Future Directions for the National Quality and Disparities Reports

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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, SW
• Medical Director for System Improvement, SWHP
• Professor of Medicine and Humanities in Medicine,
  TAMHSC

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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

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Future Directions- Operational Issues

• Timing of Release Same time eg week after New
  Years or week before Super Bowl
• Frequency of Release Annually versus quarterly
• Mechanisms Paper vs Web
• Media Face 60 Minutes vs Oprah

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Future Directions - Impact

• Passive Reports- react to environment and
  document change
• Active Reports- focus on where change needs to
  occur to increase Value

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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

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Future Directions- Other Uses

• Accreditation of Systems
• Individual Licensure
• Assessment of Competency
• Differentiation impacting choice and reward

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Current NQR/NDR and IOM Goals Should the Future
be 4?

• National Quality Report
• Safe
• Patient Centered
• Timely
• Effective
• Efficient
• Equitable

• National Disparities Report
• Safe ½
• Patient Centered ½
• Timely ½
• Effective ½
• Efficient
• Equitable

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Future Directions- Drive Change

• System Care Accountability
• Individual Accountability (patient, practitioner
  and provider)
• Comparative Effectiveness adoption of change

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Future Directions Actionable Levels

• National
• State
• System
• Individual

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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?

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• Questions?

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