Director's Update

National Advisory Council, November 2011

On November 4, 2011, Nancy E. Donaldson, Arthur (Tim) Garson, Junius J. Gonzales, Lisa M. Latts, Keith J. Mueller, Xavier Sevilla, Bruce Siegel and Jane Sisk made this presentation at the meeting of the National Advisory Council.

Slides

  1. Director's Update.
  2. NAC Members With Expiring Terms.
  3. Overview.
  4. FY 2012 Budget Proposal.
  5. Overview.
  6. Nighttime-Breathing Treatments Most Effective to Treat Sleep Apnea.
  7. Guides Help Spanish Speakers Make Treatment Decisions.
  8. Guides Compare Benefits, Risks of Treatments for GERD.
  9. DMARDs Effective in Treating Juvenile Arthritis.
  10. Little Evidence for Some 'Off-Label' Uses of Atypical Antipsychotic Drugs.
  11. Birth Defects May Be Linked to Hypertension, NOT Treatment.
  12. Formal Parent Training Effective To Treat Young Children With ADHD.
  13. AHRQ Creates Clinical Preventive Services Research Centers.
  14. Research Centers for Excellence in Clinical Preventive Services.
  15. In the News.
  16. Knowledge Transfer Case Study: Washington State Medicaid.
  17. Knowledge Transfer Case Study: Hawaii Dept. of Human Services.
  18. MEPS Impact Citation Private Sector Uses.
  19. MEPS Impact Citations Private Sector Uses.
  20. MEPS Impact Citations Public Sector Uses.
  21. Missouri Department of Health and Senior Services.
  22. Health Literacy Missouri: University of Missouri Center for Health Policy.
  23. Fletcher Allen Health Care (VT).
  24. OSF Medical Group (IL/MI).
  25. Spanish Catholic Center of Catholic Charities (DC).
  26. Overview.
  27. Health Care Innovations Exchange: Find Innovations by State.
  28. Questions are the Answer: 2011.
  29. Added Focus on Prioritizing.
  30. Patient Engagement is a Team Sport.
  31. Infrastructure for Maintaining Primary Care Transformation (IMPaCT).
  32. IMPaCT Grantees.
  33. Update From the U.S. Preventive Services Task Force.
  34. New Efforts to Increase Transparency & Stakeholder Engagement.
  35. First Annual Report to Congress.
  36. 2011-2015 CERTs Centers.
  37. New Research From Effective Health Care Program—Stents in CKD.
  38. New Research From Effective Health Care Program—Child ADHD.
  39. New on AHRQ's Public Reporting Front.
  40. New Work Underway: Feasibility of Collecting Data on Physicians and Their Practices.
  41. Significant Findings: AHRQ's HIV Research Network (HIVRN).
  42. News From AHRQ's Healthcare Cost and Utilization Project (HCUP).
  43. Consumer Health IT in the Home: Design Considerations.
  44. Health Care Comes Home: The Human Factors.
  45. Active Aging Research Center.
  46. Award of Pathways to Quality.
  47. 2010 MEPS-IC Family Premium Estimates Now Available for Use in Setting State Tax Credits for Small, Private Sector Firms Under Health Care Reform.
  48. MEPS Informs Policy and Practice.
  49. Advancing HHS Data Strategy and Planning Efforts.
  50. Consumer Assessment of Health Providers and Systems (CAHPS®).
  51. National Healthcare Quality and Disparities Report (NHQR/DR.
  52. Patient Safety Organizations (PSOs).
  53. AHRQ Patient Safety Portfolio.
  54. AHRQ Annual Conference.
  55. NAC Subcommittee.
  56. Today's Agenda .

Slide 1. Director's Update

Text Description is below the image.

Carolyn Clancy, MD
National Advisory Council
November 4, 2011 

Top of Page

Slide 2. NAC Members With Expiring Terms

Text Description is below the image.

  • Nancy E. Donaldson.
  • Arthur (Tim) Garson.
  • Junius J. Gonzales.
  • Lisa M. Latts.
  • Keith J. Mueller.
  • Xavier Sevilla.
  • Bruce Siegel (Chair).
  • Jane Sisk—retired from CDC. .

