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Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
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Appendix F


Workshop Agenda

LEARNING WHAT WORKS
Infrastructure Required to Learn Which Care Is Best

A LEARNING HEALTHCARE SYSTEM WORKSHOP
IOM ROUNDTABLE ON EVIDENCE-BASED MEDICINE

JULY 30–31, 2008
LECTURE ROOM, THE NATIONAL ACADEMY OF SCIENCES
WASHINGTON, DC 20001




Issues motivating the discussion

  1. Substantial demand for greater insights into the comparative clinical effectiveness of clinical interventions and care processes to improve the effectiveness and value of health care.
  2. Expanded interest and activity in the work needed—e.g., comparative effectiveness research, systematic reviews, innovative research strategies, clinical registries, coverage with evidence development.
  3. Currently fragmented and largely uncoordinated selection of studies, study design and conduct, evidence synthesis, methods validation and improvement, and development and dissemination of guidelines.
  4. Expanding gap in workforce with skills to develop data sources and systems, design and conduct innovative studies, translate results, and guide application.
  5. Opportunities presented by the attention of recent initiatives and the increasing possibility for development of an entity and resources for expanded work on the comparative effectiveness of clinical interventions.
  6. Growing appreciation of the importance of assessing the infrastructure needed for this work—e.g., workforce needs, data linkage and
Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
×

improvement, new methodologies, research networks, technical assistance.

  1. Desirability of a common venue to identify and characterize the need categories, begin to estimate the shortfalls, consider approaches to addressing the shortfalls, and identify priority next steps.

Discussion assumptions: (1) Resources will be available to expand work on the comparative effectiveness of medical interventions, and (2) a designated entity will exist with a formal charge to coordinate the expanded work.

Goal: Clarify the elements and nature of the needed capacity, solicit quantitative and qualitative assessments of the needs, and characterize in a fashion that will facilitate engagement of the issues by policy makers.

DAY ONE

8:00

WELCOME AND INTRODUCTIONS

John W. Rowe, Columbia University & IOM Roundtable on Evidence-Based Medicine

8:15

KEYNOTE: A VISION FOR THE CAPACITY TO LEARN WHAT CARE WORKS BEST

What are the core elements of a robust and sustainable capacity for comparative effectiveness research? How do they relate to each other as a real infrastructure? What are the priorities and how might we build upon, link, and improve existing public and private system elements?

Mark B. McClellan, Brookings Institution & IOM Roundtable on Evidence-Based Medicine

8:45

SESSION 1: THE WORK REQUIRED

Each presenter will describe the nature of the activity and what is known about the current capacity, suggest an approach to determining the necessary capacity, give an “opening bid” estimate of what that need might be, and offer initial suggestions on policies or activities for progress.

Chair: Mark B. McClellan, Brookings Institution & IOM Roundtable on Evidence-Based Medicine

Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
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➢   The Cost and Volume of Current Comparative Effectiveness Research

Erin Holve, AcademyHealth

➢   Intervention Studies That Need to Be Conducted

Douglas B. Kamerow, RTI International

➢   Clinical Data Sets That Need to Be Mined

Jesse A. Berlin, Johnson & Johnson

➢   Knowledge Synthesis and Translation That Need to Be Applied

Richard A. Justman, UnitedHealthcare

[9:45 – 10:00 BREAK]

 

➢   Methods That Need to Be Developed

Eugene H. Blackstone, Cleveland Clinic

➢   Coordination and Technical Assistance That Need to Be Supported

Jean R. Slutsky, Agency for Healthcare Research and Quality

OPEN DISCUSSION (60 minutes)

11:30

LUNCH PRESENTATION: THE POTENTIAL RETURNS FROM EVIDENCE-DRIVEN HEALTH CARE

Gail R. Wilensky, Project HOPE

1:00

SESSION 2: THE INFORMATION NETWORKS REQUIRED

 

Each presenter will describe the nature of the systems required to capture and use data for insights on clinical effectiveness and to ensure effective and efficient review and dissemination of those insights. Presenters will also describe what is known about the current capacity, give a rough estimate of the necessary capacity, and offer initial suggestions on policies or activities for progress.

Chair: Kathleen A. Buto, Johnson &Johnson

➢   Information Technology Requirements

Robert H. Miller, University of California at San Francisco

➢   Data and Information Hub Requirements

Carol C. Diamond, The Markle Foundation

Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
×

➢   Integrative Vehicles Required for Evidence Review and Dissemination

Lorne A. Becker, Cochrane Collaboration

  OPEN DISCUSSION (45 minutes)

2:30

SESSION 3: THE TALENT REQUIRED

Session Three will review the competencies and workforce necessary to carry out comparative effectiveness work, including the presentation of initial estimates of the workforce needed in key areas, comments on the estimates from end users of such research, and insights on the implications for training programs.

