National Advisory Council 2012 April - Director's Update

On April 13, 2012, Carolyn Clancy, MD, made this presentation at the meeting of the National Advisory Council.

Slides

  1. Director's Update
  2. New Members
  3. Member Updates
  4. Overview
  5. FY AHRQ 2012 Budget
  6. FY 2012 Budget Details
  7. FY 2012 Budget Request
  8. FY 2012  Request Details
  9. AHRQ Move
  10. Old Parklawn Building
  11. New Parklawn Building
  12. Overview
  13. AHCPR-Funded Chronic Disease Self-Management Program
  14. E-Prescribing Safe and Efficient, But Barriers Remain
  15. AHRQ, Hispanic Groups Promote Use of Spanish-Language Resources
  16. Consumers Choose High-Value Providers When Given Good Data
  17. Saint Louis University School of Medicine
  18. Alliant/GFMC, the Medicare Quality Improvement Organization for Georgia
  19. Primary Health Care Centers (GA)
  20. Alliant/GFMC, the Medicare Quality Improvement Organization for Georgia (II)
  21. St. Barnabas Rehabilitation and Continuing Care (NY)
  22. Schuyler Ridge Nursing Home (NY)
  23. StayWell Health Management (MN)
  24. Overview
  25. AHRQ Nursing News
  26. March AHRQ-Sponsored Health Affairs Articles on Public Reporting
  27. Introducing 6th Web Site Based on MONAHRQ: Arkansas
  28. New Toolkit Supports Efforts to Improve Quality and Safety
  29. New Findings Health IT Effects on Hospital Costs, Outcomes, and Patient Safety
  30. New ACTION Project Reducing Readmissions for Medicaid Patients
  31. Research Efforts Tied to Implementation of the Affordable Care Act
  32. USA Today Screenshot: 5% of patients account for half of health care spending
  33. MEPS-Based Simulations
  34. Recently Released Summary Products
  35. Consumer and Clinician Products Coming Soon
  36. ADHD Medications and Risk of Serious Cardiovascular Events in Adults
  37. Patients With Diabetes Who Undergo Bariatric Surgery Do Not Have Lower Health Care Costs
  38. Comparative Effectiveness of Oral Antidiabetic Drugs on Kidney Function
  39. 4th Methods Symposium: From Efficacy to Effectiveness
  40. Collaborations in HHS Health Data Initiative (HDI)
  41. New PCMH Resources and Activities
  42. Improving Care Coordination in Primary Care: Measure Development
  43. Update from the U.S. Preventive Services Task Force
  44. USPSTF Welcomed Four New Members
  45. Health Information in the Home - Human Factors Assessment
  46. Health IT Videos
  47. AHRQ Health IT Research Funding
  48. Health IT Research Published in JAMIA
  49. Patient Safety Organizations and the Affordable Care Act
  50. PSOs and Common Formats
  51. IOM Report on Health IT and Safety
  52. 2011 National Healthcare Quality and Disparities Reports
  53. 2012 National Healthcare Quality and Disparities Reports
  54. Nationwide Implementation of CUSP for CLABSI
  55. Healthcare-Associated Infections Priority Performance Goal (HAI-PPG)
  56. 2012 AHRQ Annual Conference
  57. Today's Agenda

Slide 1. Director's Update 

1. Director's Update.

Carolyn Clancy, MD
National Advisory Council
April 13, 2012

 

Slide 2. New Members 

2. New Members.

  • Jane Durney Crowley, Executive Vice President and Chief Administrative Officer, Catholic Health Partners.
  • Michael P. Johnson, PT, PhD, OCS,  Division Director & Chief Clinical Officer, Home Health Practice, Bayada Home Health Care.
  • Newell E. McElwee, III, PharmD, MSPH, Executive Director, U.S. Outcomes Research, Merck Global Affairs.
  • Henry H. Ng, MD, MPH, FAAP, FACP, Internist-Pediatrician MetroHealth Medical Center and Assistant Professor, Case Western School of Medicine.
  • David Fredrick Penson, MD, MPH, Director, Center for Surgical Quality and Outcomes Research, Vanderbilt University Medical Center Professor of Urologic Surgery, Vanderbilt University.
  • Harry Paul Selker, MD, MSPH, Dean, Tufts Clinical and Translational Science Institute, Tufts University; Executive Director, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center.