Top of Page

Slide 3. Overview

Text Description is below the image.

  • The Big Picture
    • FY 2012 Budget Request.
  • Recent Accomplishments:
    • In the News.
    • Impact Case Studies.
  • AHRQ Program Updates.
  • Today's Agenda. .

Top of Page

Slide 4. FY 2012 Budget Proposal

Text Description is below the image.

  • The President's proposed Fiscal Year 2012 budget for AHRQ includes:
    • $65 million for patient safety research, including $34 million to reduce and prevent healthcare-associated infections.
    • $46 million for patient-centered health research, of which $24 million comes from the Patient-Centered Outcomes Research Trust Fund.
    • $28 million for health information technology. .

Top of Page

Slide 5. Overview

Text Description is below the image.

  • The Big Picture:
    • FY 2012 Budget Request.
  • Recent Accomplishments:
    • In the News.
    • Impact Case Studies.
  • AHRQ Program Updates.
  • Today's Agenda. .

Top of Page

Slide 6. Nighttime-Breathing Treatments Most Effective to Treat Sleep Apnea

Text Description is below the image.

  • AHRQ comparative effectiveness report on treating sleep apnea:
    • Estimated 12 million Americans have sleep apnea; millions more undiagnosed.
    • "CPAP" breathing machine most effective.
    • Mouthpiece worn at night also effective.
    • All treatments have possible side effects.

http://www.effectivehealthcare.ahrq.gov

Image: A photograph of a sleeping man is shown. 

Top of Page

Slide 7. Guides Help Spanish Speakers Make Treatment Decisions

Text Description is below the image.

  • Guides in Spanish discuss treatment options for:
    • Heart disease.
    • Managing pain from broken hip.
    • Rotator cuff tears.
    • Depression after brain injury.
    • Human growth hormone for children with cystic fibrosis.
    • Radiotherapy for head and neck cancer.
  • AHRQ offers Spanish guides for a total of 23 different conditions.

http://www.effectivehealthcare.ahrq.gov/index.cfm/research-summaries-for-consumers-clinicians-and-policymakers/informacion-en-espanol/.

Images: The covers of three Spanish-language guides are shown. 

Top of Page

Slide 8. Guides Compare Benefits, Risks of Treatments for GERD

Text Description is below the image.

  • Plain-language summary guides for clinicians and consumers, based on evidence review from Effective Health Care Program.
  • Compare treatments for GERD (gastroesophageal reflux disease).
  • Proton pump inhibitor medications are effective, but no differences between types and dosages.
  • GERD (also known as acid reflux) affects up to 4 percent of Americans, costing an estimated $3,355 annually per patient.

http://www.effectivehealthcare.ahrq.gov

Image: The cover of the GERD report is shown. 

Top of Page

Slide 9. DMARDs Effective in Treating Juvenile Arthritis

Text Description is below the image.

  • AHRQ comparative effectiveness report on treating juvenile arthritis:
    • Affects up to 400 of every 100,000 children in the USA.
    • Development of disease-modifying anti-rheumatic drugs (DMARDs) has improved treatment of arthritis.
    • DMARDs more effective than traditional treatments in improving symptoms.
    • Long-term effects unknown.

http://www.effectivehealthcare.ahrq.gov

Image: The cover of the DMARDs report is shown. 

Top of Page

Slide 10. Little Evidence for Some 'Off-Label' Uses of Atypical Antipsychotic Drugs

Text Description is below the image.

  • Effective Health Care Program report shows little evidence to support off-label use of atypical antipsychotic medications (APMs) for substance abuse, eating disorders, or insomnia.
  • Evidence does support use of some atypical APMs for dementia, anxiety, and obsessive-compulsive disorder.

http://www.effectivehealthcare.ahrq.gov

Image: The first page of the executive summary for the off-label use of atypical antipsychotic medications report is shown. 

Top of Page

Slide 11. Birth Defects May Be Linked to Hypertension, NOT Treatment

Text Description is below the image.

