component 1: introduction to health care and public health in the u.s. 1.9: unit 9: the evolution...

Component 1: Introduction to Health Care and Public Health in the U.S.

1.9: Unit 9: The evolution and reform of healthcare in the US

1.9c: Quality Indicators And Comparative Effectiveness

Component 1/Unit 9c Health IT Workforce Curriculum Version 1.0/Fall 2010 2

Quality Indicators In Medicine

• What is quality?• "the degree to which health services for

individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge."

What Does Quality Mean?

• Better patient outcomes (patient health)• Better system performance (patient care)• Better professional development (clinician

learning)

• Scientific evidence + particular context = measured performance improvement


Agency for Healthcare Research and Quality (AHRQ)

• Part of Department of Health and Human Services• Mission: “to improve quality, safety, efficiency, and

effectiveness of health care for all Americans”– Safety and quality: Reduce risk of harm– Effectiveness: Improve health care outcomes– Efficiency: Transform research into practice


Methods To Promote Quality

• Metrics for measuring quality– Process measures– Outcome measures

• Role of EHR in improving quality– Data collection– Data analysis

• Plan-Do-Study-Act (PDSA) cycle• Organizational standards


Comparative Effectiveness Research (CER)

• In 2008 the Institute of Medicine noted that patient care “should be based on the conscientious, explicit, and judicious use of current best evidence”

• In 2009 the IOM defined CER as “…evidence that compares the benefits and harms of alternative methods…”



Comparative Effectiveness

• Generate evidence from research studies • Compare drugs, tests, healthcare delivery

methods, etc.• Researchers may look at existing studies, or

devise new studies• They may develop or use different methods

and sources of data

Steps in Comparative Effectiveness Research

• Review and synthesize current medical research

• Promote and generate new evidence and analytic tools

• Train and develop clinical researchers• Translate and disseminate research findings to

diverse stakeholders


Benefits of CER

• CER stakeholders – spectrum of individuals who make informed decisions that will improve health care

• CER may provide information about benefits and harms

• CER can compare costs of different treatments based on outcomes

• CER helps patients and physicians to choose between treatments


Emphasis on CER Is A Part of Healthcare Reform

• The American Recovery and Reinvestment Act of 2009 created the Federal Coordinating Council for Comparative Effectiveness Research


component 1: introduction to health care and public health in the u.s. 1.9: unit 9: the evolution...

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