Re-appointed:

  • Bruce Siegel, MD, MPH, Chief Executive Officer, National Association of Public Hospitals and Health Systems.

 

Slide 3. Member Updates 

3. Member Updates.

New Roles:

  • Andrea H. McGuire, MD, MBA, President and Chief Operating Officer—Meridian Health Plan.
  • Welton O'Neal, PharmD, VP, Medical Affairs—CryerHealth, LLC.

Awards:

  • Helen Darling—recipient of a 2012 National Committee for Quality Assurance Health Quality Award for her sustained leadership promoting health care quality as an issue of commercial competitiveness.

 

Slide 4. Overview 

4. Overview.

  • The Big Picture:
    • FY 2012.
    • FY 2013 Budget Request.
  • Recent Accomplishments:
    • In the News.
    • Impact Case Studies.
  • AHRQ Program Updates.
  • Today's Agenda.

 

Slide 5. FY AHRQ 2012 Budget 

5. FY AHRQ 2012 Budget.

  • $369 M—$3 M less than FY 2011.
  • Plus:
    • $12 M in Prevention and Public Health Funds.
    • $24 M from Patient-Centered Outcomes Research Trust Fund.
  • Total AHRQ Funding in FY 2012—$405 M.

 

Slide 6. FY 2012 Budget Details 

6. FY 2012 Budget Details.

  • $16.6 M for Patient-Centered Outcomes Research
    (+$24 M from the Patient-Centered Outcomes Research Trust Fund [PCORTF]).
  • $15.9 M for Prevention/Care Management
    (+$12 M from the Prevention and Public Health Fund).
  • $3.7 M for Value Research.
  • $25.6 M for Health Information Technology (Health IT).
  • $65.6 M for Patient Safety ($34 M Healthcare-Associated Infection [HAI]).
  • $108.4 M for Crosscutting ($15.9 M in new grants).

 

Slide 7. FY 2012 Budget Request 

7. FY AHRQ 2013 Budget Request.

  • $334.4 M—$34.7 M less than FY 2012.
  • Plus:
    • $12 M in Prevention and Public Health Funds.
    • $62.4 M from Patient-Centered Outcomes Research Trust Fund.
  • Total AHRQ Funding in FY13—$408.8 M.

 

Slide 8. FY 2012  Request Details 

8. FY 2013 Request Details.

  • $10.0 M for Patient-Centered Outcomes Research
    (+$62.4 M from the Patient-Centered Outcomes Research Trust Fund [PCORTF]).
  • $15.9 M for Prevention/Care Management
    (+$12 M from the Prevention and Public Health Fund).
  • $3.6 M for Value Research.
  • $25.6 M for Health Information Technology (Health IT).
  • $62.6 M for Patient Safety ($34 M Healthcare-Associated Infection [HAI]).
  • $88.9 M for Crosscutting ($2.7 M in new grants).

http://www.ahrq.gov/about/mission/budget/2013/web13over.html

 

Slide 9. AHRQ Move 

9. AHRQ Move.

  • The General Services Administration (GSA) awarded a 15-year lease to the owners of the Parklawn Building:
    • The entire building will be completely renovated which will create a new, modern, and efficient facility.
    • Only concrete and steel infrastructure will remain.
    • The Department of Health & Human Services (HHS) employees will be located in the A and B wings and the A-B head house.
  • Four OPDIVs will move into this space:
    • Agency for Healthcare Research and Quality (AHRQ).
    • Health Resources and Services Administration (HRSA).
    • Indian Health Service (IHS).
    • Substance Abuse and Mental Health Services Administration (SAMHSA).
    • Components of the Program Support Center (PSC).

 

Slide 10. Old Parklawn Building 

10. Old Parklawn Building.

Image: A photograph shows the old Parklawn Building.

 

Slide 11. New Parklawn Building 

11. New Parklawn Building.

Image: An artist's rendering shows the Parklawn Building as it will look after renovation.

 

Slide 12. Overview 

12. Overview.

  • The Big Picture:
    • FY 2012.
    • FY 2013 Budget Request.
  • Recent Accomplishments:
    • In the News.
    • Impact Case Studies.
  • AHRQ Program Updates.
  • Today's Agenda.

 

Slide 13. AHCPR-Funded Chronic Disease Self-Management Program 

13. AHCPR-Funded Chronic Disease Self-Management Program .

Image: A newspaper clipping titled "Same Room, Different Ailments" shows photographs of people attending a chronic-disease self-management workshop at the Santa Clara Valley Medical Center in San Jose, California.

