Reform Update: PCORI board notes need for better communication

The need for better communication—with research applicants, patients and practicing clinicians—was a frequent topic of discussion at the Patient-Centered Outcomes Research Institute's board of governors meeting on Monday.

The Washington-based not-for-profit, established by the healthcare reform law to promote and fund comparative-effectiveness research, awarded $40.7 million in research grants in December and aims to commit a total of more than $350 million in 2013 and more than $500 million in 2014, said Dr. Joseph Selby, PCORI's executive director.

Steven Lipstein, vice chair of PCORI's 21-member board of governors and president and CEO of 12-hospital BJC HealthCare, St. Louis, said the sequestration and other budget-tightening measures have put a frustrating strain on researchers, “making it more and more difficult to succeed in applications for funding.” He argued that PCORI's approach, which requires a high degree of patient involvement in research, could be perplexing to potential applicants.

“We have to work with the research community to help them understand what we need them to do,” Lipstein said during the meeting.

Dr. Harlan Krumholz, a Yale professor, cardiologist and member of PCORI's board of governors, agreed, saying there were plenty of “talented investigators standing on the sidelines” because of uncertainty about how best to approach the application process.

“From a research perspective, we need to engage them in ways that we haven't,” Krumholz said, who suggested posting examples of successful applications on PCORI's website.

Board members also stressed the need to communicate PCORI's mission with patients in an understandable way. Dr. Grayson Norquist, professor and chairman of the department of psychiatry and human behavior at the University of Mississippi Medical Center, Jackson, and a PCORI board member, said the organization's goals and progress “might make perfect sense” to those involved in comparative effectiveness research, but more is needed to be done to ensure consumers understand, too.

During the meeting, Selby reviewed the group's draft strategic plan for the upcoming year, which includes more close collaboration with HHS' Agency for Healthcare Research and Quality and the National Institutes of Health. He listed 10 critical activities for 2013, such as funding broad and targeted research projects, establishing baselines for evaluating progress and establishing a program that matches patients with researchers.

PCORI also provided some of the metrics that it will use to gauge success of its approach, including the number of people trained and involved in research, and the number and types of publications that cite PCORI-funded findings.

The Center for Medicare and Medicaid Innovation lowered the minimum beneficiary threshold from 500 to 350 for its Comprehensive ESRD Care Initiative. Launched in February, the program tests a coordinated, shared-savings model for delivering and paying for care of patients with end-stage renal disease, a population that accounted for more than $20 billion in Medicare spending in 2010. Although program applicants were initially required to have 500 matched beneficiaries to participate, the Innovation Center said it lowered the threshold “after review of numerous feedback and suggestions from organizations interested in new models of ESRD care.”

The New Jersey Hospital Association released quality data from the 62 hospitals that are participating in its Hospital Engagement Network. The association was one of 26 HENs chosen by HHS to help hospitals meet the targets of its $1 billion Partnership for Patients initiative. New Jersey hospitals “demonstrated measurable improvement” on adverse drug events, patient falls, central line-associated bloodstream infections and other types of preventable harm, according to the one-year status update. One quality indicator—early elective deliveries—remained unchanged at the one-year mark, but the NJHA said most of the state's hospitals have cracked down on elective deliveries before 39 weeks' gestation and are also working to reduce obstetrical adverse events.

Launched in April 2011, the Partnership for Patients aims to reduce the number of hospital-acquired conditions by 40% and lower the rate of hospital readmissions by 20% by the end of 2013.

The Patient-Centered Outcomes Research Institute named Regina Yan COO, tasked with day-to-day operations of the Washington-based not-for-profit research group. Yan, former COO of the Peterson Institute for International Economics, replaces Dr. Anne Beal, PCORI's first COO who now serves as the organization's deputy executive director and chief officer for engagement.

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