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The new year is often a time for self-reflection and learning—a brief moment of looking back before the revitalizing energy of spring returns to move us forward with renewed energy. And so it has been with PCORI.

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PCORI Leadership by PCORI Executive Director Nakela L. Cook, MD, MPH.
Nakela L. Cook, MD, MPH
Executive Director, PCORI

2021 was another year of adaptation for PCORI, as we continued to wrestle with the impact of the COVID-19 pandemic and the changes that it has brought to so many areas of our lives and work, including those of the patient and stakeholder communities we serve. It was also a year in which PCORI began a comprehensive strategic planning process, guided by extensive stakeholder input—one that will come to full fruition in 2022 and provide the north star that will illuminate our path for the next several years.

The foundation of the strategic plan is already firmly in place—the Board-adopted National Priorities for Health and a proposed Research Agenda that is currently being refined following a public comment period. These documents signal a new approach that will ensure that PCORI’s funding of comparative clinical effectiveness research (CER) is even more relevant to our nation’s critical health issues.

Building on this foundation, we are developing a detailed, iterative Research Project Agenda that will provide specific guidance for our funding decisions and will be regularly updated through a transparent, stakeholder-engaged process. The planning process also provides the opportunity to accelerate the infrastructure for patient-centered outcomes research and leverage the expertise of our Methodology Committee to advance PCORI’s new strategic direction, as well as to refine the strategic vision for future phases of PCORnet®, The National Patient-Centered Clinical Research Network. You can follow the progress of PCORI’s strategic plan and sign up for email updates on our website.

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PCORI Strategic Planning Timeline Graphic

At the highest level, PCORI's new strategic plan represents a focus on health outcomes and impact, as we continue to progress from the National Priorities for Research that guided our first phase. This focus on outcomes recognizes the broad research landscape and the larger context of patients’ lives that influence their health—including the impact of social determinants of health that are often significant drivers of healthcare and health outcomes. To make headway, PCORI will develop new partnerships, and strengthen existing ones, across multiple sectors for engaged research approaches and to facilitate the uptake of relevant research results. PCORI is positioned to make a unique contribution at the intersection of healthcare and health outcomes with real world issues, the complex realities of patients’ lives across all the places in which they “live, work, learn, and play.” We intend to embrace this role wholeheartedly.

Health Equity to the Fore

The change in language in PCORI’s National Priorities from “address health disparities” to “achieve health equity” is perhaps the boldest articulation of PCORI’s refined focus on health outcomes, and it also represents our renewed commitment to contribute to addressing the major challenges facing the nation. The COVID-19 pandemic has clearly brought a new surge of momentum to the longstanding imperative to address the health inequities that continue to plague the country. Achieving health equity is an aspirational goal that we cannot achieve alone. This work will require particular attention to the partnership-building already noted, as well as the development of new engagement models to guide PCORI’s funding of patient-centered CER and other engagement, dissemination and implementation, and research infrastructure initiatives.

In this quest to achieve health equity, more sophisticated use of data will help us clearly define the challenges we face and measure our progress in overcoming them. For PCORI, this begins with looking both inward and externally, to learn from our own and others’ experiences. This year we aim to substantially advance or complete three projects examining our processes and structures; one will focus on our research award applicants, one on PCORI study participants, and one on the factors that influence participation in research partnerships. The aim of all three projects will be to understand how we can best support the involvement of people who have lived experience with different circumstances and backgrounds, especially those who have historically been excluded from the research enterprise.

The change in language in PCORI's National Priorities from 'address health disparities' to 'achieve health equity' is perhaps the boldest articulation of PCORI’s refined focus on health outcomes, and it also represents our renewed commitment to addressing the major challenges facing the nation.

Another powerful tool is the four equity and inclusion guiding principles—Inclusion, Equitable Partnerships, Trust/Trustworthiness, and Accountability/Actionability—recently developed by PCORI’s Advisory Panel on Patient Engagement, following a rigorous review of the research practices and materials of a broad range of equity-minded PCORI stakeholders. The principles are designed to ensure that enhancing diversity, equity, and inclusion is an explicit goal of research partnerships from the start. We encourage research teams to embrace these foundational principles in their work.

Funding Priorities and Innovations

In 2022, PCORI will launch three cycles of ambitious funding announcements, to include innovations that reflect the changing research landscape and that will also streamline the submission process, enhance clarity about which funding opportunity is most appropriate for a given study, and assist applicants in their long-range research planning.

Among the most significant developments is PCORI’s new Broad Pragmatic Studies funding opportunity, which combines our previous Pragmatic Clinical Studies and Broad funding opportunities into one announcement with a ceiling of awards of $10 million, allowing for research projects of varied size and scope. We will also be continuing the Special Areas of Emphasis (SAE) program from 2021, which will cover two areas: (1) addressing systemic racism, discrimination, and bias in healthcare systems and care delivery, and (2) health system-level interventions to improve health care worker well-being and reduce burnout.

Targeted funding announcements this year will address the two topics that were included in our 2019 reauthorizing language—maternal morbidity and mortality and intellectual and developmental disabilities—as well as interventions for adolescent alcohol use and the prevention and treatment of delirium, among others.

We will also be piloting or continuing several innovations in our funding processes, including

  • A fast-track resubmission process that will allow submissions that meet eligibility criteria to be resubmitted through a streamlined process
  • The ability to request coverage of qualifying patient care costs, and
  • An application deferral program that was strongly supported by applicants whose personal and professional lives had often been disrupted by the COVID-19 pandemic.

Finally, a major new initiative from PCORI’s Dissemination and Implementation program is the Health Systems Implementation Initiative (HSII), for which notices of intent are due March 29 and final applications July 26, 2022. Through HSII, PCORI will fund participating healthcare delivery systems and provider-affiliated health plans to undertake implementation projects directly in their care delivery settings, with the goal of promoting the uptake of PCORI-funded evidence into practice. PCORI’s Board of Governors has committed five years of funding, up to $50 million, to this exciting new initiative.

Through all of these initiatives and innovations we aim to build on the successes, lessons, and stakeholder input of PCORI’s first phase, to accomplish our mission more effectively than ever, and to confidently embrace our growing role as a leader in patient engagement, in CER, in dissemination and implementation—and in the urgent national dialogues around health and health care.

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The Patient-Centered Outcomes Research Institute sends weekly emails about opportunities to apply for funding, newly funded research studies and engagement projects, results of our funded research, webinars, and other new information posted on our site.

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