Health Care Delivery Needs To Be A Science Too, Carolyn Clancy Tells University Of Maryland
From the 6 May 2011 Medical News Today article
Carolyn Clancy, MD, director of the federal Agency for Healthcare Research and Quality (AHRQ), says that although the U.S. “leads the way” in science to develop medical methods, the country still needs to treat health care delivery as a science.
Health care should emulate Starbucks in teamwork, Clancy told a standing-room audience at Pharmacy Hall at the University of Maryland School of Pharmacy. “They get it. You order a drink at the cashier, even one of those complicated ones. The cashier repeats it back to you and writes it on the cup. Then she repeats it to the person making it, who also repeats it. Most of medicine has not done that. They do a better job at Starbucks.” …
…Delivering the annual Andrew G. Dumez Memorial Lecture, “Research Meets Practice at the RX: Keeping Patients and Consumers at the Center of Care,” Clancy provided a high-level view of the current challenges to improve the quality of care, as well as the pharmacists’ roles in those challenges. As a producer of what Clancy called “benchmark” reports for health care industry and policymakers, AHRQ “supports research that helps people make more informed decisions and improves the quality of health care services,” according to its website.
Clancy praised the current collaborative trend in health care research, which is designed to inform health care decisions by providing evidence on the effectiveness, benefits, and harms of different treatment options. The evidence is generated from research studies that compare drugs, medical devices, tests, surgeries, or ways to deliver health care. Such “patient-centered research,” she said, greases the skids of scientific advances into actual clinical practice and usable information for clinicians and patients.
During the creation of the American Recovery and Reinvestment Act of 2009, “All parties agreed,” she said, that “patient-centered care needs to involve more than clinical intervention. It also needs to include such things as drug-to-drug interaction, care management, avoiding hospital stays” and more.
Clancy said a recent AHRQ report found that progress has been made in data collection in the health care system as more providers are collecting and storing patient data. The team concept in health care transcends the “my data” mentality of the past, she said. “We are getting to a point when data are ubiquitous, allowing for more success in using comparative effectiveness as a tool, with improved methods that can support learning and improvement at the front lines of care delivery.”
Addressing the pharmacy students in attendance, Clancy said, “If there was ever a time when we need you, it is now. It is becoming increasingly important to safety and quality is to do medicine as a team sport. And the pharmacist is a vital member of the team.” …..
Related articles
- Health Care Quality Still Improving Slowly, but Disparities and Gaps in Access to Care Persist (jflahiff.wordpress.com)
- Navigating the Health Care System (nlm.nih.gov)
New Tutorials from HCUP (US Healthcare Cost and Utilization Project)
HCUP On-line Tutorial Series
From the AHRQ (Agency for Healthcare Research and Quality) press release
HCUP Offers New Online Tutorial Series’ Modules
AHRQ is pleased to announce the release of a new module and an updated re-release of a favorite in the HCUP Online Tutorial Series. These online trainings are designed to provide data users with information about HCUP data and tools, as well as training on technical methods for conducting research using HCUP datasets.
- The all-new Calculating Standard Error tutorial is designed to help users determine the precision of the estimates they produce from the HCUP nationwide databases. Users will learn two methods for calculating standard errors for estimates produced from the HCUP nationwide databases.
- The newly revised HCUP Overview Course is a helpful introduction to HCUP for new users. The original course has been updated to include the latest additions to the HCUP family of databases and tools, including the Nationwide emergency Department Sample.
The HCUP Online Tutorial Series is available on the HCUP-US Web site. For more information, contact HCUP User Support at hcup@ahrq.gov.
Related Articles
- HCUP Facts and Figures: Statistics on Hospital-based Care in the United States (jflahiff.wordpress.com)
- New Analysis Illustrates the Hidden Burden of Atrial Fibrillation on Healthcare Spending and Resources in Each State (prnewswire.com)
- AHRQ News And Numbers: Medication Side Effects, Injuries, Up Dramatically (jflahiff.wordpress.com)
- New Tab: Tutorials (tinysewingempire.wordpress.com)
AHRQ News And Numbers: Medication Side Effects, Injuries, Up Dramatically
From the 13 April 2011 Medical News Today article
The number of people treated in U.S. hospitals for illnesses and injuries from taking medicines jumped 52 percent between 2004 and 2008 – from 1.2 million to 1.9 million — according to the latest News and Numbers from the Agency for Healthcare Research and Quality. These medication side effects and injuries resulted from taking or being given the wrong medicine or dosage.
