Dashboard Review First Quarter of FY-2017 Joe Selby, MD, MPH - PowerPoint PPT Presentation

Dashboard Review First Quarter of FY-2017 Joe Selby, MD, MPH Executive Director 1

On Target Projected/Target Q2 2016 Board of Governors Dashboard Off Target Q3 2016 First Quarter FY-2017 (As of 12/31/2016) Needs Board Attention Q4 2016 Our Goals: Increase Information, Speed Implementation, and Influence Research Too Early to Evaluate Q1 2017 Narrative Examples Funds Committed to Research Project Performance Operating Budget Inputs Includes funds committed to PCORnet Does not include Research Awards Target 100 Goal One Budgeted $428M for FY-2017 Budgeted $81M for FY-2017 > 90% Increasing Information 90 Percent Use of a decision aid in 80 patients with low risk chest Actual Actual 70 pain increased understanding of risk and safely decreased Process 60 the rate of admission to an Q2 Q3 Q4 Q1 0 20 40 60 80 0 100 200 300 400 500 observation unit for cardiac 50 $ Millions $ Millions testing % of Projects On Track Draft Final Research Reports PCORI Peer Review Public Reporting of Research Findings Goal Two Speeding Implementation 100 100 100 Target Target Target We awarded one of our first 100 % > 90% Outputs > 90 % 75 75 D&I projects to a PCORI- 75 Percent Percent Percent funded study on preventing First data to be First data to be 50 2 8 19 50 50 non-administration of VTE N= available in Q2-17 available in 3 14 23 prophylaxis to implement Q2/Q3-17 25 25 25 the intervention in two large Q2 Q3 Q4 Q1 Q1: NA Q1: NA NA hospital settings 0 0 0 % of DFRRs On Time % Peer Review process % Abstracts Posted to Uptake less than 5 Months PCORI.org in <90 days Goal Three Altmetrics Research in PCORnet Results Published in Literature Influencing Research Projects Underway in PCORI is credited as a model Number of Publications 40 30 PCORnet (Cumulative) with Altmetric Score >20 for Henry Ford Health 15 4 Research Projects System’s Patient Engagement Externally 30 Use 1 Research Center (PERC), Funded or Articles CER 2 2 Articles CER 20 6 10 which brings together Co-funded Results Results 20 1 3 researchers and patient 1 advisory groups to improve 10 PCORI- 5 Other Other 10 1 patient care funded Publications 2 Results 0 0 0 Impact Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 2

Results of PCORI Research: Shared Decision Making in ED for Evaluation of Low Risk Chest Pain Safely Decreases Hospital Admissions Chest pain is the second most common reason patients visit emergency departments across the United States. To avoid missing a heart attack diagnosis, doctors frequently admit patients to the hospital even when they are at very low risk. These low-risk admissions result in unnecessary testing, patient anxiety, and disruption in patients’ lives, as well as increased healthcare costs. This study compared the effectiveness of shared decision making vs. usual care in choice of admission for observation and further cardiac testing or for referral for outpatient evaluation in patients with low risk chest pain. Use of the decision aid increased patient knowledge about their risk, increased engagement, and safely decreased the rate of admission to an observation unit for cardiac testing. • Awarded 2012, Assessment of Prevention, Diagnosis, and Treatment Options project Hess EP, Hollander JE, Schaffer JT, et al. Shared Decision Making in Patients with Low Risk Chest Pain: Prospective Randomized Pragmatic Trial. BMJ . December • Principal Investigator: Erik Paul Hess, MD, MS, 2016. 355:i6165 Mayo Clinic ” Results (Abstract) : Compared with usual care, patients using the decision aid had greater knowledge of their risk for acute coronary syndrome and options for care (questions correct: decision aid, 4.2 v usual care, 3.6; mean difference 0.66, 95% Patients can be effectively educated CI 0.46 to 0.86), were more involved in the decision (observing patient involvement scores: decision aid, 18.3 v usual care, 7.9; 10.3, 9.1 to 11.5), and and engaged in the emergency care less frequently decided with their clinician to be admitted for cardiac testing setting in decisions about testing and (decision aid, 37% v usual care, 52%; absolute difference 15%; P<0.001). There follow-up… it is feasible to do so in the were no major adverse cardiac events due to the intervention. flow of clinical care. 3

Dissemination of Results: D&I Project for Preventing Venous Thromboembolism (VTE) AHRQ has called VTE prevention in patients the number one strategy to improve patient safety in hospitals. A PCORI-funded study found that patients want to be educated on VTE, and that educating bedside nurses and implementing a patient-centered education intervention led to significant reduction in non-administration of VTE prophylaxis. PCORI Dissemination Project: This project aims to scale up the implementation of a patient-centered VTE prevention education intervention in 2 settings: 1. To all floors of the large, academic teaching hospital where the intervention was originally tested (Johns Hopkins) 2. To all floors of a medium-sized community, suburban, non-teaching hospital The goal is to decrease refused doses of VTE prophylaxis among inpatients within these two hospitals. If successful, this D&I project will result in improved quality of patient-nurse communication and more informed patient decisions regarding the choice to take VTE pharmacologic prophylaxis.

