Dashboard Review First Quarter of FY-2016 Joe Selby, MD, MPH Executive Director Michele Orza, ScD Senior Advisor to the Executive Director
On Target Projected/Target Q2 2015 Board of Governors FY-2016 Dashboard Off Target Q3 2015 Q1 (As of 12/31/2015) Needs Attention Q4 2015 Our Goals: Increase Information, Speed Implementation, and Influence Research Q1 2016 Expenditures – Total Budget, Up to $424M Funds Committed to Research, Up to $554M % of Research Projects on Track Inputs Q2 Q3 Q4 Q1 Research 80 Awards Budgeted 70 Budget 60 Percent Research 50 Awards Actual Expected 40 30 All Other Budget 20 Q1 2016 Budgeted Process Actual Q1 Actual 10 Q1 Actual ($3M) All Other Actual 0 % of Research Projects Meeting 100% of 0 100 200 300 400 500 600 0 50 100 150 200 250 300 350 in Green Zone Recruitment $ Millions $ Millions (Q1: N=296) (Q1: N=114) Final Progress Reports Submitted Journal Articles PCORnet Phase II Research Projects Underway in PCORnet 70 Q2 Q3 Q4 Q1 25 Expected Actual Number of Projects Target 60 Outputs 20 50 Actual 40 0 5 10 15 20 15 30 Q1 Actual 2016 Target 10 20 Networks Engaged in Research Projects 5 10 Target 0 0 Actual Journal Articles Journal Articles About or Q2-15 Q3-15 Q4-15 Q1-16 Uptake Published By Awardees By PCORI 0 10 20 30 Methodology Standards Uptake Results of Engagement in Research Results: Increasing Information In this study, engagement of patients led to the A study aiming to improve patient-centeredness 75 20 design of a peer-driven intervention for sleep and reduce ordering of low-value tests found apnea treatment: a Peer-Buddy approach, which is that physician education alone may not be 15 Use 50 being compared to standard care. Experienced sufficient to induce lasting changes in behavior. patients are helping those newly diagnosed with 10 sleep apnea learn to use a challenging but effective 25 Results: Increasing Information treatment . If successful, the Peer-Buddy approach 5 A study on chronic opioid therapy found greater may be a useful tool for NA reductions in high-dose prescriptions in group 0 0 treatment of other chronic practice settings, which had additional physician Methodology CME/CE Methodology Standards diseases, such as diabetes, Citations Certificates initiatives, than among contracted physicians. Impact heart failure, and HIV. 2
Goal 1 Results: Health Plan Initiative to Mitigate Chronic Opioid Therapy Risks Von Korff M, Dublin S, et al. The Impact of Opioid Risk Reduction Initiatives on High- Dose Opioid Prescribing for Patients on Chronic Opioid Therapy . J Pain, Jan 2016. Epub Oct 2015. • Awarded 2013, Improving Healthcare Systems Project • Principal Investigator: Michael Von Korff, ScD, Group Health Research Institute This observational cohort study evaluated a healthcare system initiative to reduce risks of long- term opioid use, comparing its group practice physicians with its contracted physicians . Group practice physicians were exposed to the health plan’s multi-part initiative to reduce high- dose chronic opioid therapy by changing physician expectations regarding appropriate prescribing. Contracted physicians were exposed only to statewide guidelines and legislation. Reductions in prescribing of high opioid dose, average daily dose, and excess opioid days supplied were substantially greater among group practice physicians exposed to additional initiatives to alter shared physician expectations, compared with the contracted physicians. 3