  • Taking angiotensin-converting enzyme (ACE) inhibitors in first trimester of pregnancy poses no greater risk of birth defects than other high blood pressure medications or no drugs at all.
  • Findings suggest high blood pressure itself may increase risk of birth defects, rather than treatment.
  • ACE inhibitors are widely prescribed to treat hypertension.
  • New study from Effective Health Care Program's DEcIDE Network published in BMJ.

Li DK, Yang C, Andrade S, et al. Maternal exposure to angiotensin converting enzyme inhibitors in the first trimester and risk of malformations in offspring: a retrospective cohort study. BMJ 2011; 343:d5931

Image: The first page of the cited BMJ article is shown. 

Top of Page

Slide 12. Formal Parent Training Effective To Treat Young Children With ADHD

Text Description is below the image.

  • AHRQ comparative effectiveness review on attention deficit-hyperactivity disorder (ADHD) intervention and evaluation:
    • Approximately 5 percent of children worldwide diagnosed with ADHD.
    • Formal training for parents is effective and does not harm children age 6 and under.
    • Less evidence supporting use of drugs such as Ritalin to treat children age 6 and under.

http://www.effectivehealthcare.ahrq.gov

Image: The cover of the ADHD report is shown. 

Top of Page

Slide 13. AHRQ Creates Clinical Preventive Services Research Centers

Text Description is below the image.

  • 3-year grants totaling $4.5 million:
    • Research focuses on improving clinical preventive services.
    • Advances national research agenda in health equity, patient safety, and health systems implementation.
    • Three centers:
      • Northwestern University in Chicago.
      • University of North Carolina at Chapel Hill.
      • University of Colorado Anschutz Medical Campus.

Images: Photographs of buildings at the three clinical preventive services research centers are shown.

http://www.ahrq.gov/about/cp3/ 

Top of Page

Slide 14. Research Centers for Excellence in Clinical Preventive Services

Text Description is below the image.

  • Centers will complement other Federal investments in prevention and public health by focusing on the role of primary care in improving the health of all Americans.
  • Designed to support the National Prevention Strategy.
  • Three focus areas:
    • Safety: University of North Carolina at Chapel Hill.
    • Equity: Northwestern University.
    • Implementation: University of Colorado.
  • 3-year initial awards (with potential competitive renewal).
  • $1.5M per year per award.
  • Initially funded through the Patient Protection and Affordable Care Act (ACA) Prevention & Public Health Fund. .

Top of Page

Slide 15. In the News

Text Description is below the image.

The Dallas Morning News reported on patient safety in TX hospitals using the AHRQ Patient Safety Indicators, Sunday, Oct. 16, 2011

Image: A page from the Dallas Morning News shows articles titled "How The News did the Texas hospital patient safety analysis" and "Most area hospitals lag in safety, data shows." 

Top of Page

Slide 16. Knowledge Transfer Case Study: Washington State Medicaid

Text Description is below the image.

  • AHRQ's Effective Health Care Program (EHC).
  • Used 6 EHC products:
    • Vaginal Birth After Cesarean: to design new program.
    • Cesarean Delivery on Maternal Request: to enact legislation to develop patient decision aids.
    • Comparative Effectiveness of Management Strategies for Gastroesophageal Reflux Disease: to initiate clinical decisionmaking algorithm resulting in savings.

Image: An illustration captioned "Gastroesophageal Reflux" shows a stomach and how the lower esophageal sphincter opens to allow reflux.

Photo: MedicineNet, Inc. 

Top of Page

Slide 17. Knowledge Transfer Case Study: Hawaii Dept. of Human Services

Text Description is below the image.

  • Consumer Assessment of Health Providers and Systems (CAHPS®) Survey and Medicaid Medical Directors Learning Network:
    • Used survey findings for public reporting and pay-for-performance initiatives.
    • Found that CAHPS Health Plan Survey's instruction reduced likelihood of bias and error.
    • Developed consumer guide using CAHPS results for adult care.
    • Members use performance information to choose plans based on quality of care. .

Top of Page

Slide 18. MEPS Impact Citation Private Sector Uses

Text Description is below the image.

