Round Table: International Experiences in Research Governance Patricia Pitman June 10, 2008

PANELISTS  Carolyn Clancy, Director of Agency for Healthcare Research and Quality (AHRQ)  Sharon Arnold, Director of Robert Wood Johnson Foundation’s Health Care Financing and Organization Initiative (HCFO)  Susan Law, VP of Research and Evaluation and the Canadian Health Services Research Foundation (CHSRF)  Kieran Walshe, Research Director Dept of Health’s Institute for Health Research Service Delivery and Organization Research Program (SDO)

Institutional Differences Ownership Mission Budget Size Focus

POLICIES & APPROACHES Priority setting Funding modalities Knowledge transfer Impact assessment

AHRQ 1.Goal: Improve quality, safety, effectiveness and efficiency of health care for all Americans. 2.Focus: (full spectrum) Portfolios: Health IT; Care Management and Prevention; Patient Safety and Quality; Comparative Effectiveness Research; Value-Based Health Care; Emerging Issues and Innovations 3. Funding source: Congressional appropriations 4.Total Budget: $334.5 M, $KT 4-5M, $27.4 M for training researchers 5.Other HSR Funders: NIH, CDC, VA, foundations 6. Challenges: Balancing investments in business lines (research and data, synthesis and tools and dissemination and implementation) Best approaches to KT and dissemination / implementation.

1. Goal: To fund policy relevant research in healthcare financing and organization 2. Focus: Changes in health care financing and organization that have implications for public policy. 3. Funding source: RWJF, which determines the amount. 4. Budget: Base of $3M, with additional funding for special solicitations. 5. Other HSR Funders: Federal government is primary funder (NIH, AHRQ, VA and CDC), but among foundations RWJF is largest. 6. Challenge :  Evaluating the policy relevance of proposals  Disseminating the research findings to policymakers who can use them. HCFO

1.Goal: To promote evidence-informed decision-making in healthcare management and policy. 2.Focus: Research topics are theme-based following national consultation exercise every 3-4 years. Currently they are: quality and safety; healthy workplaces; change management; decision-making 3.Funding source: Endowment from federal government : $151.5M 4.Budget: Annual budget: $13-15M –research: $3M –training for researchers: $2M –KT: $1.8M –training for research use $3.4M –program and adm. support: $4.5M 5.Other HSR Funders: Institute of Health Services and Policy Research, = other institutes in Canadian Institutes of Health 5.2 m. ….or 4% of total health research. 6. Challenge: Evaluation of impact (demonstrating value-added for investment in HSPR – related to long-term sustainability) CHSRF

1. G oals: – Commission research AND produce evidence – Build capacity amongst those who manage services to conduct research and to understand and use research literature 2. Focus: Healthcare service delivery and organization. 3. Funding source: part of the Department of Health. Budget set annually by negotiation with the DH Director General for Research. 4. Total budget: Commissioned research currently $16M per year, but will increase to $24M over the next two years. $5M will go to KT. 5. Other HSR Funders?: The Department of Health has a separate policy research program that spends around $60M. Some research is also commissioned by the Economic and Social Research Council, charitable research funders, and other bodies. 6. Challenge : KT: Build stronger links with and support from the NHS management community for our research, and to see much more effective processes for knowledge mobilization and utilization. SDO

1.Approaches to Priority-Setting and Proposal Selection  How do you set research priorities?  What is the balance of stakeholder involvement?  How is relevance or potential system impact assessed at the proposal stage?

2. Funding Modalities  What is the spectrum of funding mechanisms and project types you use for different objectives?  What are the trade-offs of different models?

3. Knowledge Transfer  Budget allocated to KT?  Range of mechanisms and tools used?  Repercussions of increased attention to KT?  Role in influencing university culture?

4. Impact Assessment  Are you accountable for demonstrating the impacts of your investments and, if so, to whom?  What is being measured and how?  Any changes in policy as a result of assessments?