The federal agency also found that in 2008:
– The top 5 medicines that had more than 838,000 people treated and released from emergency departments were: unspecified medicines (261,600); pain killers (118,100), antibiotics (95,100), tranquilizers and antidepressants (79,300), corticosteroids and other hormones (71,400).
– For patients admitted to the hospital, the top five medicines causing side effects and injuries were corticosteroids (used for such illnesses as asthma, arthritis, ulcerative colitis, and other conditions–283,700 cases), painkillers (269,400), blood-thinners (218,800), drugs to treat cancer and immune system disorders (234,300), and heart and blood pressure medicines (191,300).
– More than half (53 percent) of hospitalized patients treated for side effects or other medication-related injuries were age 65 or older, 30 percent were 45 to 64, 14 percent between 18 and 44, and 3 percent under age 18. Children and teenagers accounted for 22 percent of emergency cases.
– About 57 percent of the hospitalized patients and 61 percent of emergency department cases were female.
This AHRQ News and Numbers is based on data in Medication-related Adverse Outcomes in U.S. Hospitals and Emergency Departments, 2008. The report uses data from the agency’s 2008 Nationwide Inpatient Sample and 2008 Nationwide Emergency Department Sample. For information about these two AHRQ databases, go here.
Reports on Health Care Disparities at the State Level Available
Reports on Health Care Disparities at the State Level Available
From the AHRQ (Agency for Healthcare Research and Quality) press release
AHRQ has released two reports from its Healthcare Cost and Utilization Project that provide information on approaches to using race/ethnicity data for reducing disparities in the quality of health and health care. The data is from the 2010 National Health Quality Report and National Healthcare Disparities Report.
The following reports focusing provide information on approaches to using race/ethnicity data for reducing disparities in the quality of health and health care.
- State Documentation of Racial and Ethnic Health Disparities to Inform Stategic Action (PDF file, 647 KB; HTML)
- State Uses of Hospital Discharge Databases to Reduce Racial and Ethnic Disparities (PDF file, 205 KB)
Also…
2010 National Healthcare Quality & Disparities Reports
For the eighth year in a row, the Agency for Healthcare Research and Quality (AHRQ) has produced
the National Healthcare Quality Report (NHQR) [Full Report (PDF File, 4.4 MB) PDF Help] and
the National Healthcare Disparities Report (NHDR [Full Report (PDF File, 4.3 MB) PDF Help{).
These reports measure trends in effectiveness of care, patient safety, timeliness of care, patient centeredness, and efficiency of care. New this year are chapters on care coordination, health system infrastructure. The reports present, in chart form, the latest available findings on quality of and access to health care.
Related Articles
- Health Care Quality Still Improving Slowly, but Disparities and Gaps in Access to Care Persist (jflahiff.wordpress.com)
- “2010 National Healthcare Quality & Disparities Reports” and related posts (nnlm.gov)
- Patient Safety Awareness Week 4: National Quality and Disparities Reports Show Need For Improvement (hcfama.org)
- Kaiser’s Monthly Update on Health Disparities – Kaiser Family Foundation (policyabcs.wordpress.com)
- Health Care Quality Still Improving Slowly, but Disparities and Gaps in Access to Care Persist (nlm.nih.gov)
- Health Disparities Still a Huge Problem (lseegert.wordpress.com)
Health Care Quality Still Improving Slowly, but Disparities and Gaps in Access to Care Persist
Health Care Quality Still Improving Slowly, but Disparities and Gaps in Access to Care Persist
From the Agency for Healthcare Research and Quality (AHRQ) Press Release
ress Release Date: February 28, 2011
Improvements in health care quality continue to progress at a slow rate—about 2.3 percent a year; however, disparities based on race and ethnicity, socioeconomic status and other factors persist at unacceptably high levels, according to the 2010 National Healthcare Quality Report and National Healthcare Disparities Report issued today by the Department of Health & Human Services’ (HHS) Agency for Healthcare Research and Quality (AHRQ).The reports, which are mandated by Congress, show trends by measuring health care quality for the Nation using a group of credible core measures. The data are based on more than 200 health care measures categorized in several areas of quality: effectiveness, patient safety, timeliness, patient-centeredness, care coordination, efficiency, health system infrastructure, and access.
