In effort to study high-performing health care systems and their ability to adopt and implement evidence-based medicine, the Agency for Healthcare Research and Quality (AHRQ) is establishing three National Centers of Excellence through a five-year $52 million grant. The UC Berkeley School of Public Health’s Center for Healthcare Organizational and Innovation Research (CHOIR) will collaborate with the Dartmouth Institute for the Clinical and Evaluative Sciences (TDI) and the High Value Healthcare Collaborative (HVHC) to form one of these centers.
The centers will study how complex health care delivery systems disseminate evidence-based findings and provide lessons learned to inform the dissemination of findings in other settings. Increasingly, clinicians work within complex health systems. Understanding how health systems disseminate information on what works and what does not work will facilitate successful dissemination of evidence-based practices moving forward.
“This award represents an unprecedented opportunity to spread the relatively small pockets of health system high performance now occurring in the United States to the entire country,” says Stephen Shortell, Blue Cross of California Distinguished Professor, Health Policy and Management, and faculty director of CHOIR.
The center Berkeley is participating in will conduct a national survey of health care organizations and systems throughout the United States, as well as conduct qualitative research, in order to better understand the inner workings of health care systems, in particular how they adopt and implement biomedical, delivery, and patient engagement innovations.
“We are interested in how the organizations accelerate the adoption of effective interventions,” says Elliott Fisher, director of TDI and principal investigator of the new Center for Excellence. “We want to be able to target interventions to those most likely to benefit, and limit the use of low-value interventions.”
This collaborative center’s work will build on the base of knowledge already developed by the investigators at the three organizations, including taxonomies of health care systems, physician organizations, and accountable care organizations. HVHC is a consortium of 17 health care delivery systems that provide care to over 70 million people in 31 states. Its mission is to improve healthcare value for its service population while serving as a model for national health care reform.
“Results of this work promise to save lives, improve quality of care, and lower costs,” says Dr. Lucy Savitz of HVHC. Dr. Savitz, Intermountain Healthcare, and Dr. Nilay Shah, Mayo Clinic, are research leads for the new center, representing HVHC.
The new center will draw on implementation science and organizational change frameworks to take on five initial projects. One will look at the impact of environmental influences on the emergence of integrated care systems more broadly. Another will investigate the implementation and success of internal management and incentive systems. The remaining three will look at the adoption and use of innovations in diverse health care systems in the following areas: biomedical, care delivery, and patient engagement.
“The center will provide a unique opportunity to examine the impact of patient engagement strategies used by practices on clinical outcomes as well as patient-reported outcomes of care, including patients’ physical and social functioning,” says Hector Rodriguez, associate director of CHOIR, about the patient engagement project.
The AHRQ Centers of Excellence project is funded by the Patient Centered Outcomes Research Trust Fund, which was created by the Affordable Care Act to assist, through research, patients, clinicians, purchasers and policy makers, in making informed health decisions by advancing the quality and relevance of evidence-based medicine. The grants will begin in September this year.
By Linda Anderberg
- New AHRQ-Funded Centers to Study Health Systems and Their Efforts to Disseminate Patient-Centered Outcomes Research