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McClellan Announces ‘Historic’ Pharmacy
Quality Alliance CMS
Proposes New Process for Beneficiary Appeals Collaborative Forum to
Raise Awareness of Need for HIT Adoption AHRQ Study Quantifies Wrong-Site
Surgeries Brailer Resigns from Top Health IT Post CCHIT Launches Certification
of Ambulatory EHRs Family Practice Management Features Article
on Lean Practice PBS Documentary to Highlight Quality Improvement in
Two Hospital Systems At
a special Open Door Forum in Washington, Centers for Medicare & Medicaid
Services Administrator Mark McClellan, MD, PhD, discussed the formation
of the Pharmacy Quality Alliance (PQA), a public/private effort with
founding members including the American Pharmacists Association (APhA),
America’s Health Insurance Plans (AHIP), the National Association
of Chain Drug Stores (NACDS), the National Community Pharmacists Association
(NCPA), and other leading consumer groups, pharmacy organizations, employer
groups, physician organizations, and health plans. The PQA, formally
announced a press event on April 19, seeks to “develop strategies
for defining and measuring pharmacy performance.” Modeled after
other similar alliances such as the Ambulatory Quality Alliance, PQA
will use a consensus-building process to identify measurements of quality
at the pharmacy and pharmacist level and will support the collection
of data for use in public reporting. “To succeed in task 1d3 now and in the 9th Scope of Work, it is
critical that QIOs work to develop relationships with stakeholders in
the pharmacy industry and profession,” said Lisa Geiger Croce,
AHQA Director of Government Affairs, who attended the Open Door Forum. “The
PQA is an excellent opportunity for QIOs to foster these relationships
and get involved at the start of the development of quality and reporting
standards for Part D.” The PQA process may serve as a step leading to pharmacy payment reforms. “Paying
more for higher quality and less costly care is a critical priority for
CMS: just as providing high quality care and avoiding preventable complications
and costs is a high priority for the nation’s health professionals,” said
McClellan during the April 19 press event. AHQA Executive Vice President David Schulke commented, “Dr. McClellan
is once again on target with a quality initiative, and his thoughtful
attention to reform pharmacy payment will yield big dividends. At present,
a pharmacist could work all day identifying and correcting medication
errors and neither he nor his employer would receive a penny of compensation.
That means at a time when there are 90,000 preventable serious or fatal
adverse drug events annually among ambulatory older Americans, the payment
system is a powerful disincentive for pharmacies, as employers, and pharmacists,
as highly trained health care professionals, to provide this vital service
to the public.” At the Open Door Forum, Laura Cranston, the newly appointed Executive
Director of PQA, said that participation will be open to all interested
parties. A steering committee will govern PQA, and two initial work groups
have been formed: 1) Quality metrics and measures development and 2)
reporting. Participants can join a work group at will. They will convene
via teleconference announced at least three months in advance on the
PQA website (www.PQAAlliance.org), which is expected to be live next
week. The Centers for Medicare & Medicaid Services recently announced
a proposed rule that would bring notification procedures for hospital
discharge of Medicare beneficiaries in line with non-hospital discharge
procedures. Under current regulations, Medicare beneficiaries receive
a notice of discharge or non-coverage of services only when he or she
disagrees with an impending hospital discharge. Other Medicare providers
such as nursing homes, home health agencies, hospice providers and comprehensive
outpatient rehabilitation facilities, use a two-step discharge notice
process that provides a generic notice two days prior to discharge, and
if the beneficiary files a complaint, a more detailed notice follows. The proposed rule would replace the current hospital discharge procedures
with a similar two-step process. In step one, hospitals would provide
all inpatient Medicare beneficiaries a standardized, generic notice of
non-coverage the day before discharge (versus the two day notice for
non-hospitals). A beneficiary may contact their QIO to appeal the decision
if he or she disagrees. At that time, the hospital would submit a more
detailed notice of discharge to the beneficiary. The proposed rule covers
both Medicare fee-for-service and Medicare Advantage. Comments on the proposed rule are due to CMS no later than 5 p.m. June
5, 2006. National
Health IT Week – One Vision, One Voice, the first annual
public/private collaborative forum of health IT experts and stakeholders
will be held in Washington, June 5-8. As an organizational sponsor, AHQA
joins more than 30 health IT stakeholders and various health care professional
groups in the event, which aims to strengthen partnerships and foster
widespread health IT adoption. Sponsoring organizations will come together during the week to hold
a number of public events, meetings and conferences to draw national
attention to the necessity for health IT adoption. A cornerstone of these
coalition activities will be National Health IT Day -- a forum for administration
officials, legislators, and industry leaders to discuss high priority
health care issues. Scheduled for Wednesday, June 7, National Health IT Day will include
presentations by members of Congress and other leaders, such as Newt
Gingrich, former Speaker of the House & Founder, Center for Health
Transformation, Mark McClellan, MD, PhD, Administrator, Centers for Medicare & Medicaid
Services, (CMS), and Carolyn Clancy, MD, Director, Agency for Healthcare
Research & Quality (AHRQ). Dual conferences on health IT implementation will be held June 4-7 by
the Agency for AHRQ http://healthit.ahrq.gov/ and the Healthcare Information & Management
Systems Society (HIMSS). http://www.himss.org/summit/. “This first-ever National Health IT Week will help ensure that
private and public entities alike are working to full effect toward the
common goals of better quality of care and greater cost effectiveness
through health IT,” said AHRQ Director Carolyn M. Clancy, MD. Registration for events is individual. The AHRQ conference and HIMSS
Advocacy Day events are free. Registration for National Health IT Day