“All Americans should have access to high-quality, appropriate and safe health care that helps them achieve the best possible health, and these reports show that we are making very slow progress toward that goal,” said AHRQ Director Carolyn M. Clancy, M.D. “We need to ramp up our overall efforts to improve quality and focus specific attention on areas that need the greatest improvement.”
Gains in health care quality were seen in a number of areas, with the highest rates of improvement in measures related to treatment of acute illnesses or injuries. For example, the proportion of heart attack patients who underwent procedures to unblock heart arteries within 90 minutes improved from 42 percent in 2005 to 81 percent in 2008.
Other very modest gains were seen in rates of screening for preventive services and child and adult immunization; however, measures of lifestyle modifications such as preventing or reducing obesity, smoking cessation and substance abuse saw no improvement.
The reports indicate that few disparities in quality of care are getting smaller, and almost no disparities in access to care are getting smaller. Overall, blacks, American Indians and Alaska Natives received worse care than whites for about 40 percent of core measures. Asians received worse care than whites for about 20 percent of core measures. And Hispanics received worse care than whites for about 60 percent of core measures. Poor people received worse care than high-income people for about 80 percent of core measures.
Of the 22 measures of access to health care services tracked in the reports, about 60 percent did not show improvement, and 40 percent worsened. On average, Americans report barriers to care one-fifth of the time, ranging from 3 percent of people saying they were unable to get or had to delay getting prescription medications to 60 percent of people saying their usual provider did not have office hours on weekends or nights. Among disparities in core access measures, only one—the gap between Asians and whites in the percentage of adults who reported having a specific source of ongoing care—showed a reduction.
Each year since 2003, AHRQ has reported on the progress and opportunities for improving health care quality and reducing health care disparities. The National Healthcare Quality Report focuses on national trends in the quality of health care provided to the American people, while the National Healthcare Disparities Report focuses on prevailing disparities in health care delivery as it relates to racial and socioeconomic factors in priority populations.
The quality and disparities reports are available online at http://www.ahrq.gov/qual/qrdr10.htm, by calling 1-800-358-9295 or by sending an E-mail to ahrqpubs@ahrq.hhs.gov.
For more information, please contact AHRQ Public Affairs: (301) 427-1892 or (301) 427-1855.
Use Twitter to get AHRQ news updates: http://www.twitter.com/ahrqnews/
How to Create a Pill Card to Keep Track of Meds
AHRQ (Agency for Healthcare Research and Quality) has a one page guide on how to create a pill card.
The guide includes a template, clip art from Microsoft Word, and what information to include.
An excerpt
Table 1: Organize Information for the Pill Card
| Medicine | Important Information in Simple Terms | Incorporating This Information into a Pill Card | Possible Graphics Used |
|---|---|---|---|
 Simvastatin20mg |
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 Furosemide20mg |
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| Insulin
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AHRQ Healthcare 411 podcasts
AHRQ Healthcare 411 podcasts
From a recent AHRQ (Agency for Healthcare Research and Quality) listserv item
AHRQ’s Healthcare 411 is a podcast series you can listen to at home or on the go. Available in English and Spanish, 60-second audio podcasts are designed for consumers. Log on and listen to Healthcare 411; or subscribe and we’ll send stories directly to your computer or personal media player. Select to listen to our latest audio podcast on e-prescribing and reducing medication costs.
A sampling of podcasts (Entire list is here ; Search option is here)
- Effective Health Care: Helping You Make Better Treatment Choices
- Tips on Going Home From the Hospital
- Asking Questions to Get the Care You Need
- Online Health Information
- Torn Rotator Cuff
- Treating Stable Coronary Heart Disease
What Is Comparative Effectiveness Research?
What Is Comparative Effectiveness Research?
