Moving On: From PCORI to the State House
About Us
- About PCORI
- The PCORI Strategic Plan
- Governance
- Evaluating Our Work
- PCORI's Advisory Panels
- Procurement Opportunities
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Provide Input
- Draft Key Questions: Systematic Review of the Impact of Doula Support During Pregnancy, Childbirth and Beyond (2024)
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Past Opportunities to Provide Input
- Patient-Centered Economic Outcomes Landscape (2023-2024)
- Systematic Review of Audio Care for the Management of Mental Health and Chronic Conditions (2023) -- Draft Key Questions
- Proposed New Methodology Standards for Usual Care as a Comparator (2023)
- Stakeholder Views on Components of 'Patient-Centered Value' in Health and Health Care (2023)
- PCORI's Proposed Research Agenda (2021-2022)
- Proposed National Priorities for Health (2021)
- Proposed Principles for the Consideration of the Full Range of Outcomes Data in PCORI-Funded Research (2020)
- Proposed New PCORI Methodology Standards (2018)
- Data Access and Data Sharing Policy: Public Comment (2017)
- Proposed New PCORI Methodology Standards (2017)
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Comment on the Proposed New and Revised PCORI Methodology Standards (2016)
- 1. Standards for Formulating Research Questions
- 10: Standards for Studies of Diagnostic Tests
- 12. Standards on Research Designs Using Clusters
- 13: General Comments on the Proposed Revisions to the PCORI Methodology Standards
- 2: Standards Associated with Patient-Centeredness
- 3: Standards for Data Integrity and Rigorous Analysis
- 4: Standards for Preventing and Handling Missing Data
- 5: Standards for Heterogeneity of Treatment Effects
- 6: Standards for Data Registries
- 7: Standards for Data Networks as Research-Facilitating Structures
- 8. Standards for Causal Inference Methods
- 9. Standards for Adaptive Trial Designs
- Peer-Review Process Comments (2014)
- Draft Methodology Report Public Comment Period (2012)
- Leadership
I arrived at PCORI in August 2012, ready to join a growing organization. I was employee number 23 and not quite sure what I’d signed on to. What I knew was that I wanted to help PCORI succeed in achieving its mission of making healthcare research more patient-centered. On day 1, I may not have had a computer or phone line, but my heart was all in. As a family physician, health services researcher, and fanatic about involving the community in research, I was ready to work with patients and stakeholders to create a new body of patient-centered outcomes research that would make a difference in patients’ lives.
I am now preparing to leave PCORI and head to my home state of Delaware to serve as the nominee for Secretary of Health and Social Services. In this role, I will be charged with keeping Delawareans healthy, ensuring they get the health care they need, and providing children, families, and seniors with the essential services they depend on. It is the largest department in Delaware's government, with an annual budget close to $2 billion and nearly 4,500 employees. I intend to bring PCORI’s focus on patient centeredness and stakeholder engagement to my new duties.
In my early days at PCORI, I helped recruit like-minded, passionate staff members. I also worked with research leaders who wanted to be among the first to receive research funds, and I established PCORI’s early policies and procedures for topic prioritization. I recall fondly our first all-staff retreat, held to establish our strategic plan. We all spoke up and by the end of the day, we had created the framework for our first key strategies for research. Around the same time, we worked out a plan to determine how to set priorities for research.
I have continued to see uninsured patients weekly as a volunteer in a clinic, where I am reminded that patients and clinicians need better evidence to make decisions.
An early assignment from Joe V. Selby, MD, MPH, PCORI’s Executive Director, was to figure out where gaps in evidence existed, so we could select topics for our first set of targeted funding announcements, which came out in June 2013. I had to present the Board of Governors with a plan for making those decisions.
We developed an initial prioritization process and a ranking method, and we evaluated existing evidence on dozens of topics. I remember late-night sessions of working with other staff to read articles, put together topic briefs, and plan for meetings that would include patients, caregivers, clinicians, and other healthcare stakeholders. We did it all: finding articles and writing documents, as well as running the copier, stuffing packets, and making everything look presentable.
