How many applied? (David and Diane)How many want to apply?How many funded? (5%) (vs. NIH 18%, down from 30%)
UCSF CER - What PCORI Wants (Symposium 2013)
The Center for Translational and PolicyResearch on Personalized Medicine What PCORI Wants Kathryn A. Phillips PhD Professor of Health Economics & Health Services Research Dept Clinical Pharmacy/IHPS/Cancer Center, UCSF
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?
AwardsNational Pharmaceutical Council <firstname.lastname@example.org>
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)
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
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