September / October 2007
NEWS ITEMS FROM SOURCES WORLDWIDE
Pulse
New AHRQ/IHI Report:
HIT for Improving Quality in Primary Care
An AHRQ-funded report, Health Information Technology for Improving Quality of Care in Primary Care Settings, prepared by the Institute for Healthcare Improvement, is now available. The report examines opportunities and challenges for utilizing health information technology for quality improvement in primary care and includes specific "change ideas" for practices exploring this arena.
To download the report, see www.ihi.org, search for it on www.ahrq.gov or go to:
http://healthit.ahrq.gov/portal/server.pt/gateway/
PTARGS_0_1248_661809_0_0_18/AHRQ_HIT_Primary_Care_July07.pdf.
National Quality Agenda, Payment Reform, and Care Integration Are Keys to Improving Quality and Patient Safety
As healthcare quality and patient safety concerns rise, the latest Commonwealth Fund Health Care Opinion Leaders survey finds leaders united behind several key reform measures: more than half (56%) support the creation of a new public-private entity to coordinate quality efforts and form a national quality agenda; 95% believe that fundamental payment reform is needed; and three-fourths (73%) say that greater organization and integration of provider care is necessary for improved quality and efficiency.
Within these broad categories, the survey found consensus for specific strategies — many that include government leadership:
- 90% of respondents said use of health information technology should be mandated for Medicare providers within 5 or 10 years;
- half (51%) support financial incentives for physicians and hospitals to provide high quality care;
- 59% of respondents support public reporting of providers' performance on quality measures;
- only 7% felt that the current Patient Safety and Quality Improvement Act was sufficient to guarantee patient safety; three-fourths felt information about a physicians' or hospitals' patient safety record should not be confidential; and
- 73% support Medicare reform that would pay "medical homes" — defined as a healthcare setting that provides patients with timely, well-organized care, and enhanced access to providers — for care coordination.
In a new data brief on the survey findings, Health Care Opinion Leaders' Views on the Quality and Safety of Health Care in the United States, Katherine Shea, Tony Shih, and Karen Davis of The Commonwealth Fund find that opinion leaders agree the United States healthcare system isn't designed to provide high quality healthcare and changes must be made at the highest levels. A report released in August by The Commonwealth Fund, An Analysis of Leading Congressional Health Care Bills, 2005‚2007: Part II, Quality and Efficiency, found that current legislative proposals fall short of a national strategy for healthcare quality and efficiency.
"We were surprised at the amount of support the survey showed for government leadership in key areas, and for public-private partnerships in setting a national quality agenda," said Commonwealth Fund President Karen Davis. "My hope is that policymakers and providers will see the value in the kind of unified policy these opinion leaders support. We need to move away from our fragmented system of care and move toward national strategies that will ensure all Americans the high performance healthcare system they deserve."
Despite wide agreement and support for reforms opinion leaders did identify challenges. Nearly 8 of 10 (79%) said that physician autonomy would be a challenge to care integration, and 69% said the lack of financial incentives would be a barrier. However, only 14% felt that consumer resistance would be a barrier.
Opinion leaders surveyed include experts from four broad healthcare sectors: academia and research organizations; healthcare delivery; business, insurance, and other health industry; and government and advocacy groups. Elected officials and media representatives were excluded. The online survey was conducted by Harris Interactive® on behalf of The Commonwealth Fund and focused solely on healthcare quality. The survey was completed online by 214 experts.
Source: The Commonwealth Fund
Methodology: The Commonwealth Fund Health Care Opinion Leaders Survey was conducted online by Harris Interactive between June 4, 2007, and July 1, 2007. The survey was administered via e-mail to a panel of 1,467 opinion leaders in health policy and innovators in healthcare delivery and finance. The final sample included 214 respondents from various industries. Typically, samples of this size are associated with a sampling error of +/‚ 6.7 percent. However, that does not take other sources of error into account. This online survey is not based on a probability sample and therefore no theoretical sampling error can be calculated. The sample was developed by The Commonwealth Fund, Modern Healthcare magazine, and Harris Interactive. Data from this survey were not weighted.
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