PCORI and the Effort to Promote Better Patient Outcomes with Telehealth

The Patient-Centered Outcomes Research Institute, or PCORI, funds the research that helps healthcare providers improve their clinical decision-making. The goal of the organization is to promote research initiatives that establish best practices and decision support, which ultimately promote better patient outcomes.

A key initiative within the organizations National Priorities and Research Agenda is the push to study telemedicine and it’s affect on vulnerable populations. This article will look at the connection between telehealth, PCORI-funded projects, and better healthcare outcomes for America’s patient populations.

“Engaging patients, caregivers, clinicians, insurers, and other healthcare community members is at the core of PCORI’s unique approach to research funding. Our goal is to support research that will provide reliable, useful information to help people make informed healthcare decisions and improve patient care and outcomes.”
PCORI website

PCORI funding comes from Congressional appropriations, Medicare and Medicaid, and the PCOR fee assessed on private insurers. These funds target clinical effectiveness research in eight specific population categories:

• Ethnic and racial minorities
• Low socioeconomic status
• Women
• Older adults
• Patients with multiple chronic conditions
• Children
• Urban populations
• Rural communities

The organization established its national priorities in 2012, focusing on five critical areas of research in the United States:

• Prevention, diagnosis, and treatment best practices with the goal of comparing options to determine which works best for a particular population.
• Healthcare systems improvement in the area of patient access, self-care, the innovative use of technology, and care coordination.
• Communication and the dissemination of research that allows healthcare consumers and clinicians better access to information that aids in decision-making.
• Addressing the disparities between patient care in vulnerable populations and determining the healthcare best practices required to achieve better outcomes in these groups.
• Accelerating patient-centered research based on evidence-centered methodological research by expanding technology and data architectures.

PCORI is an important tool behind some of the most innovative outcomes-based research in the nation. What are the types of programs that PCORI typically funds?

PCORI has taken their overarching goals and used them to fund research that facilitates better decision-making for doctors and patients. The organization has divided its work of funding clinical research into several primary categories, including:

• Clinical effectiveness and decision research.
  The science of decision-support provides the information patients and doctors need to make decisions that will lead to the best health outcomes. Many times, the information to make these evidence-based decisions is lacking, particularly in vulnerable populations with complicating factors, such as the very young or very old. The PCORI research that is funded under this category seeks to fill clinical information gaps with valid best practices.
• Healthcare delivery and disparities research.
  Addressing the disparities between healthcare delivery to urban-centered, higher income patients with private payer insurance versus delivery to rural communities with lower income patients on government insurance, is just one example of this research category. PCORI seeks to fund projects that eliminate these barriers.
• Healthcare stakeholder engagement.
  The research funded by PCORI in this area are designed to, “increase meaningful engagement of patients, caregivers, clinicians, and other healthcare stakeholders by expanding their knowledge and skills and creating opportunities to build connections and share research findings.”

All of the research funded by PCORI focuses heavily out outcomes-based evaluation and analysis frameworks within each clinical study. The research will ultimately provide repeatable and systematized benchmarks for the provision of quality healthcare to all patient populations, including those that are currently underserved.

“As the use of digital communication tools expands sharply, there is a growing sense that telehealth can help people better manage their health and improve access to care. Telehealth could be especially valuable in areas where health professionals and facilities are sparse, potentially leading to improved outcomes for many people.”
PCORI Research Spotlight on Telehealth

Telehealth is an area of research frequently funded through PCORI. The organization supports research that typically compares the effectiveness between healthcare options for treatment, including whether a virtual house call would be more effective for a particular patient, or if a traditional on-site clinical encounter would yield a better outcome. For example, PCORI-funded research could answer key questions for both patients and physicians in the area of telehealth such as:

• Clinical provider
  If my patient with chronic diabetes or high blood pressure tracked their health at home by monitoring blood sugar or blood pressure, would their outcomes be better or worse than coming in for an on-site appointment? Would remote monitoring with telehealth devices and a phone call or video conference put my patient at risk – or better serve their needs?
• Patient
  Will my health suffer if I don’t travel to see my doctor, instead of talking to my clinician on my personal digital device? Will the doctors miss a crucial bit of information if I don’t meet them at their office? Could I save time and money but get the same or better care from my home?

These are precisely the kinds of questions that are answered in the types of telemedicine research that PCORI funds. The goal is to compile enough clinical evidence on telehealth tools to help doctors and patients make better healthcare choices about when – and if – they should use telehealth to improve patient outcomes.

What are the kinds of telehealth research and the outcomes funded by PCORI to-date?

PCORI has invested more than $305 million to fund dozens of telehealth projects. These projects have sought to use telehealth technology to:

• Promote patient self-management.
• Improve patient education and population health.
• Address disparities in treatment for vulnerable populations.
• Remote monitor chronic conditions and improve care delivery.
• Improve access to healthcare treatment.

One study sought to compare the use of a smartphone app against a peer-led on-site program to help people with serious mental illness. The study found no difference between face-to-face care delivery and the telehealth application in the areas of:

• The level of satisfaction patients felt with the care delivery they received, whether in-person or virtual.
• The level of recovery and the quality of life patients experienced, whether the treatment was via the phone app or on-site.
• The reduction in disease modality was the same, with patients experiencing lower levels of depression, anxiety, or other mental health issues whether they received in-person counseling or used the smartphone app.

While PCORI continues to fund telemedicine outcomes-based research, it’s clear that these tools hold promise for improved health outcomes and clinical care delivery.

OrthoLive is committed to telehealth. We offer a tool that can help even the smallest practice improve the lives of their orthopedic patients. Call us to find out more.