Effecting Change in Chronic Care: The Tipping Point

影响慢性病护理的变革：转折点

• 批准号: 6952810
• 负责人: Karen Kmetik
• 金额: $ 38.04万
• 依托单位: AMERICAN MEDICAL ASSOCIATION
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6952810
• 关键词: behavioral /social science research tag; chronic disease /disorder; clinical research; cooperative study; health care quality; health care service evaluation; health care service planning; health service demonstration project; health services research tag; human data; information dissemination; patient oriented research

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.

慢性病已成为美国疾病、残疾和死亡的主要原因，影响着近一半的美国人口，并占美国医疗保健支出的大部分。尽管努力提高慢性病患者的护理质量，但研究继续揭示这一人群的实践和结果存在巨大差异。这项研究提出，汇集一个独特的合作医生，雇主，健康计划，并从私营和公共部门的区域和国家的支付者，以实现一个“临界点”在医疗保健，从而加快速度，在门诊提供的医疗质量的改善，为相当一部分的慢性ITT患者在美国的人口可以发生。具体而言，美国医学协会、匹兹堡地区医疗保健计划、爱荷华州医疗保健基金会、蓝十字和蓝盾协会、医疗保险和医疗补助服务中心以及中西部健康商业集团正在合作，以确定必要的基础设施，使医生在糖尿病患者的护理点获得相关数据和临床性能测量工具，严重抑郁症或冠状动脉疾病;使数据收集，检索，并在内部和跨医生办公室，健康计划和实验室传输;识别感知的障碍，负担，以及医生和其他参与通过使用性能测量来提高慢性病患者护理质量的人员的激励措施;并确定建立一个综合数据登记处的可行性，该登记处将能够向医生提供基准数据，并向健康计划和第三方付款人提供汇总数据。实现这些目标的方法包括：在美国两个地区的初级保健医生办公室的选定样本中，对由医生联盟开发的糖尿病、重度抑郁症和冠状动脉疾病的绩效改进的绩效测量集进行适当的调整和实施;现场识别参与研究的医生、健康计划和实验室的数据能力;以及评估医生、计划、实验室和雇主使用测量工具和数据收集和交付过程的经验。

项目成果

Using health information technology-related performance measures and tools to improve chronic care.

使用与健康信息技术相关的绩效措施和工具来改善慢性病护理。

• DOI: 10.1016/s1553-7250(09)35034-5
• 发表时间: 2009
• 期刊: Joint Commission journal on quality and patient safety
• 影响因子: 2.3
• 作者: Keyser,DonnaJ;Dembosky,JacobW;Kmetik,Karen;Antman,MarkS;Sirio,Carla;Farley,DonnaO
• 通讯作者: Farley,DonnaO

Electronic health record systems: the vehicle for implementing performance measures.

• DOI: 10.1111/j.1541-9215.2005.04390.x
• 发表时间: 2005-01-01
• 期刊: The American heart hospital journal
• 作者: O'Toole, Michael F;Kmetik, Karen S;Bufalino, Vincent J
• 通讯作者: Bufalino, Vincent J