  • Medical Expenditure Panel Survey (MEPS) data used in various ways:
    • By Kaiser Family Foundation as a source of online query tools in slide tutorial providing overview of health policy data source.
    • By Duke University to study whether use of physician assistants increases office visits.
    • By Deloitte Health Solutions to develop estimates of health expenditures by family size and income level for the report, The Hidden Costs of U.S. Health Care for Consumers: A Comprehensive Analysis.
    • By Johns Hopkins University's Joint Center for Political and Economic Studies to estimate potential cost savings of eliminating health disparities for racial and ethnic minorities. .

Top of Page

Slide 19. MEPS Impact Citations Private Sector Uses

Text Description is below the image.

  • Mayo Clinic:
    • Used Medical Expenditure Panel Survey (MEPS) data to describe incidence of transitions to and from Medicaid and to characterize populations and determine whether insurance instability is associated with changes in health care utilization.
  • New America Foundation:
    • Used MEPS data in report on health insurance reform to illustrate how administrative costs could reach 45% for families purchasing non-group health insurance. .

Top of Page

Slide 20. MEPS Impact Citations Public Sector Uses

Text Description is below the image.

  • Oregon Department of Consumer and Business Services:
    • Used Medical Expenditure Panel Survey (MEPS) data on average total monthly group health insurance premiums in Health Insurance in Oregon, a yearly report for policymakers. .

Top of Page

Slide 21. Missouri Department of Health and Senior Services

Text Description is below the image.

  • AHRQ's Safety Net Monitoring Initiative: Tools for Monitoring the Health Care Safety Net and the Healthcare Cost and Utilization Project (HCUP):
    • Used in compiling first report of status of Missouri's safety net.
    • Analyzed 118 measures of county-level safety net.
    • Ranking system highlighted counties with limited access, gaps in services, shortages of providers.
    • Policymakers can now identify priority areas in need of resources. .

Top of Page

Slide 22. Health Literacy Missouri: University of Missouri Center for Health Policy

Text Description is below the image.

  • AHRQ's Health Literacy Universal Precautions Toolkit:
    • Incorporated into practice management module for health literacy training, coaching for physicians.
    • Physicians work with literacy expert to develop plan for their practice.
    • Module approved by American Board of Internal Medicine as Maintenance of Certification program.

Image: A photograph shows a physician assisting a women filling out a form.

Photo: Arkansas Progressive. 

Top of Page

Slide 23. Fletcher Allen Health Care (VT)

Text Description is below the image.

  • AHRQ's Staying Healthy and Active with Blood Thinners:
    • Incorporated into inpatient TV system and hospital patient education.
    • DVD had highest viewership of all educational listings.
    • Reaches 10-15 patients each week.
    • Coupled with individual education by a pharmacist and review of information with a nurse at discharge.

Image: The cover of the Staying Healthy and Active with Blood Thinners pamphlet is shown. 

Top of Page

Slide 24. OSF Medical Group (IL/MI)

Text Description is below the image.

  • AHRQ's Staying Active and Healthy with Blood Thinners:
    • Included in educational program helping patients safely manage anticoagulation therapy.
    • Used in primary care anticoagulation clinics in 5 regions, 1 hospital.
    • Clinics treat about 3,800 patients.
    • Links electronic medical record to AHRQ's anticoagulation education material.

Image: The cover of the Staying Healthy and Active with Blood Thinners pamphlet is shown. 

Top of Page

Slide 25. Spanish Catholic Center of Catholic Charities (DC)

Text Description is below the image.

  • U.S. Preventive Services Task Force Recommendations & ePSS:
    • Developed comprehensive preventive health screening flowchart that uses recommendations from USPSTF and Centers for Disease Control and Prevention.
    • Trained clinicians on how to use AHRQ's electronic Preventive Services Selector (ePSS) on handheld devices and computers.
    • Flowchart and training used in two medical clinics in DC.

Image: A photograph shows a hand holding a PDA and using the electronic Preventive Services Selector (ePSS) tool. 

Top of Page

Slide 26. Overview

Text Description is below the image.

