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Future Directions for the National Quality and Disparities Reports. J. James Rohack MD FACC FACP Chair, National Advisory Council to AHRQ Senior staff cardiologist, Scott & White Clinic Director, Center for Healthcare Policy, S&W Medical Director for System Improvement, SWHP
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Future Directions for the National Quality and Disparities Reports J. James Rohack MD FACC FACP Chair, National Advisory Council to AHRQ Senior staff cardiologist, Scott & White Clinic Director, Center for Healthcare Policy, S&W Medical Director for System Improvement, SWHP Professor of Medicine and Humanities in Medicine, TAMHSC
Future Directions of the NQR/NDR-Next 5 years • Policy makers: where to eliminate barriers • Practitioners: where to focus practice change • Payer: where to put resources • Patient: where to participate in change
Future Directions- Operational Issues • Timing of Release: Same time eg week after New Year’s or week before Super Bowl • Frequency of Release: Annually versus quarterly • Mechanisms: Paper vs Web • Media Face: 60 Minutes vs Oprah
Future Directions - Impact • Passive Reports- react to environment and document change • Active Reports- focus on where change needs to occur to increase Value
Future Directions- Increasing Value in Healthcare • Practical measurement: what can be measured with current systems • Ideal measurement: what change in current systems needed to have measures that will drive improvement of care and decrease in disparities
Future Directions- Other Uses • Accreditation of Systems • Individual Licensure • Assessment of Competency • Differentiation impacting choice and reward
National Quality Report Safe: ++ Patient Centered: + Timely: + Effective: ++++ Efficient: Equitable: National Disparities Report Safe: + ½ Patient Centered: ½ Timely: ½ Effective: +++ ½ Efficient: Equitable: ++++ Current NQR/NDR and IOM Goals: Should the Future be 4+?
Future Directions- Drive Change • System Care Accountability • Individual Accountability (patient, practitioner and provider) • Comparative Effectiveness: adoption of change
Future Directions – Actionable Levels • National • State • System • Individual
Future Directions Summary • Should AHRQ drive change through the NQR/NDR by prioritizing where focus of change should be? • Should the NQR/NDR be used for payment? For accountability? At System or Individual level? • Should the NQR/NDR only focus on what measures are meaningful for Value? Continue trending less meaningful measures?