Effecting Change in Chronic Care: The Tipping Point

Summary

Principal Investigator: Karen Kmetik
Abstract: Chronic conditions have become the leading cause of illness, disability, and death in the United States, affect almost half of the U.S. population, and account for the majority of health care expenditures in this country. Despite efforts to enhance the quality of care delivered to chronically ill patients, studies continue to reveal tremendous variability in both practice and outcomes in this population. This study proposes to bring together a unique collaboration of physicians, employers, health plans, and payers from the private and public sector both regionally and nationally, to achieve a 'tipping point' in health care and, thereby, accelerate the rate at which improvement in the quality of care delivered in outpatients settings for a substantial portion of the chronically itt patient population in the U.S can occur. Specifically, the American Medical Association, Pittsburgh Regional Healthcare Initiative, Iowa Foundation for Medical Care, Blue Cross and Blue Shield Association, Centers for Medicare and Medicaid Services, and the Midwest Business Group on Health are cooperating in a partnership to identify the infrastructure necessary to make relevant data and clinical performance measurement tools available to physicians at the point of care for patients with diabetes, major depressive disorder, or coronary artery disease; to enable data collection, retrieval, and transfer within and across physician offices, health plans, and laboratories; to identify the perceived obstacles, burdens, as well as incentives for physicians and others who participate in efforts to improve the quality of care for patients with chronic diseases through the use of performance measurement; and to determine the feasibility of creating an integrated data registry that will enable the provision of benchmarking data to physicians and aggregate data to health plans and third party payors. The methods by which these aims will be achieved inctude adaptation and implementation of performance measurement sets developed by the Physician Consortium for Performance improvement for diabetes, major depressive disorder, and coronary artery disease in a select sample of primary care physician offices in two regions of the U.S.; on-site identification of data capabilities for physicians, health plans, and laboratories participating in the study; and evaluation of physician, plan, laboratory, and employer experience with measurement tools and data collection and delivery processes.
Funding Period: 2002-09-30 - 2007-03-31
more information: NIH RePORT

Top Publications

  1. ncbi Assessing the validity of national quality measures for coronary artery disease using an electronic health record
    Stephen D Persell
    Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611 2927, USA
    Arch Intern Med 166:2272-7. 2006
  2. ncbi Automated review of electronic health records to assess quality of care for outpatients with heart failure
    David W Baker
    Northwestern University, Chicago, Illinois, USA
    Ann Intern Med 146:270-7. 2007
  3. ncbi Using health information technology-related performance measures and tools to improve chronic care
    Donna J Keyser
    RAND Corporation, Pittsburgh, USA
    Jt Comm J Qual Patient Saf 35:248-55. 2009

Scientific Experts

  • Donna J Keyser
  • David W Baker
  • Stephen D Persell
  • Jason A Thompson
  • Karen S Kmetik
  • David Liss
  • Neilesh S Soman
  • Karen M Burgner
  • Jennifer M Wright

Detail Information

Publications3

  1. ncbi Assessing the validity of national quality measures for coronary artery disease using an electronic health record
    Stephen D Persell
    Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611 2927, USA
    Arch Intern Med 166:2272-7. 2006
    ..To our knowledge, how well they reflect actual quality of care has not been studied. We sought to evaluate the validity of performance measures for coronary artery disease (CAD) using an ambulatory EHR...
  2. ncbi Automated review of electronic health records to assess quality of care for outpatients with heart failure
    David W Baker
    Northwestern University, Chicago, Illinois, USA
    Ann Intern Med 146:270-7. 2007
    ..Electronic health records (EHRs) may be used to assess quality of care...
  3. ncbi Using health information technology-related performance measures and tools to improve chronic care
    Donna J Keyser
    RAND Corporation, Pittsburgh, USA
    Jt Comm J Qual Patient Saf 35:248-55. 2009
    ..The measures and tools focused on adult diabetes, major depressive disorder, chronic stable coronary artery disease, heart failure, hypertension, and asthma...