That early work formed tight bonds; the staff felt like family. Many of those people continue to step up, do whatever is necessary, and train others in PCORI’s culture of excellence and service.
Over the past four years, I have served PCORI as a Scientist, a Program Officer, and Deputy Chief Science Officer, as well as a member of many cross-functional work groups. I have written policies, procedures, and funding announcement after funding announcement. Most recently, I’ve had opportunities to represent PCORI externally.
My experiences at PCORI have taught me the tools of professionalism, diplomacy, humility, and commitment needed to change systems and push agendas. I have also learned the importance of teamwork and joint solutions with colleagues, stakeholders, and patients.
I have continued to see uninsured patients weekly as a volunteer in a clinic, where I am reminded that patients and clinicians need better evidence to make decisions. This experience reminds me of the importance of exemplary patient-clinician communication and continuity of care, especially for patients who are struggling to adjust to their new home in the United States. My clinical work has pushed me to become a stronger advocate for all patients, but particularly immigrant, disenfranchised, or underprivileged individuals and families.
Because I have been afforded many excellent opportunities, I believe I have a particular responsibility to use my talents to better the health of the public, particularly those who are less able to advocate for themselves. I feel strong camaraderie with healthcare leaders, past, present, and future, who aim to improve clinical practice to better serve others. Through challenging the current healthcare system, funding patient-centered outcomes research, and committing to communities of need, I anticipate ongoing opportunities to improve people’s health. In my new role, I will continue to seek opportunities to improve patient-centered care, with a focus on better outcomes for all Delawareans.
I joined PCORI with the hope that my work would improve the health of individual patients and underserved populations, as well as influence the health policy of our nation. I am now certain that PCORI has done, and will continue to do, just that. We are starting to see findings from studies we funded that are changing the national dialogue about health research, and there will be even more exciting news and findings to come over the next three to six years.
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Comments
April 6, 2017, 11:14 PM
Comment by Linda Heller,
February 9, 2017, 1:36 PM
Comment by PCORI,
Mark, thank you for your comment. You may contact Kara Walker through the Delaware Health and Social Services website: http://dhss.delaware.gov
February 8, 2017, 11:16 AM
Comment by Mark Borer, MD,
Dear Dr. Walker, Congratulations on your appointment.
I am a child and adolescent and general psychiatrist who practices privately and also consults to a number of public and private agencies in the network of care for our youth. I am involved in several Integrated Care initiatives. I am on the Executive Committee of the AACAP, represent our Delaware Council in the Assembly, am delegate to the Patient Centered Primary Care Collaborative (PCPCC), and am active in creating access for patients in primary care to have access to a full team of mental health professionals, care managers, and the wider network of care. I consult with the Division of Prevention and Behavioral Health, several school districts, and other agencies caring for youth. I have toolkits and resource centers to help with our move toward value based care.
I would be happy to speak further with you and may be contacted at the email above.
Best wishes, Mark
January 25, 2017, 8:45 PM
Comment by PCORI,
Dear Mike, thank you for your comment.
January 25, 2017, 6:16 PM
Comment by Mike Carney,
Keep up the good work! Dr. Walker,
Let's make Delaware first again.
All the best,
Mike
January 19, 2017, 1:53 PM
Comment by PCORI,
Dear Edward and Emmanuel, thank you both very much for your kind comments and feedback.
January 18, 2017, 6:02 PM
Comment by Edward Sekscenski,
Hello! I'm a retired CMS researcher living in Ocean View. I look forward to following your health initiatives in Delaware, especially in Sussex County.
January 16, 2017, 4:57 AM
Comment by Emmanuel Ayers, MD,
Excellent work Kara! Congratulations on your new opportunity! The state of Delaware will be well served by your talents, gifts, passion and commitment.
Dr.Walker-
Welcome Back to Delaware! We look forward to working with you and learning from you! Delaware is a state that could be a leader in creating model patient-centered, evidence-based programs. DHSS has many gifted and skilled people that can help DHSS divisions,programs and services be more efficient, collaborative and efficient to serve Delawareans. We wish you every success & hope you enjoy eating more crabcakes! :)