Saturday, December 17, 2011

Patient-Centered Care Discussed

The ECRI Institute’s 18th Annual Conference “Patient-Centeredness in Policy and Practice” co- organized by FDA was held late November in Silver Spring, Maryland. The conference attendees gathered to hear presentations and panel discussions centered on defining patient-centeredness, what programs are currently working, and does patient-centeredness have staying power?

Presenters including leading policy makers such as Margaret Hamburg, MD Commissioner FDA, Carolyn Clancy, MD, Director AHRQ, Jeffrey Shuren, MD, JD, Director for Devices and Radiologic Health at FDA, Janet Woodcock, MD, Director, Center for Drug Evaluation and Research, at FDA, and Joe V. Selby, MD Executive Director for the Patient-Centered Outcomes Research Institute.

Joel Kuppersmith MD, Chief R&D Officer at the Veterans Health Administration presented a comprehensive picture of how patient-centered care is helping the veteran population. As Dr. Kuppersmith noted, the VA is a large system with 8 million enrollees and treats 6 million patients per year at 1200 sites of care.

He reported that the VA is meeting the need for patient-centered care through the use of telehealth technologies, through community-based clinics, and via secure messaging. He described how in general our current care model should transition to patient-centered care by focusing on the person’s, culture, preferences, and lifestyles.

Kuppersmith discussed how the VA’s assets are being utilized to move to patient-centered care. This is being achieved through the use of the VA’s Electronic Health Record to provide computerized decision support, the VA’s ability to access sophisticated national databases containing clinical and administrative data, the VA’s extensive experience in working with quality and performance measures, and the fact that the VA research program is embedded in the healthcare system.

To better manage care, veterans need to have a primary point of contact within the healthcare system using a team approach to manage their care, assist in coordinating their care including transitions in and out of hospitals, and provide more proactive care management if needed.

One of the VA’s assets is the Quality Enhancement Research Initiative (QUERI) that studies and facilitates the transfer of new treatments, tests, and models of care into routine clinical practice. QUERI is looking specifically at what is needed to provide patient-centered care, how to increase the options for access and empowering patients to manage their own health care and make individual treatment decisions, how to make systems and clinical improvements to support the veterans care, and determine the research needed to address specific unanswered issues.

Just recently, QUERI and the Office of Specialty Care Transformation have been funded to develop a model that emphasizes specialty care support for the “Patient Aligned Care Team” assigned to the veteran to help manage their chronic diseases.

Looking down the road, the VA wants to help veterans obtain the best and most complete care. To meet this need, the VA developed the “Million Veteran Program” (MVP) to create a genomic database over 5-7 years to provide genetic information for one million veterans in the healthcare system.

MVP is in place to provide genomic customization or treatments and treatments based on gene expression. The program’s database will have DNA specimens and link to tissue specimens, provide access to the VA EHR system, have IT capability to identify patients for a variety studies, and have the use of the latest analytical tools.

Go to for more information on the Conference.