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Six QIOs Form Multi-State
SCIP Collaborative AHRQ
Launches New ‘Learning
Resources' To Help Providers Adopt Health IT Medicare Health Support
Programs Enroll More than 100,000 Chronically Ill Beneficiaries Study of PACE Program Shows
Home Care Effective HIMSS Conference: Brailer
Plans to Assess RHIOs; Leadership Survey Results SureScripts to Give MDs,
Patients Access to Medication Histories Near Perfect Flu Shot Rate
Comes with Price Call
for Nominations: 2006
John M. Eisenberg Award Costlier
Heart Care May Indicate Inefficient Use of Technology,
Study Says Study:
Key Elements to Effective Use of Patient Survey Data
Identified QIOs in Michigan, Illinois, Indiana, Kentucky, Ohio,
and Wisconsin have formed an independent collaborative
to collectively address the 8 th Scope of Work goal
of reducing surgical complications by 25% in identified
participant group (IPG) hospitals in every state. The
collaborative, a spin-off of the national SCIP effort,
is called SCIP6. It is designed to provide a platform
to share best practices, convey experiences, and increase
spread beyond individual state borders. The QIOs involved in SCIP6 are: Illinois Foundation
for Quality Health Care, Health Care Excel (IN and
KY) MPRO, Ohio KePro, and MetaStar. Together they will
share resources and expenses for conference calls,
speakers, events, and interventions. Through SCIP6 they will conduct virtual meetings
and a monthly conference call, providing IPG hospitals
in all six states the opportunity to network and learn
from each other as well as from experts in the field
of surgical care. The hospitals will also share quarterly,
aggregate data for each of the SCIP quality of care
measures across all six states. To
support peer-to-peer interaction, the collaborative
has set up a secured internet forum where SCIP6 participants
can ask questions and gain insight from the experiences
of their peers, whether in the same town or another
state. “SCIP6 allows providers in Ohio to know what
providers in Michigan are doing in similar situations,” said
Sylvia Carson, Senior Marketing/Communications Specialist,
Illinois Foundation for Quality Healthcare. The
collaborative will also provide a sustainability model
so providers can learn how to work individually to
maintain achievements. In addition, SCIP6 plans to
evaluate the effectiveness of this innovative approach, “Evaluation
is going to be very key part of this project. We like
to see this as a model that other states can benefit
from,” said Carson. The kickoff of SCIP6 is scheduled to take place
on February 16, 2006 as a virtual meeting. David Hunt,
MD, FACS, medical officer in CMS' Quality Improvement
Group, OCSQ, will deliver the keynote address. Dr.
Hunt is the Government Task Leader for the Medicare
Patient Safety Monitoring System as well as the national
SCIP program. Contact information for the QIOs involved in SCIP6: The
Agency for Healthcare Research and Quality (AHRQ) launched
a new suite of “learning resources” to help
health care providers adopt health information technologies
(HIT) quickly and effectively by sharing lessons learned
in a timely manner. Part of the National Resource Center
for Health Information Technology, the new resources
provide information to “help health care providers
at the ground level learn from each other's real-world
experience and give them easy access to the best information
available,” said AHRQ Director Carolyn M. Clancy, MD
in a press release. The new resources are at the center's
website: http://www.healthit.ahrq.gov. How it works Included in the resource center are: Moving quickly “This is a learn-as-you-go project,” Dr. Clancy
said. “The President and HHS Secretary Mike Leavitt
have made health IT adoption an urgent priority. We're
not waiting for perfect information. We'll make good
information available as we learn it.” For
more information, contact AHRQ Public Affairs: (301)
427-1241 or (301) 427-1855. More than 100,000 Medicare beneficiaries are now
participating in the voluntary Medicare Health Support
programs, which are designed to reduce health risks
and improve the quality of life for Medicare beneficiaries
with chronic conditions, accounting for a disproportionate
share of health care expenditures and a leading cause
of illness, disability, and death. The Medicare Health Support program (initially called
the Chronic Care Improvement Program) was created as
part of the Medicare Prescription Drug Improvement
and Modernization Act of 2003; the pilots were announced
in December 2004 and operate in the following areas: Using
historical claims data, CMS identified beneficiaries
in the pilot regions who are candidates for Medicare
Health Support. More than 160,000 beneficiaries
with such chronic conditions as congestive heart failure,
complex diabetes, and chronic obstructive pulmonary
disease, were invited to participate in these programs;
100,000 are now enrolled. Beneficiaries with multiple chronic conditions often
have heavy self-care burdens and experience poor health
outcomes, increased costs, and diminished quality of
life, despite the best efforts of health care providers.