 

Slide 14. E-Prescribing Safe and Efficient, But Barriers Remain 

14. E-Prescribing Safe and Efficient, But Barriers Remain.

  • Interviews with physician practices, community pharmacies, and mail-order pharmacies reveal:
    • E-prescribing generally regarded as important tool to improve patient safety and save time.
    • Physicians and pharmacies both face barriers in realizing e-prescribing's full potential.

Image: The front cover of an issue of JAMIA is shown.

Grossman JM, Cross DA, Boukus ER, et al. Transmitting and processing electronic prescriptions: Experiences of physician practices and pharmacies. J Am Med Inform Assoc doi: 10.1136/amiajnl-2011-000515.

 

Slide 15. AHRQ, Hispanic Groups Promote Use of Spanish-Language Resources 

15. AHRQ, Hispanic Groups Promote Use of Spanish-Language Resources.

  • AHRQ launches Toma las riendas (Take the Reins) campaign to encourage Hispanics to take control of their own health and explore treatment options.
  • Campaign partners include:
    • National Hispanic Medical Association.
    • Latino Student Medical Association.
    • National Association of Hispanic Elderly.
    • National Latina Health Network.
    • Telemundo.

http://www.ahrq.gov/health-care-information/informacion-en-espanol/index.html

Image: A screenshot shows the Facebook page for the Toma las riendas campaign.

 

Slide 16. Consumers Choose High-Value Providers When Given Good Data 

16. Consumers Choose High-Value Providers When Given Good Data.

  • AHRQ-funded study in March 2012 issue of Health Affairs:
    • When asked to choose a provider based only on cost, consumers choose the more expensive option, equating cost with quality.
    • When cost and quality data are combined, consumers more easily identify providers who deliver high-quality care at a lower cost.
    • Study explored ways to present cost and quality information, such as symbols, specific figures, and labels.
    • Implications for the design of public report cards.

Hibbard JH, Greene J, Sofaer S, et al. An experiment shows that a well-designed report on costs and quality can help consumers choose high-value health care. Health Aff 2012 31:560-568.

Image: The Health Affairs logo is shown.

 

Slide 17. Saint Louis University School of Medicine 

17. Saint Louis University School of Medicine.

  • AHRQ's Health Literacy Universal Precautions Toolkit:
    • Incorporated into curriculum on clear communication techniques.
    • More than 1,200 students from seven professions took part in literacy seminars.
    • Toolkit used during clinical rotations in outreach educational activities.

Image: A photograph shows a doctor explaining something to a patient.

 

Slide 18. Alliant/GFMC, the Medicare Quality Improvement Organization for Georgia 

18. Alliant/GFMC, the Medicare Quality Improvement Organization for Georgia.

  • AHRQ's Nursing Home Survey on Patient Safety Culture and TeamSTEPPS™:
    • Safety culture survey administered in 62 nursing homes before TeamSTEPPS training; results inform best strategies to improve care.
    • QIO offered TeamSTEPPS training to every nursing home through State's biennial regional meetings.
    • Training reached 118 administrators in 62 nursing homes.
    • Results showed improved communication and teamwork skills.

Images: The covers of the Nursing Home Survey on Patient Safety Culture report and the TeamSTEPPS™ manual are shown.

 

Slide 19. Primary Health Care Centers (GA) 

19. Primary Health Care Centers (GA).

  • AHRQ's Staying Active and Healthy with Blood Thinners:
    • Used in educational program to help patients manage their anticoagulation therapy and overall health.
    • Program helped boost number of patients coming in for regular blood tests from 56% to 81%.
    • Centers received patient safety awards for efforts in improving health and care of patients using anticoagulants.

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

 

Slide 20. Alliant/GFMC, the Medicare Quality Improvement Organization for Georgia (II) 

20. Alliant/GFMC, the Medicare Quality Improvement Organization for Georgia.

  • AHRQ's Staying Active and Healthy with Blood Thinners:
    • Used as part of educational program to help Medicare patients manage anticoagulant therapy and overall health.
    • DVD and brochure provided to 1,400 Medicare Part D beneficiaries who filled warfarin prescriptions in Q1, 2009.
    • 14.5% reduction in warfarin prescriptions filled with another Rx that can cause adverse drug interaction.

