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AHRQ is preparing to make new and historic investments to disseminate and implement evidence-based innovations to improve patient and provider experience and advance healthcare delivery. Our goal is to achieve better health outcomes by keeping the needs of patients at the forefront, with a focus on underserved populations.

This rare and exhilarating opportunity is made possible by dedicated funding via the Patient-Centered Outcomes Research (PCOR) Trust Fund. Over ten years, AHRQ expects to invest approximately $100 million per year on high-impact initiatives to move local healthcare systems closer to providing more equitable, whole-person care across the lifespan.

Today, we are excited to share AHRQ’s blueprint to guide these investments: a Strategic Framework for the Patient-Centered Outcomes Research Trust Fund (PDF, 4.4 MB). The Strategic Framework, an important milestone in the Agency’s ongoing efforts to advance patient-centered outcomes research and dissemination, results from extensive collaboration with diverse healthcare interests.

Following the 2020 reallocation of the Trust Fund, AHRQ embarked on extensive deliberation and strategic planning with staff across the Agency. A draft Strategic Framework, released in 2022, specifically solicited external stakeholder input. Feedback was robust from dozens of organizations representing views from the academy, clinical practice, government, private health insurance, and community and patient advocacy.

AHRQ also commissioned at the National Academy of Science Engineering and Medicine and hosted several technical expert panels and a broad group of subject matter experts. Finally, a PCOR subcommittee provided recommendations adopted by AHRQ’s National Advisory Council. Recommendations were wide-ranging, and each was carefully considered. Over 800 pages of external stakeholder feedback were synthesized into a full report (PDF, 774 KB).

An analysis of feedback on the Strategic Framework revealed six major themes:

• Formal processes are needed to ensure stakeholder engagement throughout the research process. Research findings must be provided to communities in assessable and actionable formats for sharing with the public, policymakers, healthcare executives, clinical leaders, and others.
• Advancing health equity should be a guiding principle applicable to all framework areas rather than a stand-alone pillar. Positive outcomes, not simply documentation of inequities, were described as a critical goal.
• Erosions in trust must be recognized and addressed. Trust among patients and providers must be prioritized and extended to co-creating new and meaningful ways to achieve whole-person care.
• Issues of cost and affordability must be at the forefront. Commenters encouraged ongoing transparency of healthcare costs among patients, providers, and payers and suggested enhanced partnerships among Federal and State agencies to advance high-value care.
• Investing in training and workforce development is imperative to sustain the necessary pipeline of frontline healthcare professionals to build regional, collaborative healthcare workforce communities to further person-centered care.
• Ultimately, success will be measured by evaluating implementation and impact. Continued learning must occur to inform future initiatives and build the capacity for strategies shown to improve patient outcomes. 

The final Strategic Framework that emerged from this feedback included a foundational commitment to health equity, with consideration for AHRQ’s priority populations in all investments. Stakeholders emphasized that all initiatives should use a health equity “lens” and put patients at the center to allow for sustained, interactive, and meaningful engagement of stakeholders at all stages of the change process, “Nothing about us without us!”

The Framework identifies four main priorities for AHRQ’s investments:

1. High-quality, safe care aligned with national health priorities.
2. Prevention and improved care for people with multiple chronic conditions.
3. Patient, family, community, and provider experience of care that enhances trust in the healthcare system.
4. Primary care transformation that includes leveraging digital and clinical decision support and new models of team-based care and integrated behavioral and mental healthcare.

Ultimately, AHRQ’s Strategic Framework provides 10 cross-cutting strategies that reflect our deliberative process and are designed to guide the Agency’s goal of advancing equitable, whole-person care across the lifespan. These strategies are grouped in three broad areas:

• Building national capacity to disseminate and implement actionable knowledge into practice rapidly.
• Supporting implementation of new knowledge into practice at State and local levels.
• Training and supporting the next generation of health services researchers focusing on interdisciplinary team science, understanding community needs, and advancing health equity.

AHRQ is already in the implementation phase of our Strategic Plan. We are launching a unique PCOR training program responsive to our Strategic Framework priorities. The Learning Health System Embedded Scientist Training and Research Centers, a collaboration between AHRQ and the Patient-Centered Outcomes Research Institute, are generating great excitement nationwide.  And stay tuned; additional exciting national initiatives are in the pipeline.

We encourage our partners and stakeholders to use and reference the Strategic Framework in their work. Together, we can use this resource as a roadmap to explore meaningful and effective healthcare advancements that benefit all Americans.

Dr. Valdez is director of AHRQ. Dr. Rhodes is AHRQ’s chief implementation officer.

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