Research Prioritization for Improving Healthcare Systems

On April 19-20, 2013, we convened the Advisory Panel on Improving Healthcare Systems for training and initial discussions about research prioritization. The panel reviewed 15 research topics against PCORI’s research criteria and selected five topics for further consideration:

• Models of patient-empowering care management—Compared with usual care, what is the effect of care management (designed to optimize care coordination and continuity) on patient-centered outcomes among patients with chronic or progressive conditions, disability, cancer or other potentially life-changing illnesses? (Based on Topic 2; Topic 3; Topic 4; Topic 5; and Topic 7)
• Models of transitional care—Compared to usual care, what are the effects of different models of transitional care on patient safety and other patient-centered outcomes? (Based on Topic 15)
• Models of integration of mental health care and primary care—Compared to primary care alone, what is the effect of primary care co-located with mental health services on mental health symptoms, medication use, and other patient centered outcomes? (Based on Topic 10)
• Models of perinatal care—Compared to usual care, what is the effect of care management (designed to optimize care coordination and continuity) on PCOs among pregnant and post-partum women? (Based on Topic 6)
• Different features of health insurance coverage—What are the relative effects of different insurance features (i.e. benefit designs, utilization management, cost sharing) on chronically ill patients’ access to care, quality of care, and PCOs? (Based on Topic 14)

The selection of topics was supported by a review of research prioritization briefs.

Below is a full list of these briefs. Download the full set of briefs.

Topic 1 “Accountable Care Organizations and PCOs” Compared to usual care, what are the effects of accountable care organization (ACO) care on patient-centered outcomes (PCOs) among patients with chronic conditions?

Topic 2 “Effects of Models for Chronic Disease Management” What are the relative effects of different models of chronic care on PCOs?

Topic 3 “COPD Management” Compared to usual care, what is the effect of care management (designed to optimize care coordination and continuity) on PCOs among patients with chronic obstructive pulmonary disease (COPD)?

Topic 4 “Cancer Management” Compared to usual care, what is the effect of care management (designed to optimize care coordination and continuity) on PCOs among patients with cancer?

Topic 5 “Palliative Care Management” Compared to usual care, what is the effect of care management (designed to optimize care coordination and continuity) on PCOs among patients requiring palliative care?

Topic 6 “Pregnancy Management” Compared to usual care, what is the effect of care management (designed to optimize care coordination and continuity) on PCOs among pregnant women?

Topic 7 “Care Management of Multiple Chronic Conditions" Compared to usual care, what is the effect of care management (designed to optimize care coordination and continuity) on PCOs among patients with multiple chronic conditions?

Topic 8 “Medical Homes” Compared to care management provided by insurance companies, what is the effect of care management provided by medical homes on PCOs among patients with multiple chronic conditions (MCCs)?

Topic 9 “Non-physician Medical Homes” Compared to usual care, what is the effect of care from a non-physician patient-centered medical home on care quality and PCOs?

Topic 10 “Mental Health and Primary Care Co-location” Compared to primary care alone, what is the effect of primary care co-located with mental health services on mental health symptoms, medication use, and other PCOs?

Topic 11 “Rural Trauma” Compared to direct transportation to a regional trauma center, what is the effect of stabilization at a local hospital (followed by transfer to a regional trauma center) on survival and other PCOs?

Topic 12 “Health IT and Treatment Guidelines” Compared to usual care, what is the effect of information technology (eg, EHRs, PHRs, and decision support) on providers’ compliance with guidelines and chronically ill patients’ adherence to treatment plans? Topic 13 “Quality Improvement Strategies” What are the relative effects of different quality improvement strategies on the quality of preventive services, acute care, chronic care, and rehabilitative services—and on PCOs—for adults and children?

Topic 14 “Effect of Insurance Features” What are the relative effects of different insurance features (eg, benefit designs, utilization management, cost sharing) on chronically ill patients’ access to care, quality of care, and PCOs?

Topic 15 “Transitions in Care and Patient Safety” Compared to usual care, what are the effects of different models of transitional care on patient safety and other patient-centered outcomes?