Image: The cover of the pamphlet, Blood Thinner Pills: Your Guide to Using Them Safely is shown.

 

Slide 21. St. Barnabas Rehabilitation and Continuing Care (NY) 

21. St. Barnabas Rehabilitation and Continuing Care (NY).

  • On-Time Quality Improvement in Long-Term Care (On-Time) Program:
    • Residents with new pressure ulcers decreased by 56%.
    • Improved integration of clinical information between certified nursing assistants (CNAs) and dietary staff, social workers, nursing staff.
    • CNAs advocate better for residents after On-Time implementation.

Image: A photograph shows a medical professional assisting an elderly woman patient in a wheelchair.

 

Slide 22. Schuyler Ridge Nursing Home (NY)) 

22. Schuyler Ridge Nursing Home (NY).

  • On-Time Quality Improvement in Long-Term Care (On-Time) Program:
    • Residents with new pressure ulcers dropped from 6.5% before program to 2% after.
    • Implementation improved documentation completion to nearly 100%.
    • Reports helped identify 2 to 3 new high-risk patients each week.
    • Reports integrated into facility's information system for increased accuracy, efficiency.

Image: A photograph shows a medical professional attending an elderly man patient in a hospital bed.

 

Slide 23. StayWell Health Management (MN)) 

23. StayWell Health Management (MN).

  • AHRQ's Effective Health Care (EHC) Program Guides:
    • Incorporated guides for consumers into pool of organization's resources.
    • StayWell health coaches help make consumers aware of program guides.
    • Company learned about AHRQ guides while participating in EHC Tools for Business Project.

Image: A photograph shows a StayWell health coach showing a man how to use a touchscreen monitor.

 

Slide 24. Overview) 

24. Overview.

  • The Big Picture:
    • FY 2012.
    • FY 2013 Budget Request.
  • Recent Accomplishments:
    • In the News.
    • Impact Case Studies.
  • AHRQ Program Updates.
  • Today's Agenda.

 

Slide 25. AHRQ Nursing News) 

25. AHRQ Nursing News.

  • Beth Collins Sharp, PhD, RN, Named AHRQ's Senior Advisor for Nursing.
  • New Effective Health Care Nursing Working Group comprising leading nursing organizations:
    • Explore ways that the nursing community can play a role.
    • Explore the needs of the nursing community.
    • Embrace innovation and collaboration driven by the needs of the nursing community.
    • Sustain a new dialogue between nursing organizations and AHRQ with a goal of greater dissemination and implementation of Effective Health Care Program research and tools.

 

Slide 26. March AHRQ-Sponsored Health Affairs Articles on Public Reporting) 

26. March AHRQ-Sponsored Health Affairs Articles on Public Reporting.

  • An Experiment Shows That A Well-Designed Report On Costs And Quality Can Help Consumers Choose High-Value Health Care (J. Hibbard, J. Greene, S. Sofaer, K. Firminger, J. Hirsh).
  • Multistakeholder Regional Collaboratives Have Been Key Drivers Of Public Reporting, But Now Face Challenges (G. Young).
  • How Report Cards On Physicians, Physician Groups, And Hospitals Can Have Greater Impact On Consumer Choices (A. Sinaiko, D. Eastman, M. Rosenthal).
  • A Five-Point Checklist To Help Performance Reports Incentivize Improvement And Effectively Guide Patients (M. Friedberg, C. Damberg).
  • Advancing Public Reporting Through A New 'Aggregator' To Standardize Data Collection On Providers' Cost And Quality (H. Luft).

Image: The front cover of an issue of Health Affairs is shown.

 

Slide 27. Introducing 6th Web Site Based on MONAHRQ: Arkansas) 

27. Introducing 6th Web Site Based on MONAHRQ: Arkansas.

  • Commonwealth of Kentucky Office of Health Policy.
  • Utah Department of Health.
  • Maine Health Data Organization.
  • Hawaii Health Information Corporation.
  • Nevada Division of Health Care Financing and Policy.
  • Arkansas Department of Health.

Images: Screenshots show MONAHRQ-based Web sites for the organizations listed above.

 

Slide 28. New Toolkit Supports Efforts to Improve Quality and Safety) 

28. New Toolkit Supports Efforts To Improve Quality and Safety.

Image: The cover of the AHRQ QI Toolkit is shown.

