Happenings: Understanding Health System Leaders’ Priorities

Neil Thomas (Professor of Pediatrics and Associate Dean for Clinical Research at Penn State) speaks at the Health System Leaders’ Demonstration Project.

Last November, researchers, health system and health plan leaders, physicians, and patients from PaTH’s six health care systems met in Pittsburgh to identify research areas the network could pursue. The meeting was part of the National Patient-Centered Clinical Research Network’s (PCORnet) Health System Leaders’ Demonstration Project in which PaTH was challenged by PCORI (the Patient-Centered Outcomes Research Institute) to identify research topics of highest priority to health system leaders with the help of clinicians and patients.

The meeting began with patients talking about their experiences in health care. After patients shared their stories, participants reviewed potential research topics and were asked to choose which one they wanted to pursue most. At first, patients, clinicians, researchers, and system leaders favored very different areas. Throughout the day, though, the group discussed the merits and drawbacks of each topic, considered strategy areas, and continued voting. Through discussions and comparative deliberation, the group came to a consensus on a single topic: understanding why some people use health care resources more often than others. This topic is of high importance to health system leaders because a relatively small group of patients typically use a disproportionately high percentage of health care resources, often with little benefit to their health. The discussion revealed that both physical ailments and behavioral health problems are important to consider when examining patterns of health care use.

In January 2016, delegates from each PCORnet Clinical Research Network (CDRN) attended a meeting sponsored by PCORI and the National Academy of Medicine. PaTH was represented by Diane Holder, President and CEO of UPMC Health Plan, Neal Thomas, Professor of Pediatrics and Associate Dean for Clinical Research at Penn State, and Kathleen McTigue, Associate Professor of Medicine and Epidemiology at Pitt. They gathered with a national group of health system leaders to further explore the highest-priority questions on system performance, measurement, and operations. The conversation contributed to the development of a limited PCORI funding announcement.

Sharon Larson, PhD, of Geisinger Health System, collaborated with PaTH colleagues and members of a New York CDRN to lead the development and submission of a proposal to PCORI, which aimed to look at the factors leading to high use of health care services and quality of care issues among patients with co-occurring physical and behavioral health conditions. Although that proposal did not fund, PCORI is proceeding with research on the high-priority topic area identified by PaTH’s Health System Leaders’ Demonstration Project. More broadly, the PaTH team is committed to continuing to pursue avenues to understand what factors are driving variations in health care use and in understanding how physical and behavioral health conditions influence patterns of health care use.

Another aspect of the Health System Leaders’ Demonstration Project the PaTH team hopes to develop further is how to design events that can foster productive conversations between people with different backgrounds and experiences. The participants at this deliberation event indicated a high level of satisfaction with the day’s process and that they learned from each other’s perspectives. PaTH is excited to continue to build on this approach by engaging with stakeholders moving forward.

To learn more about the Health System Leaders’ Demonstration Project, click here.

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