Chapter 1: The Agency for Healthcare Research and Quality and the Effective Health Care Program

The Effective Health Care Program Stakeholder Guide

The Agency for Healthcare Research and Quality

The Agency for Healthcare Research and Quality (AHRQ) is a Federal agency under the United States Department of Health and Human Services. AHRQ is the lead Federal agency charged with improving the quality, safety, efficiency, and effectiveness of health care for all Americans. The research sponsored, conducted, and disseminated by AHRQ provides information that helps people make better decisions about health care.

For more information, visit the AHRQ Web site.

The Effective Health Care Program

The EHC Program was created from Section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 that authorizes AHRQ to conduct and support research with a focus on comparing the outcomes and effectiveness of different treatments and clinical approaches, as well as communicate its findings widely to a variety of audiences. The Effective Health Care (EHC) program is the nation's first coordinated program of "comparative effectiveness" research. It is the Federal government's leading effort to compare the benefits and risks of various approaches to health care—different drugs, devices, surgeries, and health care delivery arrangements—to determine which approaches work best, for which patients, and under what circumstances. The overall goal of this effort is to improve health outcomes and increase the value of the health care Americans receive.

Before the EHC Program was created, most available evidence-based information was about a single drug, medical device, or procedure tested on one group of patients. Groups such as the elderly, minorities, and individuals with complex medical problems often were not included in the research. These limitations made it difficult for clinicians and their patients to compare options and to select the treatment that was best for them given their unique circumstances. Comparative effectiveness research seeks to overcome these limitations by gathering and analyzing the evidence from multiple sources on currently available treatment options, and focuses on the impact on real patients in real-world settings.

AHRQ has built the EHC Program around the guiding principles of strong involvement of stakeholders and the maintenance of transparency and public accountability. The EHC Program's research supports the overarching goal of providing health care decisionmakers (consumers, clinicians, policymakers and others) with the best available scientific evidence to make informed health care decisions.

EHC Research Priorities

The EHC program sets research priorities based on input from diverse stakeholders. All suggestions for research are carefully considered according to a standard set of criteria. Priority is given to research topics that focus on certain medical conditions. The current medical conditions given priority for research are:

These priority topics relate to health care products or services that (1) impose high costs on the Medicare, Medicaid, or Children's Health Insurance Program (CHIP); (2) may be over- or underutilized; (3) may significantly improve the prevention, treatment, or cure of diseases and conditions which impose high direct or indirect costs on patients or society; and (4) place a great burden on people, especially those who are "priority populations" as identified by AHRQ, including

• Low-income groups.
• Minority groups.
• Women.
• Children.
• The elderly.
• Individuals with special health care needs, such as individuals with disabilities, in need of chronic or end-of-life care, or living in inner-city or rural areas.

Getting the Work Done

The EHC Program achieves its goals by awarding grants and contracts to research centers and clinical investigators to conduct timely and relevant comparative effectiveness research. The program also supports the dissemination and implementation of the research findings.

Key players in the EHC Program include:

• The Evidence-based Practice Centers (EPCs) perform in depth reviews of existing evidence.
• The DEcIDE (Developing Evidence to Inform Decisions about Effectiveness) Research Network generates new data on specific treatments and health care services.
• The Centers for Education & Research on Therapeutics (CERTs) conduct research and educate clinicians and consumers about drugs, biologicals, and medical devices.
• The Scientific Resource Center provides scientific support for the Effective Health Care Program.
• The John M. Eisenberg Center for Clinical Decisions and Communications Science organizes the research results into guides and tools that are useful to clinicians, health care policymakers, and patients.
• Individual investigators and their research groups at academic institutions and other research centers generate new evidence from original research in response to AHRQ grant opportunities.

For more information about each of the EHC Program components, visit the Effective Health Care Web site at http://www.effectivehealthcare.ahrq.gov/index.cfm/who-is-involved-in-the-effective-health-care-program1/.