Leadership Commitments to Improve Value in Health Care Finding Common Ground: Workshop Summary (2009) / Chapter Skim
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4 Moving Forward
4 Moving Forward
Pages 79-94
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From page 79... ...
The papers of the sector groups -- patients, healthcare professionals, healthcare delivery organizations, healthcare product developers, clinical investigators and evaluators, regulators, insurers, employers and employees, and individuals involved with information technology (IT) -- provided important contextual information for workshop discussions.
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From page 80... ...
Importantly, too, collaborative work holds the fundamental potential to expand basic knowledge and understanding of the use of evidence in medicine by collecting and distilling data from multiple practice settings and observational perspectives. Working jointly was also seen as a way for the sectors to help ensure that the limited resources available for evidence-based initiatives can be distributed equitably and cost-effectively.
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From page 81... ...
Suggestions included collective work to design standards for the practice of EBM, product development and approval, patient care decisions, the collection and use of data, the implementation of studies, and the terminology used in the field of EBM and technology. Cooperative work involving multiple sectors was noted as necessary for development of a common language through which various sectors can speak to each other productively about areas in which they have similar concerns.
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From page 82... ...
As has been noted, many participants supported the development of a national problem list and an inventory of best practices as priority areas for action. Many also believed that a shared vision would be further defined and inculcated through the establishment of an independent body for consideration of comparative effectiveness that engages all stakeholders in the development of more transparent and consistent approaches to judging evidence, especially in the context of decision making regarding medical policy, and provision of a neutral venue in which controversial issues can be resolved.
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From page 83... ...
An IT-focused collaborative could serve as an effective channel for the distribution of models of good practices. In addition, cross-sector work in IT could improve the patient experience through the use of such applications as personal health records that promote patient safety, systems that give patients better access to their own records, processes that improve the security and privacy of patient records, and procedures that reduce duplicative efforts and result in cost savings.
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From page 84... ...
Other areas mentioned for collaborative work included initiatives to improve the development of comparative effectiveness information, practice workflow efficiency, and decision support systems as well as initiatives to promote shared decision making. A primary opportunity underscored by several participants to support and engage healthcare providers is through the development of better information to help guide clinical decision making.
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From page 85... ...
Its goals include increased federal funding for comparative effectiveness research; the identification of knowledge gaps and the prioritization of areas for further research; and the broad dissemination of research findings to clinicians, patients, and others in formats that diverse audiences can understand. If collaboration is an important tool in educating the public about the use of evidence in health care, it is also necessary for ensuring that individuals better engage the use of evidence in clinical care.
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From page 86... ...
Another aspect would center on understanding the proper role of evidence in healthcare decisions in terms of patient care versus, for example, policy or reimbursements. CONCLUDING COMMENTS AND NEXT STEPS Overall, the spirit conveyed at the workshop was of a sense of opportunities for a variety of sectors to work together productively to link evidence and the practice of health care, and the important facilitative role that the Roundtable can play in this effort.
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From page 87... ...
In general, providers, patients, and other sectors do not yet believe that the development of evidence is an activity relevant to their experience in the routine delivery of care. In addition, participants revisited a number of the common themes that recurred throughout discussions on key advances and issues, on which stakeholders could work together (Box 4-1)
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From page 88... ...
What might • be the tangible impact of broad improvements in the availability and application of appropriate evidence for healthcare decisions for patients, for providers, and for society? Documenting the con sequences of provision of care on the basis of too little evidence or the potential benefits of providing care on the basis of the right evi dence is a prerequisite to obtaining an improved understanding of and demand for evidence-based care and stakeholder activation.
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From page 89... ...
Improve engagement in the full life cycle of interventions. How • should assessments and decisions on proposed healthcare services be tailored to ensure that each stage of the development and appli cation process for a given intervention builds efficiently to the next?
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From page 90... ...
Accelerate advances in health information technology. What can • stakeholders do to accelerate the nation's progress toward the goal of the universal application of interoperable -- or functionally accessible -- personal and organizational electronic health records, as well as toward the goal of providing real-time electronic access
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From page 91... ...
Health Insurance Portability and Accountability Act issues are being addressed by an IOM Committee expected to issue its report and recommendations in 2009, including those related to the use of clinical data for knowledge development. The Roundtable's Febru ary 2008 meeting, Clinical Data as the Basic Staple of Healthcare
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From page 92... ...
The issues and questions heard throughout the workshop explicitly underscored the importance of the unique approach of the Roundtable's activities: convening disparate stakeholders and sectors to engage in issues about which they have common concerns but, as yet, little collective
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From page 93... ...
Real prospect exists for moving forward on common ground, but it will take diligence, commitment, and leadership.
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