The Medicare Health Support programs address this problem
by connecting participants with specially trained health
professionals who help them manage adhere to their
physicians' plans of care, and reduce their health
risks. The programs use interventions such as: personalized
care plans, biometric monitoring devices, 24 hour telephonic
nurse access, and group education and support sessions. Though
the first programs have been operational less than
six months, the response from beneficiaries, their
caregivers and physicians alike has been extremely
positive, CMS stated in a press release. “Medicare
Health Support is an innovative approach to care that
represents a key priority for the future of Medicare,” said
CMS Administrator Mark McClellan, MD, PhD. More
information about the program is available online at http://www.cms.hhs.gov/CCIP. Researchers
studied 2,943 frail older people at 13 sites involved
in CMS' Program of All-inclusive Care for the Elderly
(PACE) and found that when elders who qualify for nursing-home
care because of their inability to perform daily tasks
such as dressing and bathing receive assistance through
home care – even
for just a few weeks – they are able to stay in their
own homes. Elders who lived alone without such needed
assistance were more likely to require hospitalization. The report, in the February 6 issue of the Journal
of the American Geriatrics Society was written
by Purdue researchers Laura P. Sands, Yun Wang, George
P. McCabe and Kristofer Jennings and University of
California , San Francisco , investigators Catherine
Eng and Kenneth E. Covinsky. Participants in the PACE program receive care from
an interdisciplinary team, consisting of professional
and paraprofessional staff that assesses needs, develops
care plans, and delivers integrated services. PACE
programs provide social and medical services primarily
in an adult day health center, supplemented by in-home
and referral services in accordance with participant
needs. “What this suggests is that if a homemaker or personal
assistant helps these frail elders for a few hours
a day, they would be less likely to experience medical
conditions such as hunger, dehydration, falls and skin
problems that occur when disabled older adults do not
receive needed help with daily tasks.” Sands said. “As
our government is under increasing pressure to develop
fiscally feasible solutions for caring for disabled
older people, we feel providing disabled elders with
adequate home-based care should receive further attention.” Sands
said that while the concept would not eliminate older
people's need for regular medical attention, it could
reduce preventable illness, which would improve the
quality of life for baby boomer Americans, many of whom
will need some form of care within the next decade. More
information on the PACE program is available at: http://www.cms.hhs.gov/PACE/ At the 2006 Health Information and Management Systems
Society (HIMSS) Annual Conference and Exhibition in
San Diego , David Brailer, MD, PhD, National Coordinator
for Health Information Technology, told reporters that
he plans to assess regional health information organizations,
or RHIOs. AHA
News Now, a publication of the American Hospital Association,
reported that an “ independent contractor
would assess the regional organizations this year using
secondary research and interviews with state and RHIO
officials.” The publication said that the contract
is under development and quoted Brailer as saying it
would include “tight timelines” and “specific deliverables.” Patient satisfaction, followed closely by Medicare
cutbacks and reduction of medical errors, are the issues
that will have the most impact on health care in the
next two years, said health care information technology
executives in the 17th Annual HIMSS Leadership Survey
released February 13 th at the HIMSS conference. Slightly more than half (51%) of survey respondents
identified patient satisfaction as a top business issue,
compared to 44% in last year's survey. The other top
business issues, Medicare cutbacks and reducing medical
errors, were cited by 50% and 44% of participants respectively.
Other findings include: The
survey, sponsored by ACS Healthcare Solutions, includes
responses from more than 200 IT executives who oversee
the technology operations at more than 473 hospitals
throughout the United States. More information on the HIMSS conference and the
survey is available at: http://www.himssconferencenews.org/index.php?sid=S20060213135945M02K64 SureScripts to Give MDs,
Patients Access to Medication Histories SureScripts, the nation's largest network provider
of electronic prescribing services, announced at the
Health Information and Management Systems Society (HIMSS)
Conference in San Diego that it will, for the first
time, provide physicians and patients with electronic
access to medication history while protecting patient
privacy. Ninety per cent of all pharmacies in the United
States are certified on the SureScripts network. Physicians
in Rhode Island, Massachusetts, Nevada, Tennessee,
New Jersey, and Florida will soon receive medication
history from community pharmacies when they submit
a prescription electronically. Physicians will be provided
a single view of a patient's medication history across
all prescribers, giving them access to more detailed
clinical information on current and past medications.
