund provides evidence they can trust and use, are essential if CER is to realize its potential in guiding health care.
That’s why Congress authorized PCORI’s establishment as an independent, non-profit organization focused on ensuring that the broad healthcare community is meaningfully engaged in our work. We’re governed by a diverse board that represents all stakeholders. And through an open and collaborative approach to research, we’re identifying the questions patients and other clinical decision makers need answered, so they can make better-informed choices that will lead to better outcomes.
We’ve already awarded $464.4 million to support 279 studies that advance patient-centered CER and we expect to commit another $1 billion over the next two years.
Continue reading “PCORI Works to Deliver the Comparative Evidence Health Care Stakeholders Need”
Filed Under: THCB
Tagged: CER, Comparative efectiveness research, National Pharmaceutical Council, PCORI, PCORnet
Jun 25, 2014
PCORI is pleased to announce the PCORI Matchmaking App Challenge. This initiative seeks to create research partnerships that allow innovators and patients to work together. Developers are invited to make a full functioning, ready-to-publish app that has the capability to connect patients with researchers.
We are inviting developers to create an app that brings together patients, stakeholders, or researchers, and move toward collaborative research. These apps must integrate with already established research networks, and preferably integrates social media and robust user profiles. The developer is also encouraged to include an advanced search option and customizable displays.
Reviewers will include technology experts, PCORI staff members, and members of PCORI’s multi-stakeholder Advisory Panels. Reviewers will consider how well each developer facilitates connections that allow equal access to people from different backgrounds and with varying health interests and research experience, as well as considering creativity and the past experience of the developers.
The rewards are substantial, with PCORI awarding first place with $100,000, second place with $35,000, and third place will take home $15,000.
How to Apply
To enter your team for the Challenge, please go to the pre-registration form.
PCORI and Health 2.0 will host an hour-long informational webinar on Wednesday, April 30, at 1 p.m. (ET) to present the challenge goals and guidelines. We will describe the motivation behind and purpose of the Matchmaking App Challenge; explain the submission guidelines, judging criteria, and other conditions of the challenge; and answer questions from potential applicants. Registration for the webinar is now open. Questions and answers will be posted after the event.
Continue reading “An Open Call for the PCORI Matchmaking App Challenge”
Filed Under: Health 2.0
Tagged: Health 2.0 Developer Challenge, Matchmaking App Challenge, PCORI
Mar 25, 2014
Fifty years ago, President Lyndon Johnson signed designated February as American Heart Month to acknowledge and combat the “staggering physical and economic loss to the nation” caused by cardiovascular disease.
Unfortunately, that proclamation is proving to be a timeless document.
Even with broad awareness of heart disease, expansive research and a number of clinical and public health efforts to prevent, diagnose and treat cardiovascular conditions, it remains the leading cause of death in the nation. About 600,000 people die from heart disease in the United States each year—making it responsible for one out of every four American deaths.
As a research institute dedicated to helping patients and those who care for them make better informed decisions that lead to better outcomes, the Patient-Centered Outcomes Research Institute (PCORI) is acutely interested in producing new information that supports more effective cardiovascular care. The directive in our establishing legislation to consider “disease incidence, prevalence, and burden” when prioritizing research funding is a clear call for studies of cardiovascular conditions.
I’m proud to say that PCORI has answered that call. Cardiovascular disease, including heart disease and stroke, is the most commonly studied topic in our research portfolio. It is addressed in several dozen of the 192 primary research studies that PCORI has funded to date, including projects that conduct a comparative assessment of heart disease interventions, as well as those that test the effectiveness of decision support tools. Communicating information and providing tools to patients in ways that motivate them to make healthy choices is often a major challenge for clinicians.
Our comprehensive approach funds research that addresses the gaps in both information and communication that are responsible for poor outcomes in cardiovascular care.
Continue reading “Focusing on High-Impact Comparative Studies: Cardiovascular Disease in the Spotlight”
Filed Under: OP-ED, THCB, The Vault
Tagged: Baylor College of Medicine, Brigham and Women's Hospital, PCORI
Feb 8, 2014
In the New York Times on Thursday, October 17, Topher Spiro wrote an important op-ed expressing why we need to hold onto the medical device tax that helps pay for parts of the Affordable Care Act. Spiro backs up his argument by pointing out how profitable the device industry is. To his argument I would also add the fact that this will provide the industry with more paying customers. Certainly it can afford to pay the taxes.
But I diverge from Spiro on a proposal he floated near the end of his piece:
“To complement these efforts, the new Patient-Centered Outcomes Research Institute [PCORI], a non-governmental body created by the Affordable Care Act, should pay for research that compares the effectiveness of devices so physicians can make informed choices. (Three years into its existence, the institute has initiated few, if any, studies of medical devices.”
