pec research overview 19 jan2011

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

mailto:[email protected]



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

CER Study QuestionHow did we get here?

PROCESSES OF CARE +


FACTORS+ PATIENT FACTORS → CHRONIC DISEASE

CONTROL

CER Study QuestionHow did we get here?Why CER?Why the SAFTINet population?Why these 4 cohorts?Why this research question?

Why CER 2009: The American Recovery and

Reinvestment Act allocated $1.1 billion for CER

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

http://www.iom.edu/Reports/2009/ComparativeEffectivenessResearchPriorities.aspx

IOM Priorities for Comparative Effectiveness Research (2009)

What is CER? (Institute of Medicine, 2009)



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



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

CER Study Question Research question was chosen to best

align with national priorities

CER Study QuestionPriority Populations Priority Conditions

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

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

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

Institutes of Medicine Top 100 Priority Areas

Igelhart al, NEJM(2009)

CER Study Question


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.”

CER Study Question



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

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



CONTROL

Measures of Delivery Factors



CONTROL

Patient-centered medical home (PCMH)

Integrated mental health care (IMHC)

Others

Measures of Disease ControlHEALTH CARE

DELIVERY SYSTEM FACTORS

→ CHRONIC DISEASE CONTROL

Existing electronic health record data Medicaid data, death files, etc. Enhanced data

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?

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

pec research overview 19 jan2011

Healthcare