Dashboard Review End of FY-2016 Joe Selby, MD, MPH Executive - PowerPoint PPT Presentation

Dashboard Review End of FY-2016 Joe Selby, MD, MPH Executive Director Michele Orza, ScD Senior Advisor to the Executive Director 1

Discussion Questions for Q4-16: • Do our FY-2016 Dashboard and associated background materials cover the topics that are most important for the Board to review? • Do you have questions or comments about our progress or performance on any of our Dashboard indicators? Does the in-depth focus this quarter on our cumulative results as of the end • of the fiscal year and year-to-year trends tell you what you need to know about where we are now and how we got here? • What changes would you like to see in our FY-2017 Dashboard? 2

On Target Projected/Target Q1 2016 Board of Governors Dashboard Off Target Q2 2016 Fourth Quarter FY-2016 (As of 9/30/2016) Needs Attention Q3 2016 Our Goals: Increase Information, Speed Implementation, and Influence Research Q4 2016 Expenditures – Total Budget, Up to $424M Funds Committed to Research, Up to $554M % of Research Projects on Track Inputs 100 Q1 Q2 Q3 Q4 Research Awards Budgeted Budget 80 Percent Research 60 Awards Actual Estimated 40 All Other Budget 20 Process Actual Q2 Q3 Q4 All Other Actual 0 0 100 200 300 400 500 600 0 50 100 150 200 250 300 350 % of Research Projects % Meeting All $ Millions in Green Zone Recruitment Milestones $ Millions (Q2: N=364) (Q2: N=104) Draft Final Research Reports Submitted Journal Articles PCORnet Phase II Research Projects Underway in PCORnet 25 Due Submitted Q1 Q2 Q3 Q4 60 Draft Final Research Outputs 2016 Target: 22 Target 50 20 40 Actual Reports 15 0 5 10 15 20 30 10 20 Networks Engaged in Research Projects 10 5 Target 2016 Target: 33 0 Actual 0 Journal Articles Journal Articles About or Uptake Q1-16 Q2-16 Q3-16 Q4-16 0 10 20 30 Published By Awardees By PCORI Results: Increasing Information Results of Engagement in Research Methodology Standards Uptake • For post-discharge treatment of complicated A Pipeline to Proposal project that developed 100 20 appendicitis in children, oral antibiotics are capacity for patient-engaged CER for diabetes associated with lower rates of treatment health among Latinos from low-income 75 15 Use failure and hospital revisits when compared households was funded for a PCORI Research with intravenous antibiotics Award to compare diabetes self-care programs 50 10 For post-discharge treatment of • Results: Influence 25 5 complicated pneumonia in children, oral The Center for Medicare and Medicaid Services antibiotics are associated with lower rates (CMS) Quality Measure Development Plan 0 0 of complications when compared with Methodology CME/CE Methodology Standards recognizes PCORI’s patient/caregiver engagement intravenous antibiotics Citations Certificates Impact framework as a best practice 3

Results of PCORI Research: Oral Antibiotics Safer than Intravenous for Post-Discharge Treatment of Complicated Pneumonia & Appendicitis in Children This three-part retrospective cross-sectional cohort study assessed the comparative effectiveness of oral vs. intravenous antibiotics for post-discharge treatment of acute osteomyelitis, complicated appendicitis, and complicated pneumonia in children. Across conditions, use of intravenous antibiotics is associated with higher of rates all-cause hospital revisits than oral antibiotics. Primary Outcome Secondary Outcomes Condition Publication Treatment Failure Complications All Hospital Re-visits (matched odds ratio, 95% CI) (matched odds ratio, 95% CI) (matched odds ratio, 95% CI) Adverse drug reactions Higher re-visit rate JAMA Pediatrics Acute No significant Slightly higher in PICC group in PICC group Osteomyelitis Feb 2015 difference OR 1.83 (1.03, 3.25) OR 3.61 (2.64, 4.93) Higher failure rate Related hospital re-visits Higher re-visit rate Annals of Surgery Complicated in PICC group Higher in PICC group in PICC group Appendicitis Jul 2016 OR 1.74 (1.05, 2.88) OR 2.11 (1.44, 3.11) OR 2.21 (1.33, 3.70) Adverse drug reactions Higher re-visit rate Pediatrics Complicated No significant Higher in PICC group in PICC group Pneumonia difference Nov 2016 OR 19.1 (4.2, 87.3) OR 4.71 (2.97, 7.46) ” • Awarded 2012, Assessment of Prevention, Diagnosis, and Treatment Options project A key reason that doctors may often recommend • Principal Investigator: Ron Keren, MD, MPH, the IV approach is lack of evidence about the The Children’s Hospital of Philadelphia effectiveness of oral antibiotics as an alternative. Ron Keren, Principal Investigator 4

