Policymakers charged with disseminating comparative-effectiveness research will need to proceed carefully and strategically to overcome obstacles such as a lack of standardized methodology and public perceptions of CER.
Those were among the findings of a recently released issue brief from the New England Healthcare Institute, a not-for-profit health policy research organization based in Cambridge, Mass. The brief's authors recommended several strategies for effective CER dissemination, including the integration of CER into the current push for expanded use of health information technology.
"Utilization of electronic clinical decision support is a primary goal of the
meaningful-use criteria, and thus federally supported healthcare information technology deployment creates a major opportunity to integrate CER findings into clinical decision support at the point of care," the authors said in the brief.
Created by the health reform law, the Patient Centered Outcomes Research Institute will be charged with commissioning new comparative effectiveness research projects. The Agency for Healthcare Research and Quality, on the other hand, has been given the task of disseminating that research to patients, clinicians and payers.
The authors cautioned officials from AHRQ and PCORI to consider the drivers of CER as well as the many hurdles that could impede it to make dissemination run more smoothly. One primary driver of comparative-effectiveness research, they said, is the trend toward patient-centered care, which has highlighted the need for better treatments that take into account patients' perspectives and lifestyles.
In addition to advocating for the integration of CER findings into decision support systems, the authors advised officials to set high-priority targets—particular regions of the country, for example, specific health conditions—for this information integration. "Such a strategy might be particularly relevant to disease states in which patient engagement and adherence are important and in which good clinician performance is not sufficient to ensure good outcomes," they wrote.
They also emphasized the need for open communication with the public and clinicians, as well as outreach to payers and healthcare purchasers.
"CER dissemination policy should take full advantage of other trends in healthcare improvement, most particularly the deployment of healthcare information technology," the authors said in the brief. "In the end, thoughtful and comprehensive dissemination policy will not only support the use of CER but should go far to improve the utilization of all forms of scientific evidence in the healthcare system."