Listen to me PCORI. Don’t follow this advice, unless you plan not to survive to celebrate your fourth birthday.
Consider what happened to the Agency for Healthcare Policy Research (AHCPR), when it tried to help physicians figure out the best way to treat low back pain. AHCPR was created as a stand-alone research institute, akin to the NIH, but one that would focus not on the basic science of treating disease, but instead on evaluating how well existing treatments worked.
Continue reading “Why PCORI Should Be Very Wary of Studying Medical Devices”
Filed Under: OP-ED, THCB
Tagged: AHCPR, Medical Device Tax, Medical Devices, New York Times, PCORI, Peter Ubel, The ACA
Oct 18, 2013
One of our core beliefs at PCORI is that patients, clinicians, and other front-line caregivers, and others across the healthcare community have the potential to become valued and real partners in the patient-centered outcomes research (PCOR) we support. We practice what we preach in the requirements we place on applicants for our funding and the way we evaluate their proposals.
So we’re pleased today to announce the latest example of how we’re making that principle real – a new funding program called the PCORI Engagement Awards and the first funding opportunity under this program, the Pipeline to Proposals Award.
Listening to our stakeholders
We got the idea for the Engagement Awards program last October, during our first patient engagement workshop. We asked workshop participants to provide input into how we can better serve and connect with patients and the communities interested in being involved with rigorous PCOR– which is, comparative clinical effectiveness research focused on and guided by the needs and concerns of patients. The response was a clear and broad expression of passion, expertise, and willingness within the patient and broader healthcare community to help us pursue this approach to research. The question was how best to do it.
From that discussion was born our Engagement Awards program, which is designed to leverage the community’s passion and expertise by offering targeted funding to dozens of groups of patients, providers and other healthcare community stakeholders interested in supporting the expansion of high-quality, useful PCOR and the implementation of its results.
Our philosophy is that, when the research process incorporates the perspectives of the entire healthcare system and focuses on the questions important to patients and those who care for them, the results are far more likely to be meaningfully incorporated into clinical decision-making and practice.
The Engagement Awards program will have three distinct categories:
Filed Under: Uncategorized
Tagged: Anne C. Beal, patient engagement, PCORI, Susan Sheridan, Suzanne Schrandt
Jun 19, 2013
The Patient-Centered Outcomes Research Institute has just appointed four new advisory panels that will help guide hundreds of millions of dollars in research grants. Unfortunately, while PCORI released the new advisers’ names, it neglected to tell the public who the advisory panel members really are.
Let me explain. PCORI says its advisory panels “will be instrumental in helping us refine and prioritize research questions, provide needed scientific and technical expertise [and] offer input on other issues relevant to our mission.” Panel members represent specific stakeholder groups mandated by Congress and are appointed for one year, but they can re-up for another term.
That kind of influence invites attention, and more than 1,000 individuals applied for 82 available spots. Three of the panels correspond to topics that are PCORI national priorities for research: addressing disparities; assessment of prevention, diagnosis and treatment options; and improving healthcare systems. The fourth addresses patient engagement.
So who did PCORI pick? Well, people like Charlotte Collins of Elkridge, MD, representing “patients, caregivers and patient advocates” on the patient engagement panel. That’s the sum total of identifying information given on Ms. Collins and other panel members; there is no educational or professional information at all. Continue reading “Who Are These Guys? Why the PCORI Picks Matter a Lot More Than You Probably Realize.”
Filed Under: THCB
Tagged: Michael Millenson, Panels, PCORI, Tranparency
Apr 5, 2013
Conservatives love to apply “cost-benefit analysis” to government programs—except in health care. In fact, working with drug companies and warning of “death panels,” they slipped language into Obamacare banning cost-effectiveness research. Here’s how that happened, and why it can’t stand.
Why are you reading this when you could be doing jumping jacks?
And how come you’ve gone on to read this sentence when you could be having a colonoscopy?
You and I could be doing all sorts of things right now that we have reason to believe would improve our health and life expectancy. We could be working out at the gym, or waiting in a doctor’s office to have our bodies scanned and probed for tumors and polyps. We could be using this time to eat a steaming plate of broccoli, or attending a support group to help us overcome some unhealthy habit.
Yet you are not doing those things right now, and the chances are very strong that I am not either. Why not?
Continue reading “The Republican Case For Waste In Health Care”
Filed Under: OP-ED, THCB
Tagged: Comparative Effectiveness Research, Cost effectiveness research, Costs, Dartmouth Atlas Project, GOP, Health care spending, IOM, IPAB, Medicare, NEJM, PCORI, Phillip Longman, Politics, QALY, The ACA
Mar 8, 2013
The new Patient-Centered Outcomes Research Institute (PCORI) has been asking different stakeholders about the most important issues to address with the hundreds of millions of dollars the quasi-governmental group will shortly be doling out in grants. Not surprisingly, the stakeholders have been more than happy to respond.