is $30; fees apply for other HIMSS events. For details: http://www.healthitweek.org/bridge_day.html Agenda: http://www.healthitweek.org/activities.html A study funded by the Agency for Healthcare Research and Quality finds
that wrong-site surgery is rare, seldom results in major injury, and
that hospital site-verification protocols used to prevent the error “varied
significantly.” The study “Incidence, Patterns and Prevention
of Wrong Site Surgery,” was published in the April 2006 issue of
Archives of Surgery. After assessing all wrong-site surgeries reported
to a large medical malpractice insurer between 1985 and 2004, researchers
led by Mary R. Kwaan, MD, MPH, Brigham and Women’s Hospital and
Harvard School of Public Health in Boston identified 40 cases of wrong-site
surgery -- 25 non-spine and 15 spine – and found an incidence rate
of one in every 112,994 operations. The researchers also reviewed 16
site-verification protocols and found significant variation and redundancy. “Under
optimal conditions,” the
researchers said, “the Joint Commission on Accreditation of Healthcare
Organizations Universal Protocol might have prevented 8 (62%) of 13 cases.” Since
only two-thirds of the cases might be preventable under current conditions,
the authors suggest implementation of a universal site-verification protocol
that might include: Read the
full article at: http://archsurg.ama-assn.org/cgi/content/full/141/4/353 David Brailer, MD, PhD, National Coordinator for Health Information
Technology, resigned from his post last week. Brailer was appointed by
President Bush on May 6, 2004. Brailer will continue to serve as Vice-Chair of the American Health
Information Community and as a consultant to the Department of Health
and Human Services (HHS), focusing on the President’s health care
transparency initiative. HHS announced that until a replacement is named, the Office of the National
Coordinator will continue functioning under the leadership of its four
permanent directors: Karen M. Bell, MD, MMS, Director, Office of Health
IT Adoption; John W. Loonsk, MD, Director, Office of Interoperability
and Standards; Kelly Cronin, Director, Office of Programs and Coordination;
and Jodi G. Daniel, JD, MPH, Director, Office of Policy and Research. In a prepared statement, Michael Leavitt, Secretary of Health and Human
Services, praised Brailer for making “significant progress in advancing
the President’s health IT agenda and laying the building blocks
for future progress.” The Certification Commission for Healthcare Information Technology (CCHITSM)
will publish its approved criteria for certification of ambulatory electronic
health record (EHR) products May 1. Applications for certification will
begin May 3 and continue until May 12. The first certified products are
expected to be announced by early July. A one-hour teleconference for vendors is scheduled for May 2 at 11 a.m.
EDT, to discuss the launch and application process. The presentation
will include slides and an operator-assisted Q&A session. (Call-in
Number: (877) 313-5342; Conference ID Number: 8432345). After a vendor has submitted an application, it must successfully complete
inspection and testing by a panel of three independent providers, one
of whom will be a practicing physician, and an IT security expert. If
an applicant’s product meets all the inspection criteria, it will
become “CCHIT Certified.” The process includes provision
for re-testing and appeals. The certification fee is $28,000, which includes
the application and testing fee and a first-year certification maintenance
fee. “This is an important development for physicians practicing in
ambulatory settings,” said John Tooker, MD, MBA, FACP, CEO and
Executive Vice President of the American College of Physicians, who serves
on the Commission. “It will assist physicians considering an electronic
health record system in making an informed purchasing decision, and will
ultimately contribute to the provision of quality, efficient patient
care.” Information on the certification criteria, test scripts, handbook, and
a sample contract will be available on the CCHIT website: www.cchit.org. In February, AARP released a report “Home Care Quality: Emerging
State Strategies to Deliver Person-Centered Services” that highlights
model home care quality improvement initiatives in three states. The
report also includes lessons learned from each state and a checklist
for home care quality that other states can adopt. The report highlights efforts in Wisconsin, Washington, and South Carolina
to improve the quality of care provided by taking a person-centered approach.
The report notes that states continue to be challenged by the idea of
creating “quality assurance systems that place consumer needs and
goals for quality of life first.” It points out that model states have improved communication with consumers,
encouraged greater responsiveness in care management, and implemented
more effective information technology. Wisconsin Washington South Carolina Read the report at: The April issue of Family Practice Management includes the article, “Creating
a Lean Practice: A Highly Efficient Practice Is within Your Reach if
You’re Willing to Examine Your Processes and Ruthlessly Eliminate
Waste,” co-authored by Scott Endsley, MD, MSc, medical director
of system design for Health Services Advisory Group, Arizona’s
QIO. Endsley and co-authors, Michael K. Magill, MD, and Marjorie M. Godfrey,
MS, RN, provide readers with an overall strategy for adopting the “New
Model” of family practice as proposed in the Future of Family Medicine
report. The New Model creates a personal medical home for patients and
encourages a patient-centered care approach (for more information, http://www.aafp.org/x40691.xml
) A news documentary, “Good News How Hospitals Health Themselves,” highlights
efforts at two large hospital systems to save lives and reduce errors,
infections and waste by using Toyota management principles. The show
air on PBS stations across the country this spring and summer. Lloyd Dobyns, former NBC News anchor, is the reporter for the documentary.
Dobyns will highlight how SSM Health Care System CEO Sister Mary Jean
Ryan (20 hospitals and 21,000 employees) adopted Toyota management principles
and teaching systems ideas through the Malcolm Baldrige National Quality
Award criteria. Dobyns will also discuss a Pittsburgh initiative involving
more than 40 hospitals. For a list of stations airing the documentary and local times, visit: To learn more about the documentary, visit: http://www.managementwisdom.com/  Home :: Inside AHQA :: For The Media :: Public Policy :: Advancing Quality :: Quality Connections :: SiteMap
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