AHRQ Views

Blog posts from AHRQ leaders

By Andy Bindman, M.D., Director of AHRQ What is a health care system?

We use the term routinely, generally referring to a hospital chain or a network of hospitals, medical offices, nursing homes, and other facilities operated under shared ownership. But if you ask practitioners and researchers to drill down deeper on the definition, you’re likely to get widely varying answers.

Reaching consensus on this issue is important, however. As organizations seek to become learning health care systems and assume a growing role in generating and applying evidence to support personalized care and population management, it’s essential that we learn from how health systems are developing best practices. We suspect, for instance, that there is a lot of variation among health systems as they rapidly adapt to new marketplace incentives. Exploring these issues provides an important learning opportunity. But to do so requires that we begin with a common definition of what a health system is. And that’s only one reason I’m excited about a signature AHRQ project, the Comparative Health System Performance Initiative.

Today, for the first time, AHRQ will host the three teams that are working together under a cooperative agreement to explore how health care systems adopt and incorporate evidence into the routine delivery of care.

AHRQ’s grantees—Dartmouth College, the National Bureau of Economic Research, and RAND Corporation—have been designated centers of excellence that will identify, classify, track, and compare health systems. This 5-year, $58 million project has the following laudable goals:

  • Classifying and characterizing health systems.
  • Identifying ways that health systems organize resources to generate and adopt knowledge of best practices.
  • Assessing the ways that health systems incorporate knowledge from patient-centered outcomes research (PCOR) into practice.
  • Comparing performance based on clinical and cost outcomes.

AHRQ envisions this project as a significant addition to agency efforts to support learning health care systems. The initiative’s anticipated outputs—journal publications, new tools and data resources, training opportunities—will support health systems that seek to engage in the generation of evidence and to apply evidence-based strategies as a means to increase efficiency, value, and quality of patient care. We are particularly interested to understand how health systems will use the growing availability of PCOR evidence.

The centers of excellence, with support from an AHRQ-funded coordinating center and agency staff, have already made significant strides leading up to today’s meeting.

A new section of AHRQ’s Web site now serves as the virtual home for the project, providing information about project participants, goals, and developments. Progress also has been made in establishing a consensus definition of health systems. Check out the Web site and you’ll find three thoughtful draft definitions, one by each center of excellence.

Also described on the AHRQ Comparative Health System Performance Initiative Web pages are plans for the coordinating center, working collaboratively with the centers of excellence and AHRQ, to develop a "compendium" of health care systems. Once we’ve agreed on a common definition of what a health system is, the coordinating center will develop a list or compendium of those systems that meet the definition. We anticipate the compendium will offer an interactive Web site to house information in a variety of formats that allow users to understand the characteristics of health systems, compare and contrast system attributes, and assess the association of system attributes with performance.

The initiative is designed as a marquee effort to support AHRQ’s mission—to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable. At today’s meeting with our grantees, we will aim to reach consensus on a health system definition. Over time we will explore how to use data to develop the compendium, and discuss the best ways to measure health systems’ performance.

How can you get involved? A vital aspect of the project will be dissemination of its findings. As the investigative teams learn more, you can count on AHRQ to package and distribute information that offers meaningful support to health systems and the research community. Our goal is to create a platform for shared learning that meets the needs of researchers and health systems that will generate new knowledge and ultimately contribute to improvements in care.

So keep in touch. We’ll keep you posted.

Page last reviewed September 2016
Page originally created September 2016
Internet Citation: Comparing Health Systems: AHRQ’s Signature Effort To Improve Patient Care. Content last reviewed September 2016. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/blog/ahrqviews/comparing-health-systems.html