From the US AHRQ (Agency for Healthcare Research and Quality) Web page
Comparative effectiveness research is designed to inform health-care decisions by providing evidence on the effectiveness, benefits, and harms of different treatment options. The evidence is generated from research studies that compare drugs, medical devices, tests, surgeries, or ways to deliver health care.
There are two ways that this evidence is found:
- Researchers look at all of the available evidence about the benefits and harms of each choice for different groups of people from existing clinical trials, clinical studies, and other research. These are called research reviews, because they are systematic reviews of existing evidence.
- Researchers conduct studies that generate new evidence of effectiveness or comparative effectiveness of a test, treatment, procedure, or health-care service.
Comparative effectiveness research requires the development, expansion, and use of a variety of data sources and methods to conduct timely and relevant research and disseminate the results in a form that is quickly usable by clinicians, patients, policymakers, and health plans and other payers. Seven steps are involved in conducting this research and in ensuring continued development of the research infrastructure to sustain and advance these efforts:
- Identify new and emerging clinical interventions.
- Review and synthesize current medical research.
- Identify gaps between existing medical research and the needs of clinical practice.
- Promote and generate new scientific evidence and analytic tools.
- Train and develop clinical researchers.
- Translate and disseminate research findings to diverse stakeholders.
- Reach out to stakeholders via a citizens forum.
Common questions about comparative effectiveness research
Q: Why is comparative effectiveness research needed? What problem is it trying to solve?
- If you don’t get the best possible information about your treatment choices, you might not make an informed decision on what treatment is best for you.
- When you shop for a new car, phone or camera, you have lots of information about your choices. But when it comes to choosing the right medicine or the best health-care treatment, clear and dependable information can be very hard to find.
- It’s true that some treatments may not work for everyone, and that some treatments may work better for some people than others. This research can help identify the treatments that may work best for you.
Q: What are the practical benefits of comparative effectiveness research?
- You deserve the best and most objective information about treating your sickness or condition. With this research in hand, you and your doctor can work together to make the best possible treatment choices.
- For example, someone with high blood pressure might have more than a dozen medicines to choose from. Someone with heart disease might need to choose between having heart surgery or taking medicine to open a clogged artery. Reports on these topics and others include the pros and cons of all the options so that you and your doctor can make the best possible treatment decision for you or someone in your family.
- Every patient is different — different circumstances, different medical history, different values. These reports don’t tell you and your doctor which treatment to choose. Instead, they offer an important tool to help you and your doctor understand the facts about different treatments.
- …and AHRQ Effective Health Care Program Links
- Guides for Patients and Consumers include research reviews, research reports, and summary guides
- Glossary of Terms
- Personalization and Social Media Tools – These tools (as an email list)allow you to personalize your experience with the EHC Program Web site and share it with colleagues, family, and friends.
Related Articles
- Many new drugs did not have comparative effectiveness information available at time of FDA approval (eurekalert.org)
- The differences between comparative and clinical effectiveness (kevinmd.com)
- The Role of Data Mining in Cost Effectiveness Research (medicineandtechnology.com)
- The Newspeak of comparative effectiveness research (CER) (doctorrw.blogspot.com)
- CDISC Standards at Core of FDA Cross-study Clinical Trial Repository Project (prweb.com)
- National Library of Medicine Updates (aa47.wordpress.com)
- Shall I compare thee to another drug? (blogs.nature.com)
Elsevier/MEDai enhances real-time clinical surveillance system for hospitals
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Elsevier/MEDai enhances real-time clinical surveillance system for hospitals
From the February 15, 2011 Eureka news alert
(Elsevier) Elsevier/MEDai, a leading provider of advanced clinical analytic health-care solutions, announced today the launch of the latest version of Pinpoint Review, its real-time, clinical surveillance system for hospitals. The new version will feature an expanded set of clinical watch triggers, expanded core measure alerts and three new predictions: ICU Admission Prediction, Length of Stay Prediction and Mortality Prediction.
ORLANDO, FL – 14 February, 2011 – Elsevier / MEDai, a leading provider of advanced clinical analytic healthcare solutions, announced today the launch of the latest version of Pinpoint Review®, its real-time, clinical surveillance system for hospitals. The new version will feature an expanded set of clinical watch triggers, expanded core measure alerts and three new predictions: ICU Admission Prediction, Length of Stay Prediction and Mortality Prediction.
