Quality Update for May 25, 2006

First Set of Recommendations from AHIC Approved CMS to Investigate Cutting Payment for ‘Never Events’ New Privacy and Security Contracts Awarded to QIOs, Others for National HIE Effort HHS Releases Checklist for LTC Pandemic Flu Preparation AHQA a Collaborating Organization for HIMSS Summit Study: Seniors Say Good Communication = Good Care NQF Requests Comment on ‘Serious Reportable Events in Healthcare’ JAMA Study Compares US and UK Older Adult Health First Set of Recommendations from AHIC Approved The American Health Information Community (the Community) unanimously approved 28 recommendations on how to make health records digital and interoperable while protecting patient privacy and the security of those records. HHS Secretary Michael Leavitt will now consider the recommendations. Among other recommendations, the Community advised that the Health Information Technology Standards Panel (HITSP) identify and define standards that will enable secure messaging between patients and clinicians, reporting results from laboratory testing, and availability of electronic registration information to replace the medical clipboard. The Community also recommended that the Certification Commission for Health Information Technology (CCHIT) incorporate HITSP standards as criteria for product certification on an ongoing basis, and that a subgroup be formed to discuss privacy and security issues. All CCHIT criteria for certification of ambulatory electronic health records (EHRs) were unanimously adopted. For more information on the meeting, visit: http://www.hhs.gov/healthit/m20060516.html Details on the Community are available at: http://www.hhs.gov/healthit/ahic.html Back to top CMS to Investigate Cutting Payment for ‘Never Events’ Mark McClellan, MD, PhD, Centers for Medicare & Medicaid Services (CMS) Administrator, announced recently as part of testimony on Capitol Hill that the agency is investigating ways that Medicare can help to reduce or eliminate the occurrence of “never events.” The National Quality Forum defines “never events” as those that are clearly identifiable, preventable, with serious consequences for patients, and indicative of a patient safety problem in a health care facility -- surgery on the wrong body part, for example. In the notification, CMS said that “reducing or eliminating payments for ‘never events’ would mean more resources could be directed toward preventing these events rather than paying more when they occur. The Deficit Reduction Act represents a first step in this direction, allowing CMS, beginning in FY 2008, to adjust payments for hospital-acquired infections.” The agency said it is reviewing its administrative authority to reduce payments for “never events” and will work with Congress on legislative steps that can be taken. CMS plans to “partner with hospitals and other healthcare organizations in these efforts,” the notification said. CMS also recently released a new fact sheet on “never events.” It is available at: http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=1863 Back to top New Privacy and Security Contracts Awarded to QIOs, Others for National HIE Effort The Department of Health and Human Services (HHS) announced that 22 states and territories have signed contracts to work as part of the national Health Information Security and Privacy Collaboration (HISPC) to address privacy and security policy questions affecting interoperable health information exchange (HIE); 12 more contracts are expected in coming weeks. Several QIOs are involved in or are leading in these state-based contracts. RTI International, Inc. (RTI) is working in partnership with the National Governors Association to oversee HISPC, which will work on privacy and security issues with a multi-disciplinary team of experts and 34 states and territorial governments. Earlier this year, governors of each state and territory designated an organization to submit a proposal to subcontract with RTI to manage the state-level effort. In some states, such as Iowa, West Virginia, and Mississippi, governors selected their QIO. As of press time, QIOs reporting involvement in HISPC contracts include: West Virginia Medical Institute, Iowa Foundation for Medical Care, Information and Quality Healthcare for Mississippi, Qualis Health for Washington, Stratis Health for Minnesota, Health Services Advisory Group (HSAG) for Arizona, Illinois Foundation for Quality Healthcare, Arkansas Foundation for Medical Care (AFMC), New Mexico Medical Review Association, and HealthInsight for Utah. As subcontractors, QIOs and their partners are expected to work with health care professionals, patients, technology vendors, hospitals, and others in their states and territories to: identify variations in privacy and security practices and laws affecting electronic clinical HIE; develop best practices and proposed solutions to address identified challenges; and increase expertise