D&I PFA - Limited Competition LOIs, Applications, and Awards (All Cycles) Letters of Intent Submitted Letters of Intent Accepted Applications Awards 40 LOI Acceptance Rate 100% 100% 100% 90% 86% 80% % of LOIs Accepted 30 70% Competitive LOI 60% beginning 2017 Number 19 19 20 50% 40% 14 12 30% 10 7 20% 6 6 6 5 10% 2 0 0% Cycle 1 2016 Cycle 2 2016 Cycle 3 2016 12/13/2016 (Not Yet Awarded) (Not Yet Awarded) Cycle dates = dates that awards were announced 5 Some LOIs not accepted due to administrative noncompliance

Influence Example: PCORI Credited with Serving as a Model for Patient Engagement in Research at Henry Ford Health System PCORI is credited with serving as a model for patient engagement at Henry Ford Health System Patient Engagement Research Center (PERC), which was created to develop the infrastructure for patient-centered outcomes research at Henry Ford Health System and improve the way Henry Ford delivers patient care and treatment of diseases. An AHRQ grant was awarded in 2013. Goal: Henry Ford’s flexible engagement model facilitates meaningful dialog between patients, caregivers, physicians and researchers to address topics that matter to all. Results of the PERC include: • Educating and engaging stakeholders through: Creation of a diverse Patient Advisor group (~300 currently enrolled) o Building Patient Advisors skills to collaborate as full members of research teams. o Implemented an education module to prepare researchers for effective engagement o • Expanding dedicated resources for 4 research function cores: ” Patient Engagement o Study Design, Analysis and Measurement o Patient Data Network PCORI’s support, resources and guidance o have been key to PERC’s success, Dissemination and Implementat ion o particularly PCORI website resources, and monthly guidance from the Pipeline to Proposal team– Karen Kippen 6

Influence on Research: Uptake of the PCORI Engagement Rubric PCORI Engagement Rubric CME/CE Activity released Jan 2016 Cumulative CME/CE Learners Unique Accesses CME/CE Certificates* By Profession (N=707) By Quarter (N=1862) By Quarter (N=454) Nurse 193 225 1,000 900 Physician 129 200 Unique Accesses 800 Pharmacist 109 175 676 Certificates 147 700 Nurse Practitioner 150 92 555 600 115 125 Case Manager 55 500 98 94 100 Physician Assistant 33 374 400 75 Medical Assistant 22 257 300 50 Psychologist 11 200 53 Other or 25 Unknown 100 Health Educat. Specialist 10 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 0 0 *Some learners earn multiple certificates, while many do not require certificates and access the course without seeking CME/CE 7

We actively monitor our projects, support them to be successful, and classify their progress as shown below 8

We are monitoring trends and shifts in project status Project Status by Color Zones Q3-15 to Q1-17 90 78 78 80 74 73 72 70 67 70 Green Zone Percent of Projects (%) 60 Yellow Zone 50 Off Track (Orange/Red) 40 Award Terminated* 30 25 22 21 21 20 18 20 16 9 9 7 10 6 6 5 4 0 Q3-15 Q4-15 Q1-16 Q2-16 Q3-16 Q4-16 Q1-17 *Notice of Termination Issued, <1% in each quarter 9

Projects On Track Subset of Projects in the Zone On Track, but Yellow Zone: 40 Details (Among All Projects Eligible for Color Evaluation) Q2-16 (N=326) Q3-16 (N=335) 30 Q4-16 (N=367) % Q1-17 (N=383) 20 10 0 % of Projects in the % First Time % Consecutively in % in Yellow Zone that Yellow Zone in Yellow Zone Yellow Zone improved from Red or (4+ quarters) Orange within past year 10

Projects Off Track Subset of Projects in the or Zone Percent of Projects Off Track: 40 Details (Among All Projects Eligible for Color Evaluation) Q2-16 (N=326) Q3-16 (N=335) 30 Q4-16 (N=367) % Q1-17 (N=383) 20 10 0 % Projects in the % First Time in % Consecutively in % Letter of % Award Orange or Red Zone Orange or Red Orange or Red Zone Concern Sent Terminated (3+ quarters) 11