Maximizing the returns on the considerable investment of time, human resources, and money inherent to expanding CER capacity will require an understanding of the broad range of policy needs, how existing resources might be best deployed, and a sense for how quickly various elements can be taken to the scale needed. Stuart Guterman, senior program director for the Commonwealth Fund’s Program on Medicare’s Future, outlines six broad policy areas in need of consideration: data, methods, workforce, organization, translation, and financing. Guterman noted that a roadmap for progress would identify clear end goals for each area, priority needs within and between categories, and key actors or existing infrastructure that could help initiate the activities needed. The following summarizes key points from workshop discussions to provide a starting point.
• Data. Capacity is needed to produce data relevant to healthcare decision making by providers, patients, payers, and policy makers; to ensure that the value of data is maximized by integrating these data and establishing sustainable system linkages; and to develop systems that make data and information available to appropriate users when, where, and how they are needed. While these data exist to some extent, attention needs to be focused on current gaps and how emerging health information technologies (HITs) might be applied to meet new data needs. As electronic health record (EHR) capacity is adopted across the nation, the focus should be on ensuring their usefulness—beyond billing and administration—for research and decision support. For existing resources, work to integrate and link disparate data sources and develop standards will provide an important foundation for progress, but enhanced data sharing among stakeholders will require attention to privacy and data stewardship issues.
• Methods. Research approaches are needed that meet the needs of CER end users by providing timely information that is relevant to real-world patients and decisions faced at the point of care. Priority needs include a better understanding of current methods most useful for particular questions, the development of methodological standards for these approaches, and investment to accelerate new innovative methods that enable real-time analysis and learning. Infrastructure to support methods development and to streamline the conduct of clinical research will help accelerate this work.
• Personnel development. A cadre of professionals is needed—from across healthcare sectors—dedicated to and trained in the use of