  • The Big Picture:
    • FY 2012 Budget Request.
  • Recent Accomplishments:
    • In the News.
    • Impact Case Studies.
  • AHRQ Program Updates.
  • Today's Agenda. .

Top of Page

Slide 27. Health Care Innovations Exchange: Find Innovations by State

Text Description is below the image.

Image: Screen shot from AHRQ's Health Care Innovations Exchange Web site, showing a page titled "Find Innovations by State." A map of the United States is shown, and Kansas is highlighted. 

Top of Page

Slide 28. Questions are the Answer: 2011

Text Description is below the image.

  • New ads running this fall in medical journals, including NEJM, JAMA, American Family Physician, Annals of Internal Medicine, Journal of the American Academy of Physician Assistants, Journal for Nurse Practitioners, etc.
    • Focus group feedback from patients indicates that they feel physicians are rushed and don't have time for questions.
    • Primary care physicians and nurses say patients need to prioritize questions (no time to go over every study found on the Internet).

Image: A Questions are the Answers ad is shown. 

Top of Page

Slide 29. Added Focus on Prioritizing

Text Description is below the image.

  • Web site updated to include videos featuring patients and clinicians.
  • Products include:
    • Web site expansion.
    • Brochure.
    • Waiting room video.
    • Notepads with room to write top three questions.
    • Tips for before, during, and after appointments.

Image: The cover and questions list from the pamphlet, Be More Involved in Your Health Care: Tips for Patients, is shown. 

Top of Page

Slide 30. Patient Engagement is a Team Sport

Text Description is below the image.

  • Collaboration is key:
    • Ongoing outreach to medical groups, health clinics, and waiting room settings.
    • Strong partnerships with national, State, and local organizations.
    • Networks dedicated to putting the patient at the center of care.
    • Consumer and community involvement.

Image: The cover of the Questions are the Answers DVD is shown. 

Top of Page

Slide 31. Infrastructure for Maintaining Primary Care Transformation (IMPaCT)

Text Description is below the image.

  • Purpose: Support State-level initiatives using primary care extension agents in small and medium sized primary care practices to assist with primary care redesign and transformation.
  • Spread: Each of the four grantees will create State-level collaborations with at least three other States to assist them with their State-level primary care transformation effort.
  • Awards: Four 2-year grants made in September 2011, each for a total of $1,000,000. .

Top of Page

Slide 32. IMPaCT Grantees

Text Description is below the image.

  • HEROs: New Mexico's Health Extension as a Model for Primary Care Transformation (Principal Investigator [PI]: Arthur Kaufman, University of New Mexico Health Sciences Center).
  • North Carolina IMPaCT: Advancing and Spreading Primary Care Transformation (PI: Darren DeWalt, University of North Carolina).
  • PA SPREAD: PA Spreading Primary Care Enhanced Delivery Infrastructure (PI: Robert Gabbay, Penn State Hershey College of Medicine).
  • Primary Care Extension in Oklahoma: An Evidence-Based Approach to Dissemination and Implementation (PI: James Mold, University of Oklahoma Health Sciences Center). .

Top of Page

Slide 33. Update From the U.S. Preventive Services Task Force

Text Description is below the image.

  • Draft recommendation statements available for comment:
    • Screening & Management of Obesity in Adults
      October 26 - November 23, 2011.
    • Screening for Cervical Cancer
      October 19 - November 16, 2011.
    • Screening for Prostate Cancer
      October 11 - November 8, 2011.
    • Screening for Hearing Loss in Older Adults
      October 4 - November 1, 2011.
    • Screening for Coronary Heart Disease With Electrocardiography
      September 27 - October 25, 2011. .

Top of Page

Slide 34. New Efforts to Increase Transparency & Stakeholder Engagement

Text Description is below the image.

  • Briefings on screening for prostate and cervical cancer:
    • Open to all, approximately 150 phone lines utilized on each call.
    • Each briefing provided:
      • An overview of the USPSTF and its recommendation-making process.
      • A summary of the evidence on the benefits and harms of screening.
      • A description of the specific recommendations.
      • A discussion of the USPSTF rationale.
  • Beginning in December 2011, posting all draft Research Plans for public comment:
    • Includes analytic framework, key questions, and inclusion/exclusion criteria.
    • First topic, screening for peripheral arterial disease. .

