Stakeholder Engagement and Transparency in The Effective Health Care Program (Text Version)
On September 28, 2010, Supriya Janakiraman made this presentation at the 2010 Annual Conference. Select to access the PowerPoint® presentation (2.5 MB).
Stakeholder Engagement and Transparency in The Effective Health Care Program
Supriya Janakiraman MD MPH
- Overview of the Effective Health Care Program
- Stakeholder engagement—examples of current activities and looking to the future
- Opportunities for involvement
Effective Health Care Program
- Comparative Effectiveness Research.
- Authorized under Sec. 1013 of MMA.
- To improve the quality, effectiveness, and efficiency of health care delivered through Medicare, Medicaid, and S-CHIP programs:
- Focus is on clinical effectiveness and comparative effectiveness.
Comparative effectiveness research is the conduct and synthesis of research comparing the benefits and harms of different interventions and strategies to prevent, diagnose, treat and monitor health conditions in "real world" settings. The purpose of this research is to improve health outcomes by developing and disseminating evidence-based information to patients, clinicians, and other decision-makers, responding to their expressed needs, about which interventions are most effective for which patients under specific circumstances.
Recovery Act Spend Plan, Office of the Secretary, 11/09.
Research Focus: Priority Conditions
- Arthritis and non-traumatic joint disorders.
- Cardiovascular disease, including stroke and hypertension.
- Dementia, including Alzheimer's Disease.
- Depression and other mental health disorders.
- Developmental delays, ADHD and autism.
- Diabetes mellitus.
- Functional limitations and disability.
- Infectious disease including HIV/AIDS.
- Peptic ulcer disease and dyspepsia.
- Pregnancy including preterm birth.
- Pulmonary disease/asthma.
- Substance abuse
Effective Health Care Program
A. Evidence synthesis (EPC program):
- Systematically reviewing, synthesizing, comparing existing evidence on treatment effectiveness.
- Identifying relevant knowledge gaps.
B. Evidence generation (DEcIDE, CERTs, Research Grant Awards):
- Development of new scientific knowledge to address knowledge gaps.
- Accelerate practical studies.
C. Evidence communication/translation (Eisenberg Center):
- Translate evidence into improvements.
- Communication of scientific information in plain language to policymakers, patients, and providers.
Images: Three images depict the covers of various Effective Health Care Program Research Products including research reports, systematic reviews, and consumer guides.
Stakeholder input & involvement.
Image: This figure depicting the conceptual framework outlines the core activities of the Effective Health Care Program which include evidence synthesis, evidence generation, horizon scanning, and translation. All of these activities are informed by stakeholder involvement.
- Stakeholders— Persons or groups who have a vested interest in a clinical, research or health policy decision.
- Public— Members of the general public identified without regard to medical background or experience.
Stakeholder Engagement in Evidence Synthesis
Image: This figure depicts opportunities for public involvement in the research process. For example, for research reviews, Key opportunities for involvement include:
- Nomination of research topics.
- Assisting with development of Key Research Questions, or a Research Abstract for new research.
- Suggesting members for the Technical Expert Group.
- Development of Key Research Questions, or a Research Abstract for new research.
- Suggesting peer reviewers, and providing public comment on Draft Reports.
- Providing feedback on draft Summary Guides.
- Participating in dissemination of products to health care decision-makers.
Stakeholder Engagement in Evidence Generation
- Oncology, CV, & Diabetes
Image: This figure depicts its organizational structure Diabetes Multi-Center Research Consortium (DMCRC). The Executive Committee includes AHRQ, Coordinating and Affiliate Center. The DMCRC consists of a Data Committee, and Methods Committee, and Clinical Committee, and a Stakeholder Committee; these are all coordinated by the Administrative Committee Project Manager.
Notes: The DEcIDE Network more recently has also created several consortia to meet the needs of significant priority conditions affecting large populations such as cancer, diabetes, and cardiovascular disease. One of these is the Diabetes Multi-Center Research Consortium (DMCRC), which was formed in 2008 and this figure depicts its organizational structure—which includes various committees, here I would like to highlight the consortia includes a stakeholder committee whose input informs research conducted under the consortia. This pattern of developing a stakeholder informed research agenda is an important component of the Effective Health Care Program.
Eisenberg Clinical Decisions and Communication Science Center
Scientific Evidence → Translation → Understandable and Usable Information
Facilitate Informed Health Care Decisions by:
Image: Flowchart depicts steps in the research translation process from the scientific evidence to summary guides that provide understandable and usable information.
Twenty member volunteer committee representing clinicians, consumers, government, payers, and industry
- Provides perspective on research gaps and methodology.
- Provides user perspective on EHC Program accountability and transparency.
- Identifies products most useful to decision-makers.
- Identifies opportunities for increased stakeholder involvement.
- ARRA-funded initiative to expand and systematize public and stakeholder engagement in AHRQ's Effective Healthcare (EHC) Program.
- Will develop and demonstrate deliberative methods and tools for obtaining informed public opinion as an input to decisions related to the conduct of comparative effectiveness research (CER), as well as the application of research results in policy and practice.
- Will improve methods and opportunities for stakeholder engagement, working with the EHC program components to expand stakeholder involvement in research processes and activities.
- Will support the EHC Stakeholder Group, including facilitating Stakeholder Group meetings, and managing logistical requirements.
- Disposition documents for topic nominations and selection criteria.
- Protocols posted.
- Key Questions posted.
- Draft Reports are posted.
- The Effective Health Care Program topic nomination Web site.
- A sample of a topic nomination summary document.
- A Web site screen shot of the Draft Key Questions are posted on the Effective Health Care Web site posted for public comment.
Opportunities for involvement in the EHC Program
- Nominate priorities and topics for research.
- Comment on key research questions and outcomes important to patients.
- Review draft documents.
Image: The figure depicts a screen shot of the Effective Health Care Program Website and highlights where one can nominate topics for research to be conducted by the Effective Health Care Program and comment on draft documents.
Effective Health Care Program