Patient-Centered Outcomes Research Is Critical to Improved Care

By Eugene Washington, MD

PCORI’s mission statement, which was developed by the Board of Governors last year, reads: “The Patient-Centered Outcomes Research Institute (PCORI) helps people make informed health care decisions, and improves health care delivery and outcomes, by producing and promoting high integrity, evidence-based information that comes from research guided by patients, caregivers and the broader health care community.” As someone who has been involved with PCORI now for nearly 18 months, I have come to realize that our success is inextricably intertwined with the day-to-day mission that is undertaken at our academic health centers around the country.

Just looking at the various components of the PCORI mission statement, you realize that we are talking first and foremost about taking care of patients, which is certainly a raison d’être for academic health centers. Being in a position where we have evidence-based information, but also having information that we know is patient-centered in that it comes from the perspective of patients and their caregivers, can only enhance the quality and the effectiveness of the care that we provide.

When asked about PCORI’s mission and success being critical to academic medical centers, I tend to think of it more in terms of PCORI’s success being linked to the academic medical centers. I see it as a bilateral two-way exchange.

At the core of whatever research is going to be conducted, which we’re now calling PCOR — patient-centered outcomes research — is ultimately the care that we want to provide. Increasing attention is being placed nationally on “patient-centered care.” I think at the heart of both the research and the actual care is meaningful patient engagement.

To me, that means involving patients in all aspects of research — from question development to interpretation of data — and likewise in all aspects of care delivery. Care delivery in acute settings as well as the care that increasingly we’re providing away from our clinics and from our hospitals, as we move more toward population medicine with a focus on health promotion and disease prevention, depends on patient engagement.

It’s clear that as we think about achieving our mission in PCORI, we think about at least three critical ways that our collaboration and strong partnership with academic medical centers come into play. First, it’s very much about generating new knowledge and that’s what we do at academic medical centers: This new knowledge includes how we meaningfully engage patients, new methods that need to be applied for patient-centered research, and new approaches we need to use as we talk about the dissemination of results.

Second, as we think about infrastructure, we are concerned with who is going to develop the workforce needed and who is going to train the next generation, which certainly are core competencies of academic health centers. We educate the next generation of physicians, but also other health care providers, to work in their future environments.

As we think about infrastructure, we also think about building on what already exists. When we think about clinical research — epidemiologic research, methodological research — the bulk of it is taking place in academic medical centers. With the establishment of the clinical and translational science institutes around the country, we have a golden opportunity to build on a complementary national research endeavor. So again, we see that this partnership is instrumental to our success as we attempt to optimally use resources across the country and not just those that we have at PCORI.

Finally, coming back to where I started, we all want to improve not just the care that we provide, but also the health outcomes of patients, communities, and populations. We can more clearly define what’s important to patients and in turn, improve their decision making.  Ultimately, if patients’ outcomes and overall health improve, we will have succeeded through PCORI.

It’s my position that the success of PCORI is inextricably intertwined with academic medical centers. I would encourage you to continue to play an active role in the work of PCORI and spread the word to our other colleagues about the need for the entire academic medicine community to be involved in all activities of PCORI at every stage.

—Eugene Washington, MD, MSc, Chair, Patient-Centered Outcomes Research Institute (PCORI) Board of Governors, spoke on an open conference call sponsored by the AAMC on February 24 to discuss the first draft of PCORI’s draft National Priorities for Research and Research Agenda. Dr. Washington is the Vice Chancellor, UCLA Health Sciences and Dean, David Geffen School of Medicine at UCLA. His opening remarks focused on why medical schools and teaching hospitals have a critical interest in PCORI’s success, and why the success of PCORI is critical to the patients we serve. This post is a lightly edited transcript of his remarks.

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