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The PIPC Blog

PIPC Weekly Update - August 31, 2015

8/31/2015

 
In This Week’s Issue:
1. Health Care Payment Learning and Action Network (LAN) Updates, see details below.
2. Inside Health Policy: Patient Engagement: The New Frontier in Drug Development, click here to view the article (subscription only).
3. New York Times: Let Fear Guide Early Stage Breast­ Cancer Decisions, click here to view the op-ed.
4. The Health Care Blog: PCORI is Starting to Click. Give It a Chance, click here to view the article.
5. Reuters: New Tool Will Compare Costs and Benefits of Cancer Treatments, click hereto view the article.
6. Modern Healthcare: Closer Collaboration Among Researchers, Execs Needed, clickhere to view the article.
1. Health Care Payment Learning and Action Network (LAN) Updates
​

According to a recent update from the Health Care Payment Learning and Action Network (LAN), “We are pleased to launch the LAN collaboration portal on Handshake… the social networking tool developed by MITRE which we’ll use to facilitate LAN collaboration… Once your account is created, you’ll receive email notifications when new updates are posted. Within Handshake you may connect with other LAN participants and initiate discussions on alternative payment models.”

Further, MITRE has “also created an Alternative Payment Model (APM)Framework and Progress Tracking Affiliated Community page for anyone interested in providing input and feedback to this work group. You may join this group at your own convenience. Within the group page, you will be able to share discussions, view and comment on files, and stay informed of work group events. We will create affiliated communities for other work groups once the groups are established.”

Additionally, MITRE will be hosting an LAN webinar on September 9 from 3:00 – 4:00 pm entitled LAN Learnings in September: A Virtual ACO Model. “You will also learn how a large insurer, Blue Shield of California; a physician group, Hill Physicians Medical Group; and a hospital system,Dignity Health, are collaborating on a virtual Accountable Care Organization (ACO) model for approximately 41,000 employees who receive coverage through the California Public Employees' Retirement System (CalPERS). These organizations share information and coordinate care to improve quality, cost, and service. Disease management, pharmacy, improved communication, and palliative care all play a role in this model. Hear perspectives from Kristen Miranda, Senior Vice President, Strategic Partnerships and Innovation of Blue Shield of California, Rosaleen Derington, Chief Medical Services Officer of Hill Physicians Medical Group, and Cheri Galt, Director, Managed Care of Dignity Health.” Click here to register for the webinar.

2. Inside Health Policy: Patient Engagement: The New Frontier in Drug Development

In a special report last week, Inside Health Policy reported that “the influence of patient-generated data in the drug development process is becoming more apparent as health care stakeholders and even FDA begin to embrace the concept, yet the regulatory framework lags behind advances in data collection, according to sources, who also point to privacy rules, quality concerns surrounding observational data, and delays in health care data interoperability as impediments. Some stakeholders warn that any delay in solving the disconnect between the actual use of observational data in clinical trials and the current policy framework could set advancements in the field back considerably. Others are more optimistic about navigating the regulatory barriers, but see quality concerns as the key hurdle to FDA fully incorporating such data in the approval process. As the agency and lawmakers grapple with how to integrate the glut of patient information being generated, organizations, including the pharmaceutical and technology industries, public-private partnerships and health systems, are pushing ahead full-steam.”

“A culture shift towards greater user-centered design has occurred and now, according to sources, the challenge is how to actually use the abundance of patient information to inform the drug development process in a way that upholds the clinical gold standard of safety and efficacy… In fact, as some health systems pursue their own routes to better incorporate new technology that holds the promise for even greater personalized treatment, the current regulatory framework precludes them from sharing the information gathered in a way that could greatly improve the drug development process, sources say.”

“…Attempts to update regulatory policy to adjust to the influx of aggregated data has not come without its challenges. In an opinion piece in the New England Journal of Medicine, Harvard professors Jerry Avorn and Aaron Kesselheim criticized the House 21st Century Cures legislation for a provision that would direct the FDA to explore the potential use of clinical experience evidence, such as observational studies and registries, for approvals of new indications of approved drugs, as well as to satisfy post-approval study requirements… Given the relatively new push towards patient-generated data outside of randomized controlled trials, sources believe as further advancements are made into this space some of the problems the authors bring up will be solved by time and experience.”  Click here to view the article (subscription only).

3. New York Times: Let Fear Guide Early Stage Breast Cancer Decisions

A recent op-ed in the New York Times highlights important issues around patient-centeredness and shared decision-making. “Two patients, I’ll call them Sara and Janine, both learned that they had ductal carcinoma in situ (D.C.I.S.), often referred to as Stage 0 breast cancer. Both underwent lumpectomies in their early 50s. Told that worrisome cells were found, both had another surgery. Then a third surgery was recommended. Sara decided she would rather live with the risk. Janine had the opposite response. ‘Let’s get this all out,’ she said. Each is certain she made the best decision, but can both of them be right?... The medical community has a role not only in alleviating unwarranted fears, but also in identifying rational ones. Both are essential to making good decisions in the face of uncertain trade-offs.” Click here to view the op-ed.

4. The Health Care Blog: PCORI is Starting to Click. Give It a Chance.

In a recent article for The Health Care Blog, Steve Findlay comments “PCORI has taken seriously its' mandate to involve consumers/patients in research. Patient advocates are involved from the beginning in the screening of research topics, and even in the choice of which grant applications get funded. This is a novel approach and even docs and research experts agree it's a positive development...PCORI does have the potential to accelerate the diffusion of research results and innovations. Uniquely, it's asking tough questions about why it takes so long for doctors to change their behavior and practices when research clearly indicates a change is needed.” Click here to view the article.

5. Reuters: New Tool Will Compare Costs and Benefits of Cancer Treatments

According to a recent report in Reuters, “the National Comprehensive Cancer Network (NCCN) says its new tool will provide a clearer picture of the relative value of medication options, particularly in cases where a very expensive therapy does little to improve survival... Other medical groups are also trying to address the cost issue, but not as directly as the NCCN. The American Society of Clinical Oncology (ASCO) is developing its own tool for valuing treatments, but says that its ‘net health benefit’ scores will not consider costs, although prices will be noted alongside the scores.” Click here to view the article.

6. Modern Healthcare: Closer Collaboration Among Researchers, Execs Needed

As Dr. Eric Larson and Karin Johnson reported in Modern Healthcare last week, “agencies such as the Patient-Centered Outcomes Research Institute (PCORI) and the National Institutes of Health are funding a growing number of projects designed to more rapidly improve health services, patient outcomes and consumer experiences...The benefits of these partnerships are clear...Data infrastructure development supported by PCORI's National Patient-Centered Clinical Research Network (PCORnet), recently expanded with a $142.5 million infusion, promises a return on investments in health information technology.” Click here to view the article. 

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