 

Slide 29. New Findings Health IT Effects on Hospital Costs, Outcomes, and Patient Safety) 

29. New Findings: Health IT Effects on Hospital Costs, Outcomes, and Patient Safety.

  • Findings:
    • While electronic medical records (EMRs) do not reduce rate of patient safety events—once an event occurs, they do reduce:
      • Death by 34%.
      • Readmissions by 39%.
      • Spending by 16%.
  • Conclusion:
    • EMRs contain costs by better coordinating care to rescue patients from medical errors once they occur.

Encinosa WE, Bae, J. Health information technology and its effects on hospital costs, outcomes, and patient safety. Inquiry 2011-2012 Winter;48(4):288-303.

 

Slide 30. New ACTION Project Reducing Readmissions for Medicaid Patients) 

30. New ACTION Project: Reducing Readmissions for Medicaid Patients.

  • Background:
    • Readmission rates are 50%-90% higher for Medicaid patients.
    • Medicaid patients are more concentrated in safety-net hospitals.
  • New ACTION project will:
    • Create strategies/tools to address unique challenges of Medicaid patients.
    • Test feasibility of strategies/tools at selected safety-net hospitals:
      • In multiple States, collaborating with State Medicaid agencies.
    • Refine strategies and tools based on test results.

 

Slide 31. Research Efforts Tied to Implementation of the Affordable Care Act 

31. Research Efforts Tied to Implementation of the Affordable Care Act.

  • Determination of the amount of the small employer health insurance tax credit.
  • Evaluations of the health insurance status of young adults and their health care use and costs, ages 22-25.
  • Estimates of the tax subsidy for employer sponsored insurance (ESI).
  • Analysis of trends in the health insurance status of high-risk individuals and their health care use and costs.
  • Inform allocation of Federal Medical Assistance Percentages (FMAP) matching funds for State Medicaid programs.
  • Analysis of Modified Adjusted Gross Income (MAGI) to estimate future premium subsidies based on income eligibility.

 

Slide 32. USA Today Screenshot: 5% of patients account for half of health care spending 

32. 5% of Patients Account for Half of Health Care Spending.

Image: A screenshot of the USA Today Web site shows the headline and opening paragraphs of the lead article, "5% of patients account for half of health care spending."

 

Slide 33. MEPS-Based Simulations 

33. MEPS-Based Simulations.

  • MEPS widely used inside and outside government in models to simulate Patient Protection and Affordable Care Act (ACA) effects.
  • Some ways we support these efforts:
    • Detailed reconciliation of MEPS with the National Health Expenditure Accounts (Centers for Medicare & Medicaid Services [CMS]).
    • Tax simulations.

 

Slide 34. Recently Released Summary Products 

34. Recently Released Summary Products.

  • Materials for Clinicians and Patients:
    • Analgesics for Osteoarthritis.
    • Self-Measured Blood Pressure Monitoring.
    • Non-Pharmacological Therapies for Treatment-Resistant Depression.

Images: The covers or pages of the materials listed above are shown.

 

Slide 35. Consumer and Clinician Products Coming Soon 

35. Consumer and Clinician Products Coming Soon.

  • Preventing Fractures in People with Low Bone Density.
  • Treating Urinary Incontinence.
  • Therapies for Chronic Pelvic Pain.
  • Mechanical Thrombectomy for Acute Cardiac Syndrome.

Healthy Bones: A Decision Aid for Women After Menopause.

Images: Screenshots from the Healthy Bones decision aid are shown.

 

Slide 36. ADHD Medications and Risk of Serious Cardiovascular Events in Adults 

36. ADHD Medications and Risk of Serious Cardiovascular Events in Adults.

  • AHRQ and Food and Drug Administration (FDA) study of 440,000 adults aged 25-64 years, including over 150,000 adults treated with medications for ADHD.
  • Assessed myocardial infarction, stroke, and sudden cardiac death.
  • Use of ADHD medications was not associated with an increased risk of serious cardiovascular events:
    • The result is consistent with the research team's early publication in NEJM, which found no evidence of cardiovascular risk of ADHD drugs among children and young adults.
  • New study from Effective Health Care Program's Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) Network in JAMA.

Habel LA, et al. ADHD medications and risk of serious cardiovascular events in young and middle-aged adults. JAMA 2011 Dec 28;306(24):2673-83. Epub 2011 Dec 12.

