pec research overview 19 jan2011
TRANSCRIPT
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SAFTINet Research Project Overview… and how does this relate to the PEC?
Bethany M. Kwan, PhD, MSPH Marion R. Sills, MD, [email protected] [email protected] Project Manager Lead, SAFTINet CER Project
SAFTINet
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CER Study Question HEALTH CARE DELIVERY SYSTEM FACTORS, such as
the patient-centered medical home are important to the CONTROL of asthma (children, adults)high blood pressure hypercholesterolemia
PROCESSES OF CARE +
HEALTH CARE DELIVERY SYSTEM
FACTORS+ PATIENT FACTORS → CHRONIC DISEASE
CONTROL
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CER Study QuestionHow did we get here?
PROCESSES OF CARE +
HEALTH CARE DELIVERY SYSTEM
FACTORS+ PATIENT FACTORS → CHRONIC DISEASE
CONTROL
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CER Study QuestionHow did we get here?Why CER?Why the SAFTINet population?Why these 4 cohorts?Why this research question?
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CER Study QuestionHow did we get here?Why CER?Why the SAFTINet population?Why these 4 cohorts?Why this research question?
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Why CER 2009: The American Recovery and
Reinvestment Act allocated $1.1 billion for CER
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Why CER 2009: The American Recovery and
Reinvestment Act allocated $1.1 billion for CER
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What is CER? (Institute of Medicine, 2009)
Comparative Effectiveness Research (CER) is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat and monitor a clinical condition, or to improve the delivery of care.
The purpose of CER is to assist consumers, clinicians, purchasers, and policy makers to make informed decisions that will improve health care at both the individual and population levels.
http://www.iom.edu/Reports/2009/ComparativeEffectivenessResearchPriorities.aspx
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IOM Priorities for Comparative Effectiveness Research (2009)
What is CER? (Institute of Medicine, 2009)
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Why CER 2009: The American Recovery and
Reinvestment Act allocated $1.1 billion for CER
3 recipients of the funds: NIH, AHRQ, OS-DHHS 3 recipients issued requests for proposals
to develop CER infrastructure to conduct CER studies
mandated an Institute of Medicine (IOM) study to establish national priorities for CER
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Why CER 2009: The American Recovery and
Reinvestment Act allocated $1.1 billion for CER
3 recipients of the funds: NIH, AHRQ, OS-DHHS 3 recipients issued requests for proposals
to develop CER infrastructure to conduct CER studies
mandated an Institute of Medicine (IOM) study to establish national priorities for CER
SAFTINet research
infrastructure
SAFTINet research question
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CER Study Question Research question was chosen to best
align with national priorities
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CER Study QuestionHow did we get here?Why CER?Why the SAFTINet population?Why these 4 cohorts?Why this research question?
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CER Study QuestionPriority Populations Priority Conditions
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CER Study Question
1. Low-income groups2. Minority groups3. Women4. Children5. The elderly6. Individuals with
special health-care needs (e.g., disabilities, need for chronic care or end-of-life care, or those who live in inner-city and rural areas)
1. Arthritis/joint disorders 2. Cancer 3. Cardiovascular disease4. Dementia, including Alzheimer's
Disease 5. Depression; other mental health
disorders 6. Developmental delays, ADHD and
autism 7. Diabetes Mellitus 8. Functional limitations and disability 9. Infectious diseases including HIV/AIDS 10. Obesity 11. Peptic ulcer disease and dyspepsia 12. Pregnancy including pre-term birth 13. Pulmonary disease/Asthma 14. Substance abuse
Priority Populations Priority Conditions
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CER Study Question
1. Low-income groups2. Minority groups3. Women4. Children5. The elderly6. Individuals with
special health-care needs (e.g., disabilities, need for chronic care or end-of-life care, or those who live in inner-city and rural areas)
Priority Populations
Basis for defining our SAFTINet clinic population
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CER Study Question
1. Arthritis/joint disorders 2. Cancer 3. Cardiovascular disease4. Dementia, including Alzheimer's
Disease 5. Depression; other mental health
disorders 6. Developmental delays, ADHD and
autism 7. Diabetes Mellitus 8. Functional limitations and disability 9. Infectious diseases including HIV/AIDS 10. Obesity 11. Peptic ulcer disease and dyspepsia 12. Pregnancy including pre-term birth 13. Pulmonary disease/Asthma 14. Substance abuse
Priority Conditions
Basis for defining our 4 SAFTINet cohorts:
•asthma (children, adults)
•high blood pressure •hypercholesterolemia
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CER Study QuestionHow did we get here?Why CER?Why the SAFTINet population?Why these 4 cohorts?Why this research question?
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Institutes of Medicine Top 100 Priority Areas
Igelhart al, NEJM(2009)
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CER Study Question
HEALTH CARE DELIVERY SYSTEM
FACTORS→ CHRONIC DISEASE
CONTROL
First Quartile Priority:
“Compare the effectiveness of comprehensive care coordination programs, such as the medical home, and usual care in managing children and adults with severe chronic disease, especially in populations with known health disparities.”
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CER Study Question
HEALTH CARE DELIVERY SYSTEM
FACTORS→ CHRONIC DISEASE
CONTROL
“Compare the effectiveness of comprehensive care coordination programs, such as the medical home, and usual care in managing children and adults with severe chronic disease.”
HEALTH CARE DELIVERY SYSTEM FACTORS, such as the patient-centered medical home are important to DISEASE CONTROL
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CER Study Question HEALTH CARE DELIVERY SYSTEM FACTORS, such as
the patient-centered medical home are important to the CONTROL of asthma (children, adults)high blood pressure hypercholesterolemia
HEALTH CARE DELIVERY SYSTEM
FACTORS→ CHRONIC DISEASE
CONTROL
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Measures of Delivery Factors
HEALTH CARE DELIVERY SYSTEM
FACTORS→ CHRONIC DISEASE
CONTROL
Patient-centered medical home (PCMH)
Integrated mental health care (IMHC)
Others
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Measures of Disease ControlHEALTH CARE
DELIVERY SYSTEM FACTORS
→ CHRONIC DISEASE CONTROL
Existing electronic health record data Medicaid data, death files, etc. Enhanced data
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Involving the PECHEALTH CARE
DELIVERY SYSTEM FACTORS
CHRONIC DISEASE CONTROL
What do you already measure? What is important to measure? What is feasible to measure? How can SAFTINet and PEC partners
help measure these in your practice?
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Schedule for future PEC-Research meetings
Date Topic2/16 Initial discussion of enhanced data
collection measures such as health-related quality of life and disease control measures
3/16 Initial discussion of health systems delivery characteristics measures
4/6 Asthma outcomes4/20 Cardiovascular disease outcomes5/18 Patient-Centered Medical Home measures