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The PIPC Blog

Chairman's Corner: New Opportunities for Patient-Centered CER

1/2/2014

 
As I look back at 2013, and ahead to 2014, I’m convinced that the principles guiding the Partnership to Improve Patient Care (PIPC) are more important than ever. PIPC was created to raise awareness about the value of well-designed comparative clinical effectiveness research, the important role of continued medical innovation as part of the solution to cost and quality challenges in health care, and the need to ensure that comparative clinical effectiveness research is centered on patient and provider needs to improve healthcare decision-making.  In the year ahead, we’ll face new opportunities and challenges in advancing policies that support these goals
I am encouraged that change is happening - the concept of patient-centered comparative effectiveness research (CER) is slowly being embraced, and as a result we see the development of patient-centered dissemination strategies and a focus on the usefulness of research findings for patients and providers.  PIPC looks forward to continued engagement with entities like the Patient-Centered Outcomes Research Institute (PCORI) and the National Health Council (NHC) on how to ensure that CER is useful to patients and their providers to determine the best individualized treatment strategy for that patient, including considerations for their preferred outcomes and quality of life.  Additionally, it is imperative to also recognize that access to treatment options is imperative to fulfill the promise of patient-centered CER to improve the quality of health care. 

As more CER results emerge, the approaches we take to communicating and apply results will be increasingly important. We’ll see a growing volume of CER in the years ahead, not only from PCORI but from many private sector researchers as well. And not only from clinical trials, but from new infrastructure like the Clinical Data Research Network that PCORI is creating.

Patient-centered CER has the potential to improve health and increase the quality of health care decision-making.  To reach this potential, it is imperative that dissemination of CER findings clearly communicate its limitations, as well as clear information about the subpopulations to which it applies, or does not apply.  With information that supports personalized health care decisions, patients get the right care at the right time. Reliance on “cookbook” medicine that treats to the average patient does not allow for individualized patient care and flexible treatment strategies that meet the unique needs of each patient based on the available evidence. 

Finally, we’ll see the continued emergence of new health care payment and delivery models that will play a large role in shaping how CER results are applied, how patients are engaged in decision-making, and whether they gain access to the care they need. As these so-called “alternative payment models” take hold, it will be essential to ensure patients, working closely with providers, have a strong voice. To advance PIPC’s principles in these new care models, we will be working with a wide range of stakeholders in 2014 and beyond to promote payment models that include transparent decision-making; give patients access to medical options, and are structured to engage patients as active participants in their health care. Ensuring the appropriate use of patient-centered CER in those models is essential to providing high-quality patient-centered care. Without appropriate incentives, it is difficult to imagine how patient-centered CER could be effectively utilized by patients and their providers in an environment that does not recognize the promise of personalized medicine by providing access to treatment options. 

We all need good information to make good decisions about our health, and our health care. Comparative clinical effectiveness research can help us make good health care choices, as long as we have those choices to make.  Therefore, PIPC looks forward to the application of patient-centered principles both in the generation of research, and in the use of that research to ensure appropriate access to treatment options.  

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