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

 

 Slide 37. Patients With Diabetes Who Undergo Bariatric Surgery Do Not Have Lower Health Care Costs

37. Patients With Diabetes Who Undergo Bariatric Surgery Do Not Have Lower Health Care Costs.

  • Six years following bariatric surgery, individuals with type 2 diabetes did not have lower health care costs than they had before surgery.
  • These patients did have fewer primary care visits in the years following surgery.
  • The findings were based on health insurance data of 7,806 patients with type 2 diabetes who underwent bariatric surgery using data from 7 Blue Cross Blue Shield Plans.
  • New study from Effective Health Care Program's Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) Network published in Medical Care.

Bleich SN, Chang HY, Lau B, Steele K, Clark JM, Richards T, Weiner JP, Wu AW, Segal JB. Impact of bariatric surgery on health care utilization and costs among patients with diabetes. Med Care 2012 Jan;50(1):58-65.

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

 

Slide 38. Comparative Effectiveness of Oral Antidiabetic Drugs on Kidney Function 

38. Comparative Effectiveness of Oral Antidiabetic Drugs on Kidney Function.

  • Evaluated oral antidiabetic drugs & renal outcomes by using a national Veterans Health Administration (VHA) database of 93,577 diabetic patients.
  • Compared with patients using the metformin, patients using sulfonylureas had an increased risk of a decline in kidney function, end-stage renal disease, or death.
  • Because of these new findings, the current recommendation to limit the use of metformin alone in patients with mild to moderate kidney disease should be re-examined.
  • New study from Effective Health Care Program's Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) Network published in Nature's Kidney International.

Hung AM, Roumie CL, Greevy RA, Liu X, Grijalva CG, Murff HJ, Ikizler TA, Griffin MR. Comparative effectiveness of incident oral antidiabetic drugs on kidney function. Kidney Int 2012 Apr;81(7):698-706.

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

 

Slide 39. 4th Methods Symposium: From Efficacy to Effectiveness 

39. 4th Methods Symposium: From Efficacy to Effectiveness.

  • Fourth symposium on original research methods for comparative effectiveness research (CER) and patient-centered outcomes research (PCOR).
  • June 12 and 13, 2012 at the AHRQ Conference Center and Webcast over Internet.
  • Theme is "From Efficacy to Effectiveness":
    • The proceedings will be published as a special journal supplement in 2013.
  • Registration at http://effectivehealthcare.ahrq.gov

 

Slide 40. Collaborations in HHS Health Data Initiative (HDI) 

40. Collaborations in HHS Health Data Initiative (HDI).

  • HDI Helps:
    • Consumers take control of their health and health care.
    • Employers promote health and wellness.
    • Care providers deliver better care.
    • Local leaders make better-informed decisions.
  • HDI Initiatives:
    • Publish new HHS data for public access.
    • Make existing HHS data much more accessible.
    • Publicize HHS data to innovators.
  • AHRQ Data Resources to be featured at forthcoming Health Data Initiative Forum.

 

Slide 41. New PCMH Resources and Activities 

41. New PCMH Resources and Activities.

  • Evidence and Evaluation White Papers and Briefs:
    • Early Evidence on Patient-Centered Medical Home.
    • Improving Evaluations of the Medical Home.
  • Care Coordination White Papers and Briefs:
    • Coordinating Care in the Medical Neighborhood: Critical Components and Available Mechanisms.
    • Ensuring that Patient Centered Medical Homes Effectively Serve Patients with Complex Needs.
  • Primary Care Practice Facilitation:
    • Developing and Running a Practice Facilitation Program for Primary Care Transformation: A How-To Guide.
    • Learning Community for organizations interested in primary care practice facilitation services.

http://www.pcmh.ahrq.gov

 

Slide 42. Improving Care Coordination in Primary Care: Measure Development 

42. Improving Care Coordination in Primary Care: Measure Development.

  • Measures of care coordination processes can be used to generate evidence; evaluate current practices; design, implement, and assess improvement activities; and support payment initiatives.
  • Two new reports from AHRQ address key issues in measuring care coordination in primary care: accountability and data sources:
    • Care Coordination Accountability Measures for Primary Care Practice (available now).
    • Prospects for Care Coordination Measurement Using Electronic Data Sources (coming soon).

