Our Mission Patient-Centered Healthcare Must Be the Future of American Medicine
With aging as our focus, our programs evaluate and compare healthcare delivery systems, as well as design, test and disseminate novel interventions to improve decision making. Patient-centered healthcare must be the future of American medicine.
The UTMB PCOR Center contributes to both national and local efforts by generating data relevant to decision making across disease processes and medical care settings. Patient-Centered Outcomes Research (PCOR) incorporates the realities that treatment outcomes may be different in different individuals and that patients' priorities and goals of treatment also vary. PCOR relies on input from patients and families as well as healthcare professionals.
UTMB was awarded a $4.97 million dollar grant (R24HS022134) in 2013 from the Agency for Healthcare Research and Quality (AHRQ) to conduct patient-centered outcomes research. Dispersed over a five-year period, the federal grant is being used to establish the infrastructure for a center on Patient-Centered Outcomes Research in the Elderly. Read the full news release.
Our AHRQ PCOR Infrastructure Development Grant is being used to transform UTMB into a center of rigorous, high quality, comparative effectiveness research (CER) and patient-centered outcomes research (PCOR), focused on healthcare decision-making facing older individuals, their providers, and the health systems providing their care. Our efforts involve multiple aspects of UTMB and the elderly: the aging communities we serve, their providers, and the administrators and clinical leaders responsible for implementing models of care.
We work within UTMB to understand current evidence-based best practices, and apply them to UTMB systems of care. Important goals of this work are to include on-going input and collaboration with patients and other stakeholders, and to identify or develop systems that reduce racial, ethnic and age associated disparities in health outcomes using patient-centered approaches.
The specific aims of PCOR at UTMB are:
- Establish structures for ongoing participation of key stakeholder groups and the larger community.
- Provide training and education in PCOR for UTMB investigators, clinical leadership, providers, administration, and students, with the training programs tailored to meet the needs of the different communities receiving training.
- Establish a robust infrastructure for sustainable growth and productivity in PCOR/CER.
- Conduct rigorous PCOR relevant to aging.
- Disseminate findings from PCOR/CER generated at UTMB and at other centers to the UTMB communities, and to stakeholders regionally and nationally.
- Ongoing, active evaluation of all our efforts, to allow for modifications.
Our Center is currently involved in three main research projects:
- Research Project 1: Comparative Effectiveness of Screening Mammography for Women with Limited Life Expectancy . This project relates to the question of whether or not women aged 70 and older should continue to receive yearly mammograms. Research indicates there are unnecessary risks associated with over-diagnosis of breast cancer, particularly when a patient's life expectancy is limited prior to the screening. This project incorporates the priorities of individual patients to develop a tool to inform and assist patients in their decisions regarding breast cancer screening.
- Research Project 2: Comparative Effectiveness of Patient-Centered Outcomes Following IRF and SNF Stroke Rehabilitation. The second project examines the rehabilitation services assigned to patients who have experienced a stroke. Currently, there are primarily two types of rehabilitation offered to these patients - an inpatient rehabilitation facility (IRF) or skilled nursing facility (SNF) services - but little is known about which type of care provides better outcomes for patients based on their own goals and priorities. Research from this project is being used to develop a decision support tool to ultimately improve the outcomes of rehabilitation services for stroke patients.
- Research Project 3: Community Dialogue to Identify Ethical Issues in PCOR. The third project expands on existing research regarding ethical issues related to PCOR. These ethical issues include rationing of scarce healthcare resources and the determination of when medical interventions become futile, or useless, and should therefore be discontinued. This project engages members of the community in order to include their voices in the discussion of ethics and PCOR and ultimately improve how ethical issues are addressed with regards to healthcare provision.
Patient-Centered Outcomes Research in the Elderly is led by James S. Goodwin, MD, Vice President and Chief Research Officer at UTMB. Funding is provided by the U.S. Agency for Healthcare Research and Quality (AHRQ), partnered with the Patient-Centered Outcomes Research Institute (PCORI). View information about the other PCOR Infrastructure Development Grants at the AHRQ website.