Top of Page

Slide 35. First Annual Report to Congress

Text Description is below the image.

Delivered to Congress on October 27 in conjunction with a similar, complementary report from the Community Preventive Services Task Force.

Image: The cover of the Report to Congress is shown. 

Top of Page

Slide 36. 2011-2015 CERTs Centers

Text Description is below the image.

Six Research Centers recently awarded 5-year cooperative agreements of ~$850,000 per year.

Coordinating Center changed/renamed as the CERTs Scientific Forum with increased scientific support of internal and external CERTs collaborations, including an annual project or activity.

Kaiser Permanente Center for Health Research, Portland ORScientific Forum
Brigham and Women's HospitalHealth information technology
Cincinnati Hospital Children's Medical CenterPediatric health care quality
Duke University Medical CenterCardiovascular disorders
Rutgers UniversityMental health disorders
University of Alabama—Birmingham Musculoskeletal disorders
University of Illinois—ChicagoMedication safety

 

Top of Page

Slide 37. New Research From Effective Health Care Program—Stents in CKD

Text Description is below the image.

  • Many drug-eluting stents (DES) are being placed in patient subsets that were not represented in large, pivotal RCT's.
  • New study examines the safety & efficacy of (DES) compared to bare-metal stents (BMS).
  • Focuses on "real world," i.e., Medicare-eligible patients over 65 yrs. with chronic kidney disease (CKD).
  • Study links American College of Cardiology registry to Centers for Medicare & Medicaid Services (CMS) data.
  • Results: In patients with CKD treated with a DES versus BMS, treatment with a DES appeared to be safe with an associated reduction in the rates of MI and death.

Tsai TT et al., J Am Coll Cardiol 2011; 58:1859-1869.

http://www.effectivehealthcare.ahrq.gov 

Top of Page

Slide 38. New Research From Effective Health Care Program—Child ADHD

Text Description is below the image.

  • Collaboration with AHRQ & FDA to examine serious cardiovascular events in children taking medications for ADHD.
  • Largest study to date—analyzed data from more than 1.2 million children and young adults from ages 2 to 24.
  • Study found no evidence of increased risk of serious cardiovascular effects among children and young people who use ADHD medications.
  • The possibility of a small risk cannot be ruled out because of the small number of cardiovascular events observed in the patients studied.

Cooper WO, et al. ADHD drugs and serious cardiovascular events in children and young adults. N Engl J Med 2011.

http://www.effectivehealthcare.ahrq.gov

Image: The first page of the cited article is shown. 

Top of Page

Slide 39. New on AHRQ's Public Reporting Front

Text Description is below the image.

  • Report reviews key methodological decision points that report sponsors may encounter when generating provider performance scores (MW (Friedberg and CL Damberg, RAND—available at http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/value/perfscoresmethods/index.html).
  • $ Ground-breaking study tests alternative public reporting approaches to providing consumers with information on provider cost and resource use measures (J. Hibbard, AHRQ Annual Meeting, Sept. 20, 2011).
  • Over half of States now produce a public report using AHRQ Quality Indicators (QIs); Centers for Medicare & Medicaid Services's (CMS) HospitalCompare uses AHRQ QIs to report on hospital quality nationwide. .

Top of Page

Slide 40. New Work Underway: Feasibility of Collecting Data on Physicians and Their Practices

Text Description is below the image.

  • Conduct environmental scan of past and existing physician data collection efforts and policy issues they can address.
  • Discuss strategic options of what is possible in the future (collaborations or new survey instruments).
  • Develop a prototype survey instrument to illustrate possibilities.

(AHRQ work with Mathematica Policy Research.) 

Top of Page

Slide 41. Significant Findings: AHRQ's HIV Research Network (HIVRN)

Text Description is below the image.

