Leadership Commitments to Improve Value in Health Care: Finding Common Ground: Workshop Summary (2009)

Institute of Medicine

Roundtable on Evidence-Based Medicine

Charter statement: The Institute of Medicine’s (IOM’s) Roundtable on Evidence-Based Medicine has been convened to help transform the way evidence on clinical effectiveness is generated and used to improve health and health care. Participants have set a goal that, by the year 2020, 90 percent of clinical decisions will be supported by accurate, timely, and up-to-date clinical information, and will reflect the best available evidence. Roundtable members will work with their colleagues to identify the issues not being adequately addressed, the nature of the barriers and possible solutions, and the priorities for action, and will marshal the resources of the sectors represented on the Roundtable to work for sustained public–private cooperation for change.

Issue and aim: To enhance stakeholder focus and effectiveness in activities important to achieve charter goals by outlining specific means by which each sector can contribute. This will entail the engagement of leading organizations within each sector, individually and collaboratively, in coordinated work to develop a sectoral statement that reviews the key issues and opportunities relevant to the sector, identifies a program of activities to address them, and specifies the expected outcomes if implemented. Com-

ments, but not approval, will be sought. These statements will be individually authored, will not represent a formal consensus, and will be presented for discussion at an IOM workshop.

Outcomes sought:

• Identification and action on key sector-specific opportunities to accelerate progress toward a learning healthcare system

• Collaboration within sector to engage those opportunities

• Collaboration across sectors to engage those opportunities

• Ideas for Roundtable action to facilitate

Sample sectoral statement format:

• Section 1: Overview profile of the sector and key players, emphasizing elements relevant to improving the generation and application of evidence

• Section 2: Specification and description of the key activity categories within the purview of the sector that are most important to the generation and application of evidence

• Section 3: Description, by specified category, of the sorts of sectoral initiatives and priorities that could help transform the scene

• Section 4: Identification of possible areas for collaboration and cooperation with other sectors

• Section 5: Indication of steps necessary to get the sectoral initiatives under way

• Section 6: Timetable for expected results if implemented

Approach:

• Each Roundtable member designates a lead staff person to work on the project

• Sectoral cluster coordinator, or designee, convenes initial meeting

• Sectoral group decides on approach and means of engaging participation from sector organizations not on the Roundtable

• Meetings held in whatever fashion deemed most expeditious for task, in coordination with IOM staff

• First draft completed and circulated among participants

• Review draft circulated among Roundtable members represented on sector group

• Revised review drafts assembled into consolidated draft Sectoral Strategies document and circulated for review and comment of all Roundtable members

• Presentation of background papers for public discussion at an IOM Workshop on Sectoral Strategies

Timetable:

• January: initial formation of nine sectoral clusters

• February and March: reach out to other sectoral participants

• April: first draft completed and circulated to sector participants

• May: sector review draft circulated to Roundtable members on each sector group

• June: consolidated draft Sectoral Strategies document sent to all Roundtable members

• July: public discussion at IOM Workshop on Sectoral Strategies

Sectoral clusters: (The lists below are not comprehensive, noting only Roundtable designees.)

Consumer-Patient

• Joyce Dubow, AARP (Coordinator)

• Gail Shearer, Consumers Union

• Ann Kempski, SEIU

• Carolin Hinestorsa, National Breast Cancer Coalition

Health Professionals

• Rae-Ellen Kavey, NHLBI (Coordinator)

• Kimberly Rask, Emory

• Cato Laurencin, University of Virginia

• Nancy Nielsen, AMA

Healthcare Delivery Organizations

• Bob Crane, Laura Tollen, and Kate Myers, Kaiser (Coordinators)

• Denis Cortese, Mayo Clinic

• Benjamin Druss, Emory

• Madhulika Agarwal, VHA

• Jon Perlin, HCA

• Rich Platt, Harvard Pilgrim Health Care

Evaluators/Clinical Researchers

• Rich Platt, Harvard Pilgrim Health Care (Coordinator)

• Carolyn Clancy and Jean Slutsky, AHRQ

• Cato Laurencin, University of Virginia

• Rae-Ellen Kavey, NHLBI

• Don Steinwachs, Johns Hopkins University

• Mark McClellan, Elizabeth Walker, and Elizabeth DuPre, AEI-Brookings

Employees-Employers

• Ronnie Goff, NBGH (Coordinator)

• Kathy Buto, Johnson & Johnson

• Ann Kempski, Service Employees International Union

• Cecily Hall, Microsoft

Information Technology

• Jim Karkanias, Microsoft (Coordinator)

• Adam Bosworth, Google

• Nina Schwenk, Mayo Clinic

• Gail Graham, VHA

Health Care Manufacturers

• Peter Juhn and Christina Farup, Johnson & Johnson (Coordinators)

• Pat Anderson, Stryker

• Cathy Bonuccelli, AstraZeneca

Insurers

• Jack Rowe, Columbia University (Coordinator)

• William Lawrence, North Carolina HHS

• Bob Crane, Kaiser Permanente

• Mark McClellan, Elizabeth Walker, and Elizabeth DuPre, AEI-Brookings

• Liz Goldstein, CMS

• Gerald Penden, Independence Blue Cross

Regulators

• Nancy Derr and Janet Woodcock, FDA (Coordinators)

• Mark Benton, North Carolina HHS

• Mark McClellan, Elizabeth Walker, and Elizabeth DuPre, AEI-Brookings

• Karen Milgate, CMS