 

Slide 43. Update from the U.S. Preventive Services Task Force 

43. Update From the U.S. Preventive Services Task Force.

  • First draft Research Plans posted for public comment:
    • Screening for Peripheral Arterial Disease
      December 15, 2011–January 12, 2012.
    • Genetic Risk Assessment and BRCA Mutation Testing for Breast and Ovarian Cancer Susceptibility
      February 28–March 27, 2012.
  • Final Recommendation on Screening for Cervical Cancer released March 15:
    • Change from draft Recommendation Statement posted for public comment due to new evidence:
      • The USPSTF recommends screening for cervical cancer in women ages 21 to 65 years with cytology (Pap smear) every 3 years or for women ages 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years.
    • Coordinated release with the American Cancer Society & other groups.

 

Slide 44. USPSTF Welcomed Four New Members 

44. USPSTF Welcomed Four New Members.

  • Linda Ciofu Baumann, PhD, RN
    Professor Emerita, School of Nursing
    Affiliate Faculty, School of Medicine and Public Health University of Wisconsin, Madison, WI
  • Mark Ebell, MD, MS
    Associate Professor, Epidemiology and Biostatistics
    The University of Georgia, Athens, GA
  • Jessica Herzstein, MD, MPH
    Global Medical Director
    Air Products, Allentown, PA
  • Douglas K. Owens, MD, MS
    Associate Director, Center for Health Care Evaluation, VA Palo Alto Health Care System
    Director, Center for Health Policy, Freeman Spogli Institute for International Studies
    Stanford University, Stanford, CA

Nominations for 2013 close May 15
Submit Online!

 

Slide 45. Health Information in the Home - Human Factors Assessment 

45. Health Information in the Home-Human Factors Assessment.

  • Case study of four families' health information management tasks.
  • Highlights:
    • 69 unique health information management tasks.
    • Nine different locations.
    • 22 different information storage artifacts (e.g., calendars, notebooks, cupboards).
  • Finding: Foundational consumer health IT design elements must be balanced with individual needs.

Zayas-Cabán T. Health information management in the home: A human factors assessment. Work 2012 Jan 1;41(3):315-28.

 

Slide 46. Health IT Videos 

46. Health IT Videos.

  • Dr. Kate Lapane, Brown-Virginia Commonwealth University
    • Video highlights innovative approach to generate electronic health record (EHR)-enabled culturally informed multi-media medication guidance in Spanish and English for older adults.
  • First in a series of inspirational videos featuring AHRQ Health IT grantees
  • Next in series: Dr. Lynne Nemeth, Medical University of South Carolina
  • Videos are available at http://healthit.ahrq.gov/HITFeaturedProjects

 

Slide 47. AHRQ Health IT Research Funding 

47. AHRQ Health IT Research Funding.

  • AHRQ and the National Science Foundation: Advancing Health Services through System Modeling Research
  • External interest in AHRQ Health IT Funding Opportunity Announcements (FOAs):
    • Understanding User Need and Context to Inform Consumer Health Information Technology Design
    • Understanding Clinical Information Needs and Health Care Decision Making Processes in the Context of Health Information Technology

 

Slide 48. Health IT Research Published in JAMIA 

48. Health IT Research Published in JAMIA.

  • The effectiveness of integrated health information technologies across the phases of medication management: a systematic review of randomized controlled trials
    (Grossman JM, Cross DA, Boukus ER, Cohen GR. Transmitting and processing electronic prescriptions: experiences of physician practices and pharmacies. J Am Med Inform Assoc 2011 No 18, [Epub ahead of print] PubMed PMID: 22101907)
  • Transmitting and processing electronic prescriptions: experiences of physician practices and pharmacies
    (McKibbon KA, Lokker C, Handler SM, Dolovich LR, Holbrook AM, O'Reilly D, Tamblyn R, Hemens BJ, Basu R, Troyan S, Roshanov PS. The effectiveness of integrated health information technologies across the phases of medication management: a systematic review of randomized controlled trials.  J Am Med Inform Assoc 2012 Jan-Feb; 19(1)-22-30. Epub 2011 Aug 18, Review. PubMed PMID: 21852412; PubMed Central PMCID: PMC3240758)

 

Slide 49. Patient Safety Organizations and the Affordable Care Act 

49. Patient Safety Organizations and the Affordable Care Act.

  • Section 399KK: Secretary shall make available a program for hospitals with high readmission rates to work with PSOs
    • AHRQ and CMS have undertaken some planning in order to execute this part of ACA
    • AHRQ PSO Web site enhancement launched March 6th to provide resources for PSOs to work with those hospitals

Image: The logo for Listed PSOs is shown.