  • The process of tracking CD4 counts and meds and reporting this to HIVRN members has significantly increased compliance with National Institutes of Health (NIH) prophylaxis guidelines.
  • Cost of care has remained fairly constant over past 3 years even though drug costs have risen slightly.
  • HIV-1 incidence is rising in youth (ages 12-24) due to new infections acquired through risk behaviors. .

Top of Page

Slide 42. News From AHRQ's Healthcare Cost and Utilization Project (HCUP)

Text Description is below the image.

  • 45th State joins HCUP partnership: Alaska!
  • HCUP finding: Septicemia was the single most expensive condition treated in U.S. hospitals at approximately $15.4 billion in 2009
    (HCUP Statistical Brief available at http://www.hcup-us.ahrq.gov/reports/statbriefs/sb122.jsp).
  • New HCUP data: Nationwide Emergency Department Data Sample (NEDS) for 2009 now available. .

Top of Page

Slide 43. Consumer Health IT in the Home: Design Considerations

Text Description is below the image.

  • AHRQ-funded guide published by National Research Council:
    • Rapid growth of home health care has raised many issues.
    • Guide provides human factors design considerations in health information technology (health IT) applications.
    • Helps designers and developers understand realities and complex nature of managing health at home.

Image: The cover of the Consumer Health IT guide is shown.

http://www.nap.edu/catalog.php?record_id=13205 

Top of Page

Slide 44. Health Care Comes Home: The Human Factors

Text Description is below the image.

AHRQ-funded report published by the National Research Council.

  • Health care services are rapidly moving into the home.
  • Addressing human factors can improve care.
  • Outlines foundation for integrating human factors with design and implementation of home health devices, technologies, and practices.
  • Discusses how AHRQ, Food and Drug Administration (FDA), and other Federal agencies can collaborate to improve the quality of care at home.

Image: The cover of the AHRQ-funded National Research Council report, Health Care Comes Home: The Human Factors, is shown.

http://www.nap.edu/catalog.php?record_id=13149 

Top of Page

Slide 45. Active Aging Research Center

Text Description is below the image.

  • Specialized Center (P50) to improve health and functioning of aging individuals through health information technology (health IT).
  • Awarded to the University of Wisconsin-Madison.
  • Focus on the problems that often cause older adults to leave their homes:
    • Falls.
    • Unreliable home care.
    • Difficulty managing a chronic disease.
    • Declining driving skills.

http://www.chess.wisc.edu/chess/projects/aarc.aspx 

Top of Page

Slide 46. Award of Pathways to Quality

Text Description is below the image.

  • Health information technology (health IT) horizon scanning effort.
  • Background report on current efforts to measure quality through health IT (available in 6 months).
  • Future resource and research needs (anticipated in 18 months). .

Top of Page

Slide 47. 2010 MEPS-IC Family Premium Estimates Now Available for Use in Setting State Tax Credits for Small, Private Sector Firms Under Health Care Reform

Text Description is below the image.

Image: Bar chart shows the following Family Premium Estimates:

  • Arkansas: $9,574.
  • Idaho: $9,891.
  • South Carolina: $10,873.
  • Utah: $10,994.
  • South Dakota: $11, 245.
  • United States: $13,170.
  • Illinois: $15,130.
  • Massachusetts: $15,132.
  • Connecticut: $15,306.
  • Alaska: $15,623.
  • New Hampshire: $15,976.

Small firms have fewer than 50 employees.

Source: Center for Financing, Access, and Cost Trends, AHRQ, Insurance Component of the Medical Expenditure Panel Survey (MEPS-IC), 2010. 

Top of Page

Slide 48. MEPS Informs Policy and Practice

Text Description is below the image.

Image: Screen shot shows the results of a Google News search for "Agency for Healthcare Research and Quality." 

Top of Page

Slide 49. Advancing HHS Data Strategy and Planning Efforts

Text Description is below the image.