Chair: Donald M. Steinwachs, Johns Hopkins University Bloomberg School of Public Health & IOM Roundtable on Evidence-Based Medicine

➢   Comparative Effectiveness Workforce—Framework and Assessment

William R. Hersh, Oregon Health and Science University

 
  • Reactor Panel

       Jean Paul Gagnon, sanofi-aventis

       Bruce H. Hamory, Geisinger Health System

       Steve E. Phurrough, Centers for Medicare & Medicaid Services

       Robert J. Temple, Food and Drug Administration

OPEN DISCUSSION (30 minutes)

 

➢   Panel Discussion: Training and Education Needs

  • Clinical Epidemiology and Research—Eric B. Bass, Johns Hopkins University
  • Health Services Research— Timothy S. Carey, University of North Carolina at Chapel Hill
  • Informatics—Don E. Detmer, American Medical Informatics Association
  • Guideline Development— Richard N. Shiffman, Yale University
  • Knowledge Translation—David H. Hickam, Eisenberg Center
Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
×
  OPEN DISCUSSION (30 minutes)
 

➢   Toward an Integrated Enterprise—An International Case Study

Sean R. Tunis, Center for Medical Technology and Policy

OPEN DISCUSSION (20 minutes)

5:15

HIGHLIGHTS OF DAYS DISCUSSION

  John W. Rowe, Columbia University & Roundtable on Evidence-Based Medicine

5:30

RECEPTION

DAY TWO

8:00

WELCOME AND RECAP OF THE FIRST DAY

 

J. Michael McGinnis, Institute of Medicine

8:15

SESSION 4: NEXT STEPS—PRIORITIES FOR IMPLEMENTATION

 

In this discussion of priorities, strategies, staging, and policies, each participant will offer comments that reflect on the nature (quantitative and qualitative) of the need in the relevant area, how to clarify the understanding on that count, and the possible approaches to ramping up. Specific consideration of how to take best advantage of existing manufacturer and related private sector capacity will also be discussed. Ten minutes of comments on each of the following areas, followed by open discussion.

Chair: Nancy H. Nielsen, American Medical Association & IOM Roundtable on Evidence-Based Medicine

 

➢   Information Technology Platform Requirements

Mark E. Frisse, Vanderbilt University

➢   Data Resource Development and Analysis Improvement

T. Bruce Ferguson, East Carolina Heart Institute

➢   Research Infrastructure Improvement

Daniel E. Ford, Johns Hopkins University

➢   Transforming Health Professions Education

Benjamin K. Chu, Kaiser Foundation Health Plan and Hospitals

Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
×

➢   Building the Training Capacity

Steven A. Wartman, Association of Academic Health Centers

PANEL & OPEN DISCUSSION (50 minutes)

[10:00 – 10:15 BREAK]

10:15

SESSION 5: PUBLIC–PRIVATE PARTNERSHIPS

 

Session panelists will address the following questions: How might better advantage be taken of capacity in the private sector? What existing or planned efforts might best inform the development of needed infrastructure for comparative analyses and research (e.g., biomarkers consortium, data aggregation efforts, Food and Drug Administration Sentinel Network)? Chair: W. David Helms, AcademyHealth

➢   Carmella A. Bocchino, America’s Health Insurance Plans

➢   Rachel E. Behrman, Food and Drug Association

➢   William Z. Potter, Merck Research Laboratories

PANEL & OPEN DISCUSSION (45 minutes)

11:15

SESSION 6: GETTING STARTED

This final session will be a facilitated open discussion of the priorities and strategies for building the needed infrastructure. There will be 30-45 minutes each on the following.

Chair: John W. Rowe, Columbia University & Roundtable on Evidence-Based Medicine

 

➢   The Roadmap—Policies, Priorities, Strategies, and Sequencing

Stuart Guterman, The Commonwealth Fund

➢   Quick Hits—Things That Can Be Done Now

W. David Helms, AcademyHealth

➢   Building Support

Mary Woolley, Research!America

12:45

CONCLUDING SUMMARY REMARKS AND ADJOURNMENT

J. Michael McGinnis, Institute of Medicine

Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
×

Planning Committee:

John W. Rowe (Chair), Mailman School of Public Health,
Columbia University

Stuart H. Altman, Brandeis University

Kathleen A. Buto, Johnson & Johnson

Carolyn M. Clancy, Agency for Healthcare Research and Quality

W. David Helms, AcademyHealth

Mark B. McClellan, Brookings Institution

Peter R. Orszag, Congressional Budget Office

Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
×

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Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
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Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
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Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
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Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
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Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
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Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
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Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
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Suggested Citation:"Appendix F: Workshop Agenda." Institute of Medicine. 2011. Learning What Works: Infrastructure Required for Comparative Effectiveness Research: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12214.
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It is essential for patients and clinicians to have the resources needed to make informed, collaborative care decisions. Despite this need, only a small fraction of health-related expenditures in the United States have been devoted to comparative effectiveness research (CER). To improve the effectiveness and value of the care delivered, the nation needs to build its capacity for ongoing study and monitoring of the relative effectiveness of clinical interventions and care processes through expanded trials and studies, systematic reviews, innovative research strategies, and clinical registries, as well as improving its ability to apply what is learned from such study through the translation and provision of information and decision support.

As part of its Learning Health System series of workshops, the Institute of Medicine's (IOM's) Roundtable on Value & Science-Driven Health Care hosted a workshop to discuss capacity priorities to build the evidence base necessary for care that is more effective and delivers higher value for patients. Learning What Works summarizes the proceedings of the seventh workshop in the Learning Health System series. This workshop focused on the infrastructure needs--including methods, coordination capacities, data resources and linkages, and workforce--for developing an expanded and efficient national capacity for CER. Learning What Works also assesses the current and needed capacity to expand and improve this work, and identifies priority next steps.

Learning What Works is a valuable resource for health care professionals, as well as health care policy makers.

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