PCORI Dissemination and Implementation Workshop
Richard Kronick, Ph.D., Director, Agency for Healthcare Research and Quality
Washington, DC, December 10, 2014I appreciate the opportunity to participate in this workshop with Joe Selby, executive director of the Patient-Centered Outcomes Research Institute (PCORI), and to spend a few minutes talking about the relationship between AHRQ and PCORI, as well as AHRQ's role in the implementation and dissemination of patient-centered outcomes research (PCOR).
This meeting and the work that will transpire as a result are crucial developments in our efforts to improve health care quality, safety, access and affordability in the United States.
Most people think Americans generally have access to high quality health care. The data suggests that is not necessarily the case. A tremendous amount of what we know doesn't get used in practice. Estimates of just how much evidence actually gets used vary widely, from about 7 percent to nearly 50 percent. Figuring out how to narrow that gap is a central part of the challenge we face.
This challenge is reflected in our mission statement, "To produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to work within HHS and with other partners to make sure that the evidence is understood and used."
Our mission acknowledges the fact that all of the resources we have at our disposal pale in the context of the needs of a $2.9 trillion health care system with 800,000 physicians, 2.7 million nurses, 5,000 hospitals and 330 million patients.
The job of dissemination and implementation is too big for one organization. It's a stakeholder-driven process that requires contributions from all of us.
Under the Affordable Care Act, AHRQ is charged with disseminating PCOR findings and with training researchers in the conduct of patient-centered outcomes research. We do this primarily by funding initiatives to provide evidence about the best ways to disseminate PCOR and have it used in practice. As part of that effort, we fund the development of products and tools to aid in dissemination and effective use.
PCORI and AHRQ have been collaborating since PCORI's Board of Governors and Program Development Committee were established in 2010. Last year, Joe presented at one of my first AHRQ National Advisory Council meetings as director of the Agency and we have been working together ever since.
One example: In September we announced a joint effort to evaluate the effectiveness of different treatment strategies for women with uterine fibroids. A research team from the Duke University School of Medicine is leading the project to develop a patient registry to improve the evidence base on uterine fibroids.
In addition to our work with PCORI, we're currently reviewing applications for a project to develop eight regional cooperatives that will disseminate PCOR evidence directly to primary care practices and support them in implementing clinical and organizational evidence in practice. The cooperatives are expected to improve patient health through focusing on improving implementation of the Million Hearts™ campaign ABCS (aspirin therapy, blood pressure control, cholesterol management and smoking cessation). We expect this initiative to provide support to up to 6,000 physicians and 9 million patients.
We're also devoting significant resources to evaluating how we can most effectively disseminate PCOR at the system level. Next year we will announce support of up to three Centers of Excellence on Comparative Health System Performance. These centers will develop and implement methods of measuring health system performance on cost and quality, with an emphasis on performance in disseminating PCOR. We're working on developing partnerships with intermediaries such as health systems, insurers, employers and specialty societies that are crucial to effective dissemination.
We also support the John M. Eisenberg Clinical Decisions and Communications Science Center. The Center translates patient-centered outcomes research reviews and research reports into short, plain-language summaries and tools that can be used by consumers, clinicians and policymakers.
Our Office of Communications and Knowledge Transfer is rigorously engaged in making these summaries and tools available. For example, we have distributed more than 4 million of the consumer summaries to patients. Much of this has been done through partnerships—we have 600 partnerships with national, regional and state organizations—along with a variety of marketing activities, including social media. In addition, more than 40,000 continuing education certificates have been issued.
The one consistent theme in everything I've said so far addresses the need for collaboration and for engaging stakeholders from all walks of health care. As stakeholders, your involvement is critical and I appreciate the time and perspectives of the 65 experts in the room, as well as the 400-plus webinar participants. Your feedback and input on the draft PCOR Dissemination and Implementation Framework and Toolkit will help to shape future dissemination and implementation efforts.
I look forward to working with you.
Page last reviewed December 2014