Sarah Greene on Comparative Effectiveness Research and Patient Engagement

In just 5 years there have been amazing improvements in the healthcare industry’s ability to conduct comparative effectiveness research, said Sarah Greene, MPH, former associate director, CER Methods & Infrastructure Program at the Patient-Centered Outcomes Research Institute.

How has healthcare improved its capacity to conduct comparative effectiveness research and what improvements would you like to see?

Oh it’s just amazing to think about where we were 5 years ago and where we are today. It’s just an exciting moment. We see both individual systems that are doing tremendous work in bridging the gap between research and practice, and they’re really becoming a model for other systems.

I think no one can ignore the notion that we have got to do more to close the gap between what we know in terms of the evidence and what we do in practice. We’re not quite there yet, but I’m excited to think 5 years from now how far we’ll have come.

What is the importance of patient engagement in the learning healthcare system?

Patients are pivotal for all the obvious reasons. There are no patients without data; there are no data without patients. But I think really what’s most important is that patients can drive the change. They can encourage the systems to do research. They can be more empowered and be more of a partner, really reducing the information asymmetry, because if a patient is more informed and more engaged about their healthcare, they can partner with their doctor, they can share in decision making, they can help talk through preferences if it comes to a choice between treatment A and treatment B.

So I think patients are the lynchpin and they’re really going to propel this whole notion of a learning health system forward.

With the vast amount of health data being collected, how can providers and researchers ensure that they are collecting useful data and that it is being used meaningfully?

I think that the utility of a given piece of data really is going to be in the eye of the beholder in a lot of cases. Certainly you can imagine that things like a lab value or results of an imaging are going to be vital at the point of care, they are going to be important to the patient, but I think we have to think about the overall fabric of healthcare and that it’s about putting all of the data items together.

So one data variable may not seem useful in and of itself, but it’s the assemblage of all of the data that really makes a huge difference. So it’s hard to say to a provider, ‘this piece data is more useful or less useful than that piece of data.’ It’s all got utility and it’s just a matter of being really intentional and thoughtful about how we use it and how we put it together.