  • AHRQ and the Assistant Secretary for Planning and Evaluation serve as co-chairs of the Department of Health & Human Services (HHS) Data Council.
  • Two departmental workgroups established to advance an HHS data strategy and related planning efforts:
    1. Research and Development for HHS data collection:
      • Provides recommendations on R&D efforts to facilitate improvements in the quality, utility, timeliness, and efficiency of HHS surveys and data systems.
    2. HHS Data Integration and Alignment:
      • Provides recommendations on data integration and alignment efforts that enhance analytic capacity and improve the harmonization of data sources.
      • Seeks proposals that fill data gaps related to Patient Protection and Affordable Care Act (ACA) implementation; granularity; longitudinal capacity; clinical detail; health resources and determinants and that facilitate quick response mechanisms. .

Top of Page

Slide 50. Consumer Assessment of Health Providers and Systems (CAHPS®)

Text Description is below the image.

  • Centers for Medicare & Medicaid Services (CMS) Collaboration:
    • Working with the CAHPS Consortium to ensure that patient experience survey for Home and Community-based Services (HCBS) is based on CAHPS Survey design principles.
    • Pay for reporting: Home Health Agency receives full Annual Payment Update provided they submit Home Health CAHPS data by requested deadlines.
  • Health Resources and Services Administration (HRSA) Collaboration:
    • Developing a CAHPS survey for use in HRSA's 8,000 Federally qualified health centers. .

Top of Page

Slide 51. National Healthcare Quality and Disparities Report (NHQR/DR)

Text Description is below the image.

  • 2011 NHQR/DR in final departmental clearance, expected release date—January 2012.
  • Work has started on the 2012 reports, 10th in the series.

Image: The covers of the National Quality and Disparities Reports are shown. 

Top of Page

Slide 52. Patient Safety Organizations (PSOs)

Text Description is below the image.

  • Number of listed PSOs—79 in 31 States.
  • VTE Common Format beta version published October 27.
  • March 2012—AHRQ to launch program working with high readmission rate hospitals.
  • Common Format for readmissions in development.

Image: The logo for listed PSOs is shown. 

Top of Page

Slide 53. AHRQ Patient Safety Portfolio

Text Description is below the image.

New 2011 Projects:

  • Health Care Simulation—11 new grants.
  • Perinatal Safety Program—in development.
  • Patient/Consumer Reporting of Patient Safety Events.
  • Risk Assessment of Clinical Laboratory Testing Processes.

Upcoming Projects:

  • Environmental Scan of Patient Safety Education and Training in the U.S.
  • Survey of Patient Safety Culture for Community Pharmacies.
  • Evidence Review of Patient Safety Practices. .

Top of Page

Slide 54. AHRQ Annual Conference

Text Description is below the image.

  • 2011 AHRQ Annual Conference (September 18 - 21, 2011)—1800 attendees!
  • 2012 AHRQ Annual Conference—September 9 -12, 2012—Bethesda North Marriott Hotel and Conference Center. .

Top of Page

Slide 55. NAC Subcommittee

Text Description is below the image.

  • Meet to review criteria identified by Expert Panel in Year 1.
  • Review measures nominated for potential inclusion in the improved core sets
    • What:
      • Measures developed by Pediatric Quality Measures Program (PQMP) Centers of Excellence (COEs).
      • Measures nominated through public process.
    • How? Use criteria in Candidate Measure Form.
    • Support: Summary descriptions provided by CCTAC.
  • Discuss and reach consensus on measures that meet criteria.
  • Report out to NAC chair.
  • AHRQ and Centers for Medicare & Medicaid Services's (CMS) recommend to Secretary.
  • Secretary posts improved core sets annually starting 1/1/2013. .

Top of Page

Slide 56. Today's Agenda

Text Description is below the image.

  • Director's Update.
  • AHRQ's Patient-Centered Outcomes Research Dissemination/Implementation Activities.
  • Public Comment.
  • Lunch:
    • Briefing on the Institute of Medicine (IOM) Future of Nursing Report and Campaign for Action.
  • Exploratory Discussion: What Do We Want Out of Physician Performance Measures? Developing a Conceptual Frame.
  • Public Comment.
  • Chairman's Wrap-up.

Top of Page

Current as of May 2012
Internet Citation: Director's Update: National Advisory Council, November 2011. May 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/events/nac/2011-11-nac/clancy/index.html