PCORI’s most recent day of dialogue, which I attended as a representative of the Society for Participatory Medicine (SPM), was characterized by genteel civility and a big question mark: “Is PCORI serious about transforming health care?” When I asked directly, I didn’t get much of an answer. The reason, I suspect, goes to PCORI’s origins. It is the offspring of a shotgun marriage between goo-goos and pinky-ringers, and no one is quite sure yet what this child will be once it grows up.
Let me pause here a moment to parse the political shorthand. “Goo-goos” are “good government” types, the kind of folks who trumpet the need for transparency in government or better public transit. Goo-goos, seeing the half trillion dollars or so of waste in U.S. health care system, called for a new national organization to carry out comparative effectiveness research in order to help Americans get the most value for our money.
The goo-goos pointed out that our current regulatory structure is designed to ensure that treatments are safe and effective, not compare them. Nor does the private sector have much incentive to pay for comparative studies that may undermine products currently selling quite nicely, thank you.
Continue reading “Patient Politics: the PCORI Puzzle”
Filed Under: OP-ED, THCB
Tagged: CER, Comparative Effectiveness Research, Michael Millenson, Partnership to Improve Patient Care, PCORI, Society for Participatory Medicine, The ACA
Dec 11, 2012
Like waiting outside the Vatican for the puff of white smoke, the nation sits on edge awaiting the Supreme Court’s ruling on the Affordable Care Act. The ruling, which is likely to be announced next week, could toss out the entire healthcare reform bill, chop off one of its limbs (probably the so-called individual mandate), or leave the ACA intact. Whatever the ruling, it will be chum for the blogosophere, particularly in the heat of presidential silly season.
The two fundamental challenges to American healthcare today are how to improve value (quality divided by cost) and how to improve access (primarily by insuring the tens of millions of uninsured people). The bill sought to address these twin challenges in ways that were complex and intertwined. I’ll argue that a decision by the Court to throw out all or part of the ACA will have a profoundly negative effect on the access agenda, but surprisingly little impact on the value agenda. To understand why requires that we focus less on the bewildering details (mandates, insurance exchanges, PCORI, CMMI, IPAB, etc.) and more on some big picture truths and tradeoffs.
The job of any healthcare system is to deliver high quality, safe, satisfying care to patients at the lowest possible cost. Although America certainly does specialty and high tech care like nobody’s business, on all of the key dimensions of value we aren’t very good. The numbers tell the sorry tale: we provide evidence-based care about half the time, there are huge variations in how care is delivered, we kill 44,000-98,000 patients per year from medical errors, and we spend 18% of our gross domestic product on medical care, far more than any other country.
Continue reading “Why the Supreme Court’s Healthcare Decision Will Mean a lot … and Not so Much”
Filed Under: The Business of Health Care
Tagged: Access, cost curve, Costs, Health insurance, Individual mandate, PCORI, Quality, The ACA, The Supreme Court Challenge, uninsured, Value
Jun 18, 2012
During the original debate over the Affordable Care Act, I wrote that the proposed law failed to address out-of-control Medicare spending. Two years later, this urgent problem remains.
Medicare is awash in a sea of red ink — $280 billion in cash flow deficits already and getting worse — that is driving the U.S. credit rating south and threatening the very foundations of the U.S. economy. It makes no sense to sit idly by while the social safety net unravels and the promise of our future dims.
Advocates argue the health care law solves this problem. Specifically, it creates the Independent Payment and Advisory Board, which will be formed in 2014 and could make its first recommendations in 2015. This advisory board will consist of 15 officials appointed by the president. Board members will be required to make recommendations to cut Medicare funding in years when spending growth exceeds targeted rates. For Congress to block these recommendations, it must veto the board’s proposal with a 60 percent majority and pass alternative cuts of the same size.
In other words, this board puts Medicare on a budgetary diet. What’s wrong with that?
First, the system is clearly set up so that the advisory board, rather than Congress, makes the policy choices about Medicare. This means that the IPAB is not just an advisory body — despite its name. And policy choices, which should be made by elected representatives, are not.
Second, the advisory board threatens the quality of patient care. It can, in essence, ration the health care available to seniors. While technically prohibited from directly altering Medicare benefits, the IPAB will have no choice but to attempt to ratchet back spending by slashing providers’ reimbursement rates.
Continue reading “IPAB and Medicare Costs Are Bad Medicine”
Filed Under: OP-ED, THCB, The Vault
Tagged: Douglas Holtz-Eakin, IPAB, Medicare, NICE, PCORI, The ACA
Mar 26, 2012