PCORI and Micro-Contracts

Susan Woods responded to my previous post, PCORI and Just-In Time Decisions with the research funding system doesn’t really work for anyone. It is in concrete, Agreed.  Micro Contracts could be a small intervention that could help move the dial. (As a reminder, the Boston contingent of PCORI ambassadors, including S4PM member, Ken Farbstein, made three recommendations to the PCORI Board.) This is a report on the second recommendation.

Patient-driven, patient-centric research opportunities are less likely to be prepared to submit high scoring proposals than traditional research teams.

Many professionals and patients don’t yet appreciate the innovation that patient-professional partnerships bring. We’re all patients is a common refrain from professionals when entering into collaboration with patients for the first time. That may be true, yet if that were enough, our health care system would have achieved a level of patient-centeredness that would render initiatives like PCORI unnecessary. Including people who are able work collaboratively while still retaining the unique vantage point of their own stakeholder group is critical to producing ideas innovative enough to handle the challenges our health care system is facing.
The Boston PCORI ambassadors found that

  1. PCORI’s current structure of supplying large grants to a small number of projects favors established research teams and paradigms.
  2. Alternative, nacient teams are less likely to receive highest scores in grant proposal requests.
  3. Research projects addressing partnership innovation, cultural change, social and behavioral determinants, or dissemination are likely not to be funded.

Therefore ambassadors recommended that PCORI:

  • Allocate a defined proportion of funding for a larger number of smaller projects in the form of micro-contracts that either prepare a submitting team for a high scoring large grant or addresses research into partnership innovation, cultural change, social and behavioral determinants, or dissemination.

Apparently, PCORI is considering this recommendation. I’m looking forward to following their next steps.

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3 Responses to “PCORI and Micro-Contracts”

  1. Nancy Finn says:

    I looked at the PCORI proposal way back and came to the same conclusion that the grants would go to established research teams because they have the resources to make the best proposals and to execute larger projects. I therefore did not pursue this avenue because I felt it would be a time-drain that would not lead to anything.

    I think that the idea of pushing for micro-contracts that would enable individual members of SPM to team up and work toward our common goals is brilliant and support it completely.

  2. Nora Miller says:

    It seems to me that the answer to “we’re all patients” is “Yes, but not all of us are healthcare professionals,” meaning while everyone becomes a patient at some point, the experience of being a patient when NOT an HCP is fundamentally different. There is a similarly fundamental difference between large, established research teams and grassroots, agile research projects that would qualify for micro-contracts. Large teams are ill-equipped to take advantage of micro-contracts–their overhead makes such projects unprofitable. On the other hand, small teams with highly focused innovative ideas can accomplish a lot with very little funding. It only makes sense to pursue both pathways, in my opinion!

  3. I have been in contact with PCORI since its’ inception. The promise of patient centered research into the #1 expenditure of Medicare – joint replacements would provide patients with actionable information prior to implantation. Currently patients have less information on FDA approved implants than a shopper does on a toaster oven (from Consumer Reports) – and that comes with a warranty! Thousands of metal on metal hip and surgical mesh lawsuits highlight the need for transparent, independent reporting/clinical trials. Why does PCORI not respond?

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