Influence Example: CMS Recognizes PCORI’s Patient/Caregiver Engagement Framework as a Best Practice Partnering With Patients in the Measure Development Process The Center for Medicare and Medicaid Services (CMS) Quality Measure Development Plan outlines key considerations and strategic approaches for supporting the transition to the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). CMS names PCORI’s patient/caregiver engagement framework as a best practice. ” Strategic Approach – CMS evaluates best practices related to patient/caregiver involvement in the measure development process and disseminates this information through a variety of channels, such as measure developer forums and updates to the MMS Blueprint. Recent best practices identified for partnering with patients and caregivers include: • Adopting principles from the Patient Centered Outcomes Research Institute (PCORI) person-family engagement framework. • Conducting outreach through patient organizations, other entities that focus on engaging patients (e.g., PatientsLikeMe, Patient-Centered Outcomes Research Institute), and condition-specific organizations (e.g., Arthritis Foundation, Cancer Support Center)… CMS Quality Measure Development Plan, Page 54, May 2016 (link) 5

Results of Engagement in PCORI Research: First Pipeline to Proposal (P2P) project approved for PCORI Research Award PCORI Research Project (2016): Pipeline to Proposal Project A Patient-Centered Framework to Test the (2013-2016) Comparative Effectiveness of Culturally and Culturally Appropriate Options for Diabetes Contextually Appropriate Program Options Prevention and Care for Low-Income Latinos for Latinos with Diabetes from Low-Income  Project Lead: Lidia Regino, BS, East Central Households Ministries/One Hope Centro de Vida Health  Awarded 2016, Assessment of Prevention, Center Diagnosis, and Treatment Options project  PI: Janet Page-Reeves, MA, PhD, University of New Mexico Health Sciences Center This P2P Project sought to develop capacity for  Aims to identify effective approaches in patient-engaged CER related to diabetes health for Latinos from low-income households. ensuring the integration of contextual and cultural competency in self-care programs ” • Build capacity of patient partners to better understand research process • Update and revise outreach plan and conduct Our Patient Advisors told us that gathering targeted outreach to external stakeholders data from individuals alone misses important • Generate list of CER research questions social aspects of Latino patients’ lives, so we will recruit patients and ask them to invite someone close to them to participate too. -From the funded study application 6

We are making progress on our Strategic Priority to “ Increase the proportion of research funding going to focused and targeted topics” Funds Committed by Type of PFA Cumulative Total by Fiscal Year Broad End of FY 2016 End of FY 2013 End of FY 2014 End of FY 2015 Total=$1.25B Total=$920M Pragmatic Total=$294M Total=$548M Targeted $186 $321 $50 $108 $24 $669 4 $179 $555 $440 $258 7

Engagement Awards Number of Projects Awarded, Total $ Awarded 200 20 18 175 $17.2 16 66 150 Pipeline to Proposal 27 14 $13.8 Advanced to higher tier Millions ($) Awarded Number of Awards 125 Tier 2: $25,000; Tier 3: $50,000 12 47 100 10 Pipeline to Proposal New projects 8 46 75 Tier I: $15,000 36 6 EAIN Meeting Support 50 25 Average: $136,000 4 $3.6 30 25 4 Eugene Washington 45 2 $0.8 30 Engagement Awards 15 2 Average: $237,000 0 0 2013 2014 2015 2016 8

Coming Soon: FY-2017 Dashboard Focus on CER Results & Uptake: Coming Soon • Publication of CER Results • Timeliness of Draft Final Research Reports • Timeliness of PCORI Peer Review • Timeliness of posting results to PCORI.org Dissemination and Implementation Awards • • Uptake of results posted to PCORI.org Improved Measures: • Changes to monitoring Progress of Projects • New metrics for Portfolio Management New metrics on use of PCORnet • What else would you like to see for the FY-2017 Dashboard? 9