comparative effectiveness research impact on quality and
play

Comparative Effectiveness Research Impact on Quality and Access - PowerPoint PPT Presentation

Comparative Effectiveness Research Impact on Quality and Access John Santa MD MPH Director, Health Ratings Center Consumers Union March 21, 2011 Disclosures General internist, most recent practice at the VA in 2008. Employed by


  1. Comparative Effectiveness Research Impact on Quality and Access John Santa MD MPH Director, Health Ratings Center Consumers Union March 21, 2011

  2. Disclosures • General internist, most recent practice at the VA in 2008. • Employed by Consumers Union, publisher of: – Consumer Reports – Consumer Reports – ConsumerReportsHealth.org • 20 million readers a month, older, affluent, well educated, not diverse. Trying to diversify. • Independent of industry • Non profit, non partisan

  3. R 12. Consumer A Reports employee T T E R

  4. ������������������������������������������������������������������������������������������������������������������������������������������������������� � �������������������������������������������������������������������������������������������������������������������� Health Alerts via Text ���������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������� ����������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������� � ���������������������������������������������������������� 4

  5. Comparative Effectiveness • Current context • Key consumer principles • Early successes • Important events on horizon • Comments about cancer

  6. Systems are perfectly designed to get the results they achieve.

  7. Current CE Playing Field Not Level • Industry dominates information to consumers • Pharma most prominent but all sectors effective • Billions in direct to consumer • Billions in direct to consumer • Words regulated but visuals, tone and context may be more important • Billions in physician marketing • Detailing, sampling, financial relationships • Billions in a biased research enterprise • Methodology, positive finding bias, ghostwriters

  8. Recent Examples • ProPublica analysis and release of physician financial relationship info • Fugh Berman analysis of estrogen literature • Rothman—Health Advocacy Organizations and • Rothman—Health Advocacy Organizations and the Pharmaceutical Industry • Avandia studies • St Jude Medical and US DOJ agreement – DOJ alleges kickbacks to physicians for post marketing trials and registries

  9. Key Consumer Principles • Consumers should be involved “from the start….at the top”….for appropriate CE tasks including research. • Careful selection…..of consumers and • Careful selection…..of consumers and researchers • Training, orientation, support, feedback is needed…..for both consumers and researchers. • Independence is crucial……for consumers and for researchers.

  10. Consumers Are Interested in Comparisons • Multiple successful health information releases—hospitals, drugs, treatments • Strong readership scores for all health articles—competes well with other content articles—competes well with other content • Strong media interest • Surveys show consumers use comparative data in decision making

  11. Successes • Academic detailing---Avorn and others • ClinicalTrials.gov • Drug Effectiveness Review Project – BestBuyDrugs • Hospital infections---Pronovost and others • Surgical Checklist---Gawande and others • Decision Guides---FIMDM and others

  12. Heart/Vascular Prevention Test Ratings Men, 45-54, Asymptomatic

  13. Cardiovascular Screening Tests in Healthy 40-60 year olds • 11% had a MD conversation about FU if test abnormal • 9% discussed accuracy of test • 4% knew about potential complications • 1% discussed with MD whether test saved lives 2010 Survey of Consumer Reports Subscribers

  14. On the Horizon • Medicare physician performance data • National reporting system for hospital infections • Patient Centered Outcome Research • Patient Centered Outcome Research Institute • Required reporting on physician financial relationships with industry • Insurance Exchanges

  15. Important Activities • IOM reports on CER, Systematic Reviews, Trustworthy Clinical Guidelines • AHRQ’s efforts to engage consumers— past, present and future past, present and future • NIH’s efforts to engage consumers – www.gem-beta.org/Public/EHRInitiative.aspx?cat=4 • PCORI—how will consumers be engaged? • Delivery system reform

  16. Cancer CE Opportunities • If you want to say yes, you must be willing to say no. • Context of comparisons • Poor delivery of what we know works • Poor delivery of what we know works • Overuse of what we know does not work • Prevention, diagnostic testing, “elective” treatments good starters. • “Free the data” and use it for comparisons for all---community cancer centers

  17. CONSUMER REPORTS MARCH 2011

  18. Zeno’s Paradox “To get there, you first have to make it halfway. Then you have to make it halfway from there. And then halfway halfway from there. And then halfway again. You will never arrive, but always getting closer.”

  19. “When you’re through learning, you’re through.” John Wooden Former UCLA basketball coach

  20. John Santa MD MPH Consumer Reports Health Director, Health Ratings Center santjo@consumer.org 914-378-2455

Download Presentation
Download Policy: The content available on the website is offered to you 'AS IS' for your personal information and use only. It cannot be commercialized, licensed, or distributed on other websites without prior consent from the author. To download a presentation, simply click this link. If you encounter any difficulties during the download process, it's possible that the publisher has removed the file from their server.

Recommend


More recommend