“Hospitals are facing an enormous amount of pressure to provide better, safer care with fewer complications while managing costs,” said Swati Abbott, President of Elsevier / MEDai. “Elsevier / MEDai has enhanced its predictive analytics product to continuously give hospitals and clinicians the most up-to-date tools they need to lower mortality rates and healthcare costs, provide a higher quality of care, increase patient safety and maintain regulatory compliance.”
Pinpoint Review generates predictions for acute-care patients, focusing on the likelihood of a patient developing a complication, contracting a healthcare-acquired infection or being readmitted within 30 days of discharge, while patients are still in the hospital and there is time to adjust care to avoid a negative outcome.
With the expansion of Pinpoint Review’s new predictions, care givers are able to enhance their efforts in proactive care management. Pinpoint Review unlocks the power of clinical and administrative hospital data by utilizing predictive technologies to turn data into actionable information. Empowering today’s hospitals with the ability to predict whether or not a patient will be admitted to the ICU or higher intensity care unit, a predicted length of hospital stay or patient expiration goes a long way in driving down the cost of care and brings a proactive approach to quality improvement.
Pinpoint Review addresses the increasing pressure on hospitals from entities such as the Agency for Healthcare Research and Quality and the Joint Commission on Accreditation of Healthcare Organizations to deliver a higher quality of care and fewer medical errors. Pinpoint Review alerts care providers to patients at risk for developing several of the conditions that the Centers for Medicare and Medicaid Services (CMS) no longer reimburse.
New Chapters for Effective Health Care Program’s Methods Guide for Comparative Effectiveness Reviews
New Chapters for Effective Health Care Program’s Methods Guide for Comparative Effectiveness Reviews
The Agency for Healthcare Research and Quality (AHRQ) ’s Effective Health Care Program has released two new chapters of the Methods Guide for Effectiveness and Comparative Effectiveness Reviews:
· “Finding Evidence for Comparing Medical Interventions”
· “Assessing the Applicability of Studies When Comparing Medical Interventions”
To learn more about the Methods Guide for Effectiveness and Comparative Effectiveness Reviews and to access other chapters in this guide.
About
This blog presents a sampling of health and medical news and resources for all. Selected articles and resources will hopefully be of general interest but will also encourage further reading through posted references and other links. Currently I am focusing on public health, basic and applied research and very broadly on disease and healthy lifestyle topics.
Several times a month I will post items on international and global health issues. My Peace Corps Liberia experience (1980-81) has formed me as a global citizen in many ways and has challenged me to think of health and other topics in a more holistic manner.
Do you have an informational question in the health/medical area?
Email me at jmflahiff@yahoo.com
I will reply within 48 hours.
This blog is a companion site to my Health and Medical News and Resources Web site with…
- Great places to start (locating health information)
- Links to help from others (as health care providers and support groups)
- Interactive tools (as health calculators and apps)
- Select related news sites and blogs
My professional work experience and education includes over 15 years experience as a medical librarian and a Master’s in Library Science. In my most recent position I enjoyed contributing to our library’s blog, performing in depth literature searches, and collaborating with faculty, staff, students, and the general public.
While I will never be be able to keep up with the universe of current health/medical news, I subscribe to the following to glean entries for this blog.
- Science Daily – Your source for the latest research news
- MedlinePlus email updates from the US National Institutes of Health
- Partners in Information Access for the Public Health Workforce – a collaboration of U.S. government agencies, public health organizations and health sciences libraries
- US Agency for Healthcare Research and Quality (AHRQ) news now with updates on the agency’s efforts to “improve the quality, safety, efficiency, and effectiveness of health care for all Americans”
- Research Buzz, “news about search engines, digital archives, online museums, databases, and other Internet information collections since 1998”
- Scout Report, a “weekly publication offering a selection of new and newly discovered Internet resources of interest to researchers and educators”
- KevinMD.com -“Social Media’s leading physician voice”
- EurekAlert-Medicine and Health
Health and Medical News and Resources 