Attitudes toward comparative effectiveness research and patient engagement among reproductive health clinicians.

Aim: To assess reproductive health clinicians' knowledge of and attitudes toward comparative effectiveness research (CER), patient-centered outcomes research (PCOR) and patient engagement in research.

Materials & Methods: Web-based survey of reproductive health clinicians.

Results: Among 103 responding clinicians, familiarity with CER and PCOR was moderate (35 and 44%, respectively).

Finding "truth" across different data sources.

The proliferation of new technology platforms and tools is dramatically advancing our ability to capture, integrate and use clinical and other health related data for research and care. Another critical and increasingly common source of data comes directly from patients - often in the form of Patient Reported Outcomes (PRO). As more providers and payers recognize that patient experiences reflect a critical dimension of the value proposition, these data are informing broader strategies to achieve performance improvement and accountability in health systems.

Leveraging Health IT to Reduce Disparities in Three Underserved Beacon Communities.

Using health information technology (IT) can potentially address health disparities by increasing access to care, delivering higher-quality care, improving patient-provider communication, and enhancing patient safety. It describes challenges encountered by three underserved Beacon Communities that implemented health IT interventions, including inadequate connectivity infrastructure, technical support, expertise, and financial resources; provider shortages and staff turnover; and equipment theft.

Patient Engagement and Activation in Three Underserved Beacon Communities.

Whether the setting is urban, rural, or somewhere in between, engagement strategies for the underserved require a great deal of flexibility and sensitivity to the socioeconomic, cultural, and geographic conditions of the patient population. The following report details how three unique communities designed specific strategies to engage underserved populations in the management of their chronic conditions.

Patient and Stakeholder Engagement in the PCORI Pilot Projects: Description and Lessons Learned.

Background: Patients and healthcare stakeholders are increasingly becoming engaged in the planning and conduct of biomedical research. However, limited research characterizes this process or its impact.

Objective: We aimed to characterize patient and stakeholder engagement in the 50 Pilot Projects funded by the Patient-Centered Outcomes Research Institute (PCORI), and identify early contributions and lessons learned.

Evaluating patient and stakeholder engagement in research: moving from theory to practice.

Despite the growing demand for research that engages stakeholders, there is limited evidence in the literature to demonstrate its value - or return on investment. This gap indicates a general lack of evaluation of engagement activities. To adequately inform engagement activities, we need to further investigate the dividends of engaged research, and how to evaluate these effects.

Making it local: Beacon Communities use health information technology to optimize care management.

Care management aims to provide cost-effective, coordinated, non-duplicative care to improve care quality, population health, and reduce costs. The 17 communities receiving funding from the Office of the National Coordinator for Health Information Technology through the Beacon Community Cooperative Agreement Program are leaders in building and strengthening their health information technology (health IT) infrastructure to provide more effective and efficient care management. This article profiles 6 Beacon Communities' health IT-enabled care management programs, highlighting the influence of local context on program strategy and design, and describing challenges, lessons learned, and policy implications for care delivery and payment reform.

Learning from health information exchange technical architecture and implementation in seven beacon communities.

As health care providers adopt and make "meaningful use" of health information technology (health IT), communities and delivery systems must set up the infrastructure to facilitate health information exchange (HIE) between providers and numerous other stakeholders who have a role in supporting health and care. By facilitating better communication and coordination between providers, HIE has the potential to improve clinical decision-making and continuity of care, while reducing unnecessary use of services. When implemented as part of a broader strategy for health care delivery system and payment reform, HIE capability also can enable the use of analytic tools needed for population health management, patient engagement in care, and continuous learning and improvement.

Data governance and data sharing agreements for community-wide health information exchange: lessons from the beacon communities.

Purpose: Unprecedented efforts are underway across the United States to electronically capture and exchange health information to improve health care and population health, and reduce costs. This increased collection and sharing of electronic patient data raises several governance issues, including privacy, security, liability, and market competition. Those engaged in such efforts have had to develop data sharing agreements (DSAs) among entities involved in information exchange, many of whom are "nontraditional" health care entities and/or new partners.

Considerations for community-based mHealth initiatives: insights from three Beacon Communities.

Mobile health (mHealth) is gaining widespread attention for its potential to engage patients in their health and health care in their daily lives. Emerging evidence suggests that mHealth interventions can be used effectively to support behavior change, but numerous challenges remain when implementing these programs at the community level. This paper provides an overview of considerations when implementing community-based mHealth initiatives, based on the experiences of three Beacon Communities across the United States that have launched text messaging (short message service, SMS) pilot programs aimed at diabetes risk reduction and disease management.

The Electronic Data Methods (EDM) forum for comparative effectiveness research (CER).

Background: AcademyHealth convened the Electronic Data Methods (EDM) Forum to collect, synthesize, and share lessons from eleven projects that are building infrastructure and using electronic clinical data for comparative effectiveness research (CER) and patient-centered outcomes research (PCOR). This paper provides a brief review of participating projects and provides a framework of common challenges.

Methods: EDM Forum staff conducted a text review of relevant grant programs' funding opportunity announcements; projects' research plans; and available information on projects' websites.

Evaluation design and technical assistance opportunities: early findings from the Beacon Community Program evaluation teams.

The Beacon Community Cooperative Agreement Program is funding 17 communities to build and strengthen their health information technology (IT) capabilities to enhance care coordination, improve patient and population health, and reduce or restrain costs. Based on the experiences and evidence generated by these communities, the program hopes to illustrate the possibilities of leveraging health IT to achieve desired goals. Doing so requires rigorous evaluation work, which is the subject of this issue brief.

Web-based survey of fertility issues in young women with breast cancer.

Purpose: Young women with breast cancer often seek advice about whether treatment will affect their fertility. We sought to gain a better understanding of women's attitudes about fertility and how these concerns affect decision making.

Patients And Methods: We developed a survey about fertility issues for young women with a history of early-stage breast cancer.

Cost effectiveness of treatment for benign prostatic hyperplasia: an economic model for comparison of medical, minimally invasive, and surgical therapy.

Purpose: To evaluate the cost effectiveness of minimally invasive therapy relative to medical (alpha-blocker) therapy and transurethral resection (TURP) for patients with moderate to severe symptoms of benign prostatic hyperplasia (BPH).

Methods: We constructed a decision-analytic Markov model for a hypothetical cohort of 65-year-old men with moderate to severe BPH symptoms. Microwave thermotherapy was selected to represent minimally invasive treatment.