 

Slide 50. PSOs and Common Formats 

50. PSOs and Common Formats.

  • PSO Annual Meeting and Software Developers Meeting
    • 166 registrants (as of March 19, 2012)
    • 11 PSO presentations
  • Hospital Common Formats v 1.2 published April 2012
    • Incorporates new modules for Venous Thromboembolism (VTE) and Device with Health Information Technology (Health IT).

 

Slide 51. IOM Report on Health IT and Safety 

51. IOM Report on Health IT and Safety.

  • Health IT and Patient Safety: Building Safer Systems for Better Care (11/8/11).
  • Recommendation:
    • AHRQ and Office of the National Coordinator (ONC) work together closely on health IT and safety:
      • AHRQ has been doing that and will continue to do so.
    • AHRQ fund more research on health IT and patient safety:
      • AHRQ will do that.

 

Slide 52. 2011 National Healthcare Quality and Disparities Reports 

52. 2011 National Healthcare Quality and Disparities Reports.

  • NHQR / NHDR nearing release
    • Highlights organized around National Quality Strategy priorities
    • New sections on
      • Adolescent health
      • Musculoskeletal diseases
      • Health care safety net
      • Transgender people
  • Coming Soon:
    • NHQRDRnet
    • State Snapshots

Images: The covers of the 2011 National Healthcare Quality and Disparities Reports are shown.

 

Slide 53. 2012 National Healthcare Quality and Disparities Reports 

53. 2012 National Healthcare Quality and Disparities Reports.

  • NHQR / NHDR
    • 2012 will be 10th in series
    • Addition of more National Quality Strategy (NQS) measures reflecting population need.
    • Focus on long-term trends
    • Focus on new HHS race/ethnicity standards.
  • NHQRDRnet
    • Addition of function to generate customized graphics

 

Slide 54. Nationwide Implementation of CUSP for CLABSI 

54. Nationwide Implementation of CUSP for CLABSI.

Progress in 3 Years of the Project:

  • Has expanded to 46 States, DC, and PR
  • >1,100 hospitals and >1,800 teams recruited
  • Interim Results:
    • 39%↓ in CLABSI rates (736 units w/ baseline & 1-yr. data).
    • 800 CLABSI cases prevented }
    • 200 CLABSI deaths prevented } 1st yr, 5 cohorts = 2/3 of adult ICUs
    • $13 M in excess costs averted }

 

Slide 55. Healthcare-Associated Infections Priority Performance Goal (HAI-PPG) 

55. Healthcare-Associated Infections Priority Performance Goal (HAI-PPG).

  • High priority for the Department of Health & Human Services (HHS) Secretary.
  • 11/21/11: HAI-PPG kick-off presentation to HHS Senior Leadership
  • Will be tracked by HHS and Office of Management and Budget (OMB).
  • Collaborative effort of the Centers for Medicare & Medicaid Services (CMS) (lead), AHRQ, the Centers for Disease Control and Prevention (CDC), and the Office of Assistant Secretary of Health (OASH).
  • Goals:
    • 25%↓ in in hospital-acquired central line-associated bloodstream infections (CLABSI).
    • 20%↓ in in hospital-acquired catheter-associated urinary tract infection (CAUTI).
    • To be achieved by 9/30/13 vs. 2010 baseline
    • Aligned with goals of HAI National Action Plan and Partnership for Patients (PfP).
  • AHRQ's ongoing programs will contribute significantly.

 

Slide 56. 2012 AHRQ Annual Conference 

56. 2012 AHRQ Annual Conference.

  • September 9-12, 2012
  • Bethesda North Marriott Hotel and Conference Center

Image: The banner for the upcoming conference, titled "Moving Ahead: Leveraging Knowledge and Action to Improve Health Care Quality" is shown.

 

Slide 57. Today's Agenda 

57. Today's Agenda.

  • Director's Update.
  • Update on AHRQ's Medical Liability Initiative.
  • Public Comment.
  • Lunch:
    • Reducing Disparities in Healthcare (PLACE MATTERS)
  • AHRQ's Investments Supported by Patient Centered Outcomes Research Trust Fund
  • Public Comment
  • Chairman's Wrap-up

Return to Contents

Current as of June 2013
Internet Citation: National Advisory Council 2012 April - Director's Update. June 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/events/nac/2012-04-nac/clancy/index.html