The end result combines pharmacy data with medication
data to provide physicians a more complete, timely,
and clinically sound view of a patient's medication
history. In
addition, SureScripts says it intends to work with
physicians and pharmacists to make medication history
available to patients. Following a rigorous process
guided by HIPAA compliance rules and state privacy
laws, and the adoption of strict methods for confidentiality
and authentication, consumers will be able to access
their medication history from pharmacies in their community
through personal health records applications. Both
solutions will create a more efficient, safe, and effective
opportunity for patients and physicians to avoid drug
interactions and manage complex medication regimens
or ongoing maintenance therapies. In addition, SureScripts
anticipates that the initiative will spur additional
efforts toward making electronic health records and
interoperability a reality. The
list of pharmacies participating in the announcement
includes, but is not limited to, Ahold (Giant and Stop & Shop),
Albertsons (Sav-On and Osco), Brooks Eckerd, CVS, Duane
Reed, Kerr Drug, Longs Drugs, Rite Aid, Safeway and
Walgreens. SureScripts was founded in 2001 by the National
Association of Chain Drug Stores and the National Community
Pharmacists Association. Virginia
Mason Medical Center in Seattle announced in late December
2005 that it “set a new medical center
patient safety standard,” by achieving a 96% vaccination
rate for hospital staff. Under a controversial mandate
in 2005, all 5,000 hospital staff were required to
either be vaccinated or face dismissal (medical and
religious exemptions were allowed). The national health
care worker immunization rate is 36%. “As the medical center with the highest percentage
of older patients in the region, providing the safest
possible care is our moral imperative and fundamental
to our mission. We know a simple influenza immunization
could save a life,” said Patti Crome, Senior Vice President
at Virginia Mason. In
addition to the mandate, Virginia Mason provided free
staff immunization, education about the immunization,
an awareness campaign called “Save lives – immunize,” on-site
inoculations and opportunities to request accommodations
for special circumstances. Nursing staff at the hospital objected to the mandatory
immunization and the Washington State Nurses Association
(WSNA), which represents 600 nurses at Virginia Mason,
sued to keep the hospital from firing nurses who do
not comply. Preliminary rulings allow the nurses to
refuse but Virginia Mason is appealing this decision. The hospital now requires all nurses who are not
immunized to wear masks when interacting with patients.
In late January, WSNA filed an unfair labor practice
charge against the hospital for this requirement. A call for nominations for the 2006 John M. Eisenberg
Award for Patient Safety and Quality Awards has been
announced by the National Quality Foundation (NQF)
and the Joint Commission on Accreditation and Healthcare
Organizations (JCAHO). The submission deadline for
nominations is May 1, 2006. Established in 2002 by NQF and JCAHO in memory of
John M. Eisenberg MD, Director of the Agency for Healthcare
Research and Quality, the awards recognize the achievements
of individuals who have made significant and lasting
contributions to improving patient safety and health
care quality. In addition, the awards recognize individuals
and organizations that have made an important contribution
to patient safety and health care quality in the areas
of research or system innovation through a specific
initiative or project. Award categories include: individual achievement
and initiative/project-related achievements: research,
innovation at nation or regional level, and innovation
at local or organizational level. The accomplishments
of nominees should clearly exhibit the following principles: The 2006 awards will be presented in conjunction
with the NQF Annual Meeting, October 12 and 13, 2006,
in Washington , DC . A nomination form and more information is available
at: http://www.qualityforum.org/fmNomination2006.doc In a Health Affairs web exclusive posted
February 7 th , Dartmouth researchers, economists Jonathan
Skinner and Douglas Staiger and physician Elliott Fisher
find that those regions of the country that spend more
on heart attack (AMI) care do not achieve better outcomes
than those that spend less. They suggest that the regions
spending more are essentially less efficient at using
existing tools, regardless of the cost or degree of
technology. Simply
cutting spending in high-cost areas may not be the
solution, the authors note. They recommend “improving
productivity, restructuring hospital resources, improving
the efficiency of physician treatment patterns, and
accelerating the diffusion of highly effective treatments.” Skinner's
team declares: “Efforts to develop measures of quality
and efficiency that can encourage hospitals or provider
groups to adopt low-cost, highly effective care, while
discouraging incremental spending with no apparent
benefits, might allow us to keep the golden goose of
technological progress alive and well nourished.” Along
with the study, “Is Technological Change In
Medicine Always Worth It? The Case Of Acute Myocardial
Infarction,” Health Affairs has posted perspectives
on the Dartmouth work by Stanford's Alan Garber, MD,
and Harvard's David Cutler. The study and perspectives
are available at: http://www.healthaffairs.org/ In an article in the December 2005 issue of Quality & Safety
in Health Care , researchers conclude that patient
survey information can be a useful tool in quality
improvement efforts if health care providers understand
it's potential. In
a Commonwealth Fund–supported study, “Hearing
the Patient's Voice? Factors Affecting the Use of Patient
Survey Data in Quality Improvement”, authors Elizabeth
Davies, PhD, of King's College London School of Medicine,
and Paul D. Cleary, PhD, of Harvard Medical School,
asked 14 senior health professionals and managers taking
part in a quality improvement collaborative to identify
difficulties or successes they experienced using patient
feedback or survey data. Davies and Cleary identified multiple barriers to
effective use of patient survey data including professional,
organizational, data-related barriers ranging from
traditional organizational structures to communications
issues and difficulty in data interpretation. Respondents also revealed potential secrets of success:
focusing on system changes, rather than assigning individual
blame, and developing cultures that support patient-centered
care by emphasizing physician leadership, technical
expertise, and organizational capacity.  Home :: Inside AHQA :: For The Media :: Public Policy :: Advancing Quality :: Quality Connections :: SiteMap
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