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Dynamic Chiropractic – August 26, 2012, Vol. 30, Issue 18
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Dynamic Chiropractic

Informed Health Care: Knowledge Is Power

$30 million in federal research funding is initial step in helping patients, practitioners make more informed decisions.

By Editorial Staff

Health care practitioners have a unique vested interest in the immediate and long-term future of health care; after all, your priority is both your patients' health and your own.

Out-of-control health care costs, overreliance on pharmaceuticals and horror stories of medical mismanagement have spurred rapid migration toward increased collaboration, integration, shared decision-making and evidence-based care. The focus is finally on the patient and determining what best ensures their health and wellness – the way DCs have been doing it for years, and the way the health care system should have worked all along.

Enter the Patient-Centered Outcomes Research Institute, whose mission, in the words of Christine Goertz, DC, PhD, vice chancellor for research and health policy at Palmer College of Chiropractic – and the sole chiropractic representative on the PCORI's 21-member Board of Governors – "is to help people make informed health care decisions, and improve 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." In this exclusive interview with DC, Dr. Goertz discusses the PCORI, its landmark Pilot Projects Program; the first 50 research funding awards (totalling $30 million) recently announced by the institute; and how the program will help patients and practitioners make more informed health care decisions.

Informed Health Care - Copyright – Stock Photo / Register Mark Dr. Goertz, describe the prevailing environment in health care that led to the establishment of the PCORI. What is its overriding mission / goal? Patients today have more options than ever before when it comes to making important decisions about their health and the care they receive. Unfortunately, they along with their caregivers, often do not have the information they need to make choices that reflect their unique situation, priorities or personal preferences.

The Patient-Centered Outcomes Research Institute (PCORI) was authorized by Congress to conduct research to provide information about the best available evidence to help patients and their health care providers make more informed decisions. PCORI's research is intended to give patients a better understanding of the prevention, treatment and care options available, and the science that supports those options.

PCORI is governed by a 21-member board, appointed by the Government Accountability Office, that represents a broad spectrum of stakeholders within the health care community – patients, caregivers, doctors, nurses, researchers, public health officials, payers and industry. By law, PCORI's Board is required to include at least one state-licensed integrative health care practitioner. This is the "slot" that I fill.

What was your involvement in the Pilot Projects Program? Briefly describe the program's evolution from inception to present, and your role. There are still many gaps in our understanding of areas where patient-centered outcomes research (PCOR) is most needed, and how to engage patients in the process of identifying those needs, conducting the research and disseminating the results.

The PCORI Pilot Projects Program will support the collection of preliminary data that can be used to advance the field of patient-centered outcomes research, providing input into PCORI's evolving research agenda. Pilot projects will also support the identification of methodologies that can be used to advance patient-centered outcomes research as well as identify gaps where methodological research needs further development.

Along with staff and fellow board member Gail Hunt, I led the effort to create the pilot project program – from developing the first funding announcement, to conducting informational Webinars for potential applicants, to working with NIH to establish the PCORI pilot project peer-review process, to advising the selection committee, which was chaired by fellow board member Grayson Norquist, MD, MSPH, on how best to present a slate of recommended projects to the board for approval.

We look forward to using the research results to enhance our National Priorities for Research and Research Agenda, accelerate the field of patient-centered outcomes research, and develop new methodologies for engaging patients.

Ideally, what will these first 50 research funding awards accomplish in terms of improving health care delivery? The health care delivery system suffers from a lack of information about how we can effectively communicate and engage with patients and caregivers. The Pilot Projects Program is aimed advancing patient-centered outcomes research as well as identifying gaps where methodological research needs further development.

For example, one of the pilot projects we selected will study how creating a "zone of openness" might increase patient-centered care. This project has the potential to provide practicing clinicians with the tools to needed to help improve patient-centered communication and empower patients to ask and encourage health care providers to answer patient-focused questions.

As the lone DC member of the PCORI, how do you feel your participation benefits the chiropractic profession and its advancement within the overall health care system (as opposed to not having a chiropractic member)? One of the PCORI's top priorities is to ensure that all stakeholders in the community have a voice in our work. This is central to conducting research that will be scientifically rigorous and widely accepted. I am pleased to have the opportunity to bring the integrative health care perspective to the PCORI conversation. PCORI is very open to the inclusion of a broad range of stakeholders in the research process and to funding research that covers a broad range of topics that fall within our research agenda and priorities. Integrative health care, including chiropractic, is known for being especially patient centered. I think my presence on the board serves as a reminder that we all have an important role within the PCORI enterprise.

It's an honor to serve on the board and represent my unique view. Despite the different perspectives each board member brings to the table, there is an energizing sense of cohesion among the board members and a focus on what's best for patients and the health care system.  It is exciting to be part of this dynamic, intelligent, group of people who are all committed to putting the patient at the center of the health care experience through research and information dissemination.

What else can you tell us about the future of the PCORI and the Pilot Projects Program? What's next? This is a time of incredible excitement and progress for PCORI. The 50 Pilot Projects, totaling $30 million, have been awarded to research institutions in 24 states and Washington, D.C. The application deadline for our first round of primary funding announcements was July 31, with announcement of the selected applications at the end of the year. And our highly anticipated Methodology Committee Report, which will establish standards for patient-centered outcomes research, will be open to public comment until Sept. 14.

We hope everyone will become engaged in our work. Anyone interested in finding out more about PCORI should visit us at www.pcori.org and subscribe to our mailing list.

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