evidence and the next stage of health care reform why consumer engagement is so important
Download
Skip this Video
Download Presentation
Evidence and the next stage of health care reform: Why consumer engagement is so important

Loading in 2 Seconds...

play fullscreen
1 / 12

Evidence and the next stage of health care reform: Why consumer engagement is so important - PowerPoint PPT Presentation


  • 160 Views
  • Uploaded on

Evidence and the next stage of health care reform: Why consumer engagement is so important. Steven D. Pearson, MD, MSc President, Institute for Clinical and Economic Review. What do we mean by “evidence?”. “Evidence” can have a bad aura among consumers and consumer advocates

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Evidence and the next stage of health care reform: Why consumer engagement is so important' - manjit


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
evidence and the next stage of health care reform why consumer engagement is so important

Evidence and the next stageof health care reform:Why consumer engagement is so important

Steven D. Pearson, MD, MScPresident, Institute for Clinical and Economic Review

1

what do we mean by evidence
What do we mean by “evidence?”
  • “Evidence” can have a bad aura among consumers and consumer advocates
    • Population-based instead of about the individual
    • Applied by insurers in ways that restrict access to tests and treatments desired by patients
  • Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.
    • Sackett, 1996

2

why better evidence became part of health care reform
Why better evidence became part of health care reform
  • Much of what doctors do is not based on good evidence
    • Does FDA approval mean there is good evidence?
    • Lack of good evidence commonly leads to inappropriate and often unnecessary treatment
      • Autologous bone marrow transplant for metastatic breast cancer
      • Generic drugs for rheumatoid arthritis found to be as good as more expensive and risky new drugs
      • “Tens of thousands of women each year might be able to skip at least some of the grueling treatments for breast cancer — which can include surgery, heavy chemo and radiation — without greatly harming their odds of survival.”
      • Choosing Wisely – will be discussed by Dr. Santa

3

evidence based medicine and health care reform
Evidence-based medicine and health care reform
  • Comparative effectiveness research (CER)
    • Research comparing alternative care options to determine what works best for whom, under real-world conditions
      • Systematic review of existing published evidence
      • Generation of new evidence through clinical trials but also clinical registries and existing database analyses
  • Patient-centered outcomes research (PCOR)
    • PCORI
  • Health care reform did not focus on the evidence comparing doctors and hospitals

4

why consumer engagement can be so powerful
Why consumer engagement can be so powerful
  • Helping to identify research topics
    • PCORI
    • Things over which patients have control, e.g. diet, exercise
  • Helping to identify outcomes that are more patient-centered
    • Medications for pediatric seizures
  • Helping to interpret and guide the application of results
    • Examples from CEPAC and CTAF

5

cepac and ctaf
CEPAC and CTAF
  • Collaboration among
    • Patient groups
      • Connecticut Center for Patient Safety
      • Maine Quality Counts
      • Center for Healthcare Decisions
      • Patient Advocates in Research
    • State Medicaid programs
    • Private plans
    • Large physician-hospital groups
  • Independent Council meets in public to discuss tailored evidence reviews on effectiveness and cost, to vote on evidence, and to make recommendations for best practice and policy
  • All stakeholders work together afterward to implement the findings

7

new england cepac topics and impact
New England CEPAC: Topics and Impact
  • Treatments for Attention-Deficit Hyperactivity Disorder (ADHD)
    • Helped interpret evidence and disseminate to patient networks in order to shift to behavioral therapy for youngest children
  • Treatment for severe depression
    • Perspectives on severity of condition and impact on families part of deliberation that led to first-in-nation coverage for new magnetic treatment
  • Supplemental screening options for women with dense breast tissue

8

supplemental screening for women with dense breast tissue
Supplemental screening for women with dense breast tissue
  • Consumer engagement critical in
    • Perspective on importance of the concern for masking as opposed to breast cancer risk
    • Judgments of the relative balance of benefits of identifying additional cancers and the harms of false positive results, biopsies, and anxiety
    • Determination of the information patients want and how to present it to women (see handout)
    • Dissemination of the report and materials to patient groups throughout California, New England, and nationally

10

conclusion
Conclusion
  • Evidence, its generation, interpretation, and application to improve patient outcomes and the patient experience, is an important component of the next phase of health care reform.
  • Consumers have a critical role to play in advancing the best aspects of evidence-based medicine in the interests of patients now and in the future.
  • There is a shift occurring among clinicians and researchers that offers a new opportunity for engagement. Seize it!

11

ad