Goal 1 Results: Reducing Low-Value Test Ordering in Primary Care Fenton JJ, Kravits, et al. Promoting Patient-Centered Counseling to Reduce Use of Low-Value Diagnostic Tests: A Randomized Clinical Trial . JAMA Internal, Feb 2016. • Awarded 2012, Pilot Project • Principal Investigator: Joshua Fenton, MD MPH, University of California, Davis Randomized clinical trial to evaluate the effectiveness of a standardized patient-based intervention to enhance patient-centeredness and skill in handling patient requests for low- value diagnostic tests among primary care residents. Residents received either a standard e-mail containing relevant clinical guidelines, or personalized feedback and education about patient-centered techniques to address patient concerns. The primary outcome was whether residents ordered low-value tests in 3 unannounced standardized patient follow-up visits. The educational intervention did not improve patient-centeredness or rates of low-value test ordering. Education alone may not be sufficient to induce lasting changes in test ordering behavior. 4
Results of Engagement in Research: Design of a Peer- Driven Intervention for Treatment of Sleep Apnea PCORI Study: Peer-Driven Intervention as an Alternative Model of Care Delivery and Coordination for Sleep Apnea • Awarded 2013, Improving Healthcare Systems project • Principal Investigator: Sairam Parthasarathy, MD, University of Arizona Engagement of patients led to the design of a peer-driven intervention for treatment of sleep apnea: a Peer-Buddy approach, which is being compared to standard care. In the intervention, experienced patients are trained as mentors to help others newly diagnosed with sleep apnea learn to use the challenging but effective treatment, continuous positive airway pressure (CPAP) . The original idea came from a patient that had success with CPAP, and offered to help other patients struggling with treatment. Further engagement with patients also brought other ideas to use, including a planner to help patients track appointments and a laminated contact list attached to the CPAP machine. If successful, the Peer-Buddy approach may be a useful tool for treatment of other chronic diseases, such as diabetes, heart failure, and HIV. 5
Funds Committed by Quarter FY-2016 Budget: Up to $554M Inputs Q1 Q2 Q3 Q4 FY-2016 Budgeted 3 144 86 321 Q1 Q2 Q3 Q4 FY-2016 Expected 3 114 70 270 Q1: $3M Q1 (PCORnet Coordinating Center) Q1 2016 Actual 3 0 100 200 300 400 500 600 $ Millions Expected bar: Based on historical averages for each type of PFA 6
We actively monitor our projects, support them to be successful, and classify their progress as shown below The “Percent of Projects on Track” shown on the Dashboard is the percent of projects in the green zone
The majority of our projects are on track and we are giving additional attention to those that are not Distribution of Project Status by Quarter Q1 2016 214 64 7 11 1 Q4 2015 183 67 11 13 Green Zone 1 Yellow Zone Q3 2015 180 54 9 14 Orange Zone Red Zone 1 Award Terminated* Q2 2015 130 47 16 11 0 25 50 75 100 125 150 175 200 225 250 275 300 Number of Projects *Notice of Termination Issued 8
Final Progress Reports Due by Fiscal Year (as of Q1) ( includes modifications approved so far, about 8.5% of studies shown below) Broad CER 118 120 Methods Targeted 100 PCORnet Targeted Pragmatic 80 57 60 Obesity Treatment, Uterine Fibroids, Care Transitions, Fall Prevention 37 40 36 Hypertension Asthma 23 Aspirin 17 20 10 8 8 4 2 2 2 1 1 1 0 2016 2017 2018 2019 2020 2021 Fiscal Year *Does not include contracts not yet fully executed 9
Progress of PCORnet Phase II Research Projects Underway in PCORnet Q1 Q2 Q3 Q4 Target 3 3 13 1 Q1 Actual 3 0 5 10 15 20 Networks Engaged in Research Projects FY-2016 Targets by Quarter Q1 Actual Q2 0 Q1 Q3 Q4 Target 11 2 20 Q1 Actual 12 0 10 20 30 *Projects: Numbers in Quarter 1 represent the 3 PCORI-funded Demonstration Projects (ADAPTABLE) and two Obesity Studies. In future quarters, total projects will also include projects funded by others. *Networks: Some networks will be involved in multiple projects. Future metrics will track this. 10
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