about health information privacy and security protection in communities. The states will also work to develop implementation plans for future HIE activities. The HISPC is one of four components of HHS’ plans to support nationwide HIE. In October of 2005, the Department awarded contracts to carry out these components: Harmonization of health care and technology standards, awarded to the American National Standards Institute. Development of certification criteria for functionality and interoperability for electronic health records (EHRs), resulting in the Certification Commission for Health Information Technology – or CCHIT. Development and evaluation of prototypes for a national health information network, awarded to four groups led by Accenture, Computer Sciences Corp., IBM and Northrop Grumman. Analysis and recommendations for solutions to address discrepancies in state privacy and security laws and practices affecting HIE, awarded to RTI, which created HISPC. RTI’s contract is jointly funded and managed through HHS’ Office of the National Coordinator for Health Information Technology (ONCHIT) and the National Resource Center for Health Information Technology at the Agency for Healthcare Research and Quality (AHRQ). “This work on privacy and security will leave an indelible mark on the ultimate formulation of a national health information network,” said AHRQ Director Carolyn Clancy, MD. The subcontracting states thus far are: Alaska, Arkansas, Colorado, Iowa, Illinois, Indiana, Kentucky, Massachusetts, Maine, Michigan, Minnesota, Mississippi, North Carolina, New York, Ohio, Oklahoma, Rhode Island, Utah, Washington, Wisconsin, West Virginia, and Wyoming. Additional states are expected to sign subcontracts within the next two weeks. For more information on HISPC, visit RTI’s website: http://www.rti.org/page.cfm?objectid=09E8D494-C491-42FC-BA13EAD1217245C0 Back to top HHS Releases Checklist for LTC Pandemic Flu Preparation HHS Secretary Michael Leavitt recently announced the release of the “Long-Term Care and Other Residential Facilities Pandemic Influenza Checklist,” which provides guidance for LTC facilities in preparing for a pandemic influenza response. The new checklist, developed by the Centers for Disease Control and Prevention, identifies steps that long-term care and other residential facilities can take to prepare for a pandemic, and could be helpful in other types of emergencies. The checklist includes: Develop a structure for planning and decision-making. Develop a written pandemic influenza plan that identifies individuals authorized to implement the plan and the organizational structure to be used. Develop a facility communication plan that includes key points of contact such as local and state health department officials as well as internal communications. Provide education and training to ensure that all personnel, residents, and family members understand basic prevention and control measures for pandemic influenza. Have an infection control plan in place to manage residents and visitors with pandemic influenza. Have a plan to obtain and use vaccines and antiviral drugs. Address issues related to a sudden increase in health care demands. A copy of the “Long-Term Care and Other Residential Facilities Pandemic Influenza Preparedness Checklist” is available at http://www.pandemicflu.gov/plan/LongTermCareChecklist.html. Additional pandemic planning information is available online at www.pandemicflu.gov. Back to top AHQA a Collaborating Organization for HIMSS Summit Representatives from AHQA and the QIO community will join national health information technology (HIT) leaders at the annual HIMSS Summit 2006: From Policy to Practice, June 7-8, in Washington, DC. The event coincides with National Health IT Week; AHQA is a partner for both events. Session topics at the Summit will include biosurveillance, HIT Standards, return on investment considerations, chronic care IT, standards, certification through CCHIT and health information exchange. The Summit will feature nearly 30 expert speakers and/or panelists and more than 1,000 leaders and decision makers in HIT. John Kitzhaber, MD, Former Governor, State of Oregon and President, Estes Park Institute, will deliver the closing keynote address. Other invited speakers include: Senator Barack Obama, (D-IL) and Senator Debbie Stabenow, (D-MI). In addition to the opportunity to dialogue with health IT thought leaders such as Jonathan Perlin, MD, PhD, Undersecretary for Health Affairs Department of Veterans Affairs and Brian J. Kelly, MD, Associate Partner at Accenture, the Summit offers the latest technologies on the trade show exhibit floor. Other opportunities during HIMSS Summit include town hall meetings for all seven HHS HIT-related contracts, sessions for each of the four AHIC Workgroups and the CEO IT Achievement Awards Banquet. The Summit occurs during the first National Health IT Week (June 5-8), an annual forum for public and private sectors to accelerate broader adoption of HIT with ‘One Voice. One Vision.’ HIMSS Summit and AHQA are partnering with others to support the inaugural gathering. A cornerstone of the National Health IT Week is National Health IT Day, June 7. Events of that day will include keynote speakers such as Former Speaker of the House and Founder for Center for Health Transformation, Newt Gingrich, and Carolyn Clancy, MD, Director, Agency for Healthcare Research and Quality (AHRQ). In addition, National Health IT Day will offer panel discussions on innovative ways companies are dealing with healthcare costs and perspectives on HIT from leaders in the field. HIMSS Summit and National Health IT Week attendees can take advantage of being in Washington to spend time on Capitol Hill meeting with Senators, Representatives, and their staffs during HIMSS Advocacy Days (June 5-6) where issues such as Stark and anti-kickback laws and Value-Based Purchasing (P4P) will be addressed. AHQA is a collaborator for HIMSS Summit 2006. To register to attend HIMSS Summit 2006, visit http://www.himss.org/summit/registration.asp. The price for HIMSS Summit includes National Health IT Day and lunches. Back to top Study: Seniors Say Good Communication = Good Care In a study of vulnerable patients aged 65 and over in managed care health plans, researchers found that p atient ratings of overall quality of care did not relate to technical quality of care but were associated with ratings of communication. The study, by John Chang and others, was published in the May 2 Annals of Internal Medicine. The researchers used survey questions from the second stage of the Consumer Assessment of Healthcare Providers and Systems program to determine patients’ global rating of health care and provider communication. A set of 236 quality indicators, defined by the Assessing Care of Vulnerable Elders project, were used to measure technical quality of care given for 22 clinical conditions; 207 quality indicators were evaluated by using data from chart abstraction or patient interview. “These findings guide how we should measure quality of care at the health plan level,” the authors said. They concluded that, “Vulnerable elders’ global ratings of care should not be used as a marker of technical quality of care. Assessments of quality of care should include both patient evaluations and independent assessments of technical quality.” Read the abstract at: http://www.annals.org/cgi/content/abstract/144/9/665 Back to top NQF Requests Comment on ‘Serious Reportable Events in Healthcare’ The National Quality Forum has released a request for reassessment of its list of 27 consensus standards for “Serious Reportable Events in Healthcare.” Written comments on the list will be accepted until 6:00 p.m. Eastern on June 15. The list was originally published in 2002; NQF convened a committee to reassess the list in May 2005. Its purpose is to identify preventable adverse events that should never occur and to facilitate public reporting and accountability for these actions. The list includes events in six categories: surgical, device, patient protection, care management, environmental, and criminal. Reassessment of the list is expected to ensure that: all events are current and appropriate, it meets new public accountability requirements, it will be used to define data requirements for patient safety databases, and it will be used as guidance for public reporting. Read the memo at: http://www.qualityforum.org/docs/safe-practices/txSRE_web_all_FINAL.doc.pdf Back to top JAMA Study Compares US and UK Older Adult Health A study in the May 3 issue of JAMA found that middle-aged to older Americans have higher rates of diabetes, hypertension, heart disease, heart attack, stroke, lung disease and cancer than their English counterparts. Researcher James Banks, PhD, of University College London and Institute for Fiscal Studies, London, and colleagues compared data of non-Hispanic whites in both countries to assess the relative health of older people and variances in health by socioeconomic status. They found: Diabetes prevalence was twice as high in the US (12.5%) than in England (6.1%). Hypertension was approximately 10 percentage points more common in the US. Smoking behavior was similar in both countries. Obesity rates were much higher in the US, while heavy drinking was more common in England. In both countries, disease prevalence was much higher among individuals of lower income and education. Differences in socioeconomic groups between the two countries were so great that those in the top education and income level in the US had similar rates of diabetes and heart disease as those in the bottom education and income level in England. Read an abstract at: http://jama.ama-assn.org/cgi/content/short/295/17/2037 Back to top

Home :: Inside AHQA :: For The Media :: Public Policy :: Advancing Quality :: Quality Connections :: SiteMap