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Second Round Of Negotiations On Accreditation Ends [March 30, 2007] Joint Commission Report On Hospitals, Language, And Culture [March 29, 2007] Federal Spending On Children In The U.S. Expected To Shrink [March 28, 2008] Higher Education Summit Convened [March 27, 2007] Nurse Staffing And Quality Of Care [March 26, 2007] Analysis Of Leading Congressional Health Care Bills [March 23, 2007] The Path Through Graduate School [March 22, 2007] How Many Doctors Does It Take to Treat A Medicare Patient? [March 21, 2007] Substance Abuse At Colleges And Universities [March 20, 2007] 56 Million Americans Lack Access To Basic Health Care [March 19, 2007] The State Of Aging And Health In America [March 9, 2007] American Community Survey Of U.S. Asians [March 8, 2007] American Community Survey Of U.S. Hispanics [March 7, 2007] AHRQ Health Services Research (R01) [March 6, 2007] Cross-Cohort Differences In Health On The Verge Of Retirement [March 5, 2007] American Community Survey Report of U.S. Blacks [March 2, 2007] Fulbright Scholar Program [March 1, 2007] ASAHP Among Health Groups Urging Congress To Provide Adequate Funding [February 28, 2007] “Continuity" As An Organizing Principle For Clinical Education Reform [February 27, 2007] Nation's Report Card On 12th-Grade Reading And Mathematics Achievement [February 26, 2007] AHRQ 2007 Summer Internships Available [February 23, 2007] Colleges Raised Record $28 Billion Last Year [February 22, 2007] Federal Health Care Spending Is Unsustainable [February 21, 2007] Higher Education Act Reauthorization [February 20, 2007] Allied Health Legislation Introduced In Senate [February 19, 2007] Aged Patients Fail To Report Problems With Medications [February 16, 2007] CHEA “Talking Points” On The Value Of Accreditation [February 15, 2007] Accounting For The Cost Of Health Care In The U.S. [February 14, 2007] OECD Health Care Quality Indicators Project [February 13, 2007] Barriers To Comparison Shopping For Health Services [February 12, 2007] Learning From High Performance Health Systems Around The Globe [February 9, 2007] Decreasing Health Care Costs By Increasing Educational Attainment [February 8, 2007] Measuring The Impact Of Health Professions Education Programs [February 7, 2007] Public Reporting And Transparency In Health Care [February 6, 2007] A Rapid Learning Health System [February 5, 2007] Health At Top Of List Of Ways The U.S. Could Change The World [February 2, 2007] Effectiveness Of Continuing Medical Education [February 1, 2007] Second Round Of Negotiations On Accreditation Ends Joint Commission Report On Hospitals, Language, And Culture Federal Spending On Children In The U.S. Expected To Shrink If the federal budget were cut and served like an apple pie, children might be fighting for crumbs by 2017. A new Urban Institute report shows that spending on children has fallen as a share of domestic spending between 1960 and 2006, but will shrink dramatically over the next ten years under current law. Are youngsters becoming an afterthought? Overall, federal children's spending increased in real terms from $53 billion in 1960 to $333 billion in 2006, or from 1.9 to 2.6 percent of GDP. Yet as a share of federal domestic spending, children's spending declined from 20.1 to 15.4 percent. Meanwhile, spending on the automatically growing, non-child portions of Social Security, Medicare, and Medicaid, nearly quadrupled from 2.0 to 7.6 percent of GDP ($58 billion to $993 billion) over the same time period. Over the next ten years, children's programs are scheduled to decline both as a share of GDP and domestic spending because they do not compete on a level playing field with these rapidly growing entitlement programs. The full report may be accessed by clicking Higher Education Summit Convened A 25-point list of "action items" focused on improving college access, affordability, and accountability was the result of a day-long summit convened last Thursday by the U.S. Department of Education. Approximately 300 individuals, including college presidents, corporate CEO's, and congressional representatives participated in the conversation, dubbed "A Test of Leadership: Committing to Advance Postsecondary Education for all Americans." Convened by Education Secretary Margaret Spellings, the summit focused on issues surrounding five key recommendations made by the Secretary's Commission on the Future of Higher Education, including aligning K-12 and higher education expectations; increasing need-based aid for access and success; using accreditation to support and emphasize student learning outcomes; serving adults and other non-traditional students; and enhancing affordability, decreasing costs, and promoting productivity. For additional information, click http://www.ed.gov/news/pressreleases/2007/03/03222007.html . Nurse Staffing And Quality Of Care Research was conducted to assess how nurse to patient ratios and nurse work hours were associated with patient outcomes in acute care hospitals, factors that influence nurse staffing policies, and nurse staffing strategies that improved patient outcomes. In the absence of randomized controlled trials, observational studies were reviewed to examine the relationship between nurse staffing and outcomes. Meta-analysis tested the consistency of the association between nurse staffing and patient outcomes; classes of patient and hospital characteristics were analyzed separately. Higher registered nurse staffing was associated with less hospital-related mortality, failure to rescue, cardiac arrest, hospital acquired pneumonia, and other adverse events. The effect of increased registered nurse staffing on patients safety was strong and consistent in intensive care units and in surgical patients. The report may be downloaded from the Web at Analysis Of Leading Congressional Health Care Bills The first of a two-part series, a new report analyzes and compares leading congressional bills and Administration proposals to expand health insurance coverage introduced over 2005–2007. The Commonwealth Fund commissioned The Lewin Group to estimate the effect of the bills on stakeholder and health system costs and the projected number of individuals who would become newly insured through them. The proposals fall into three categories: those that propose fundamental reform of the health insurance system, those that would expand existing public insurance programs, and those that seek to strengthen employer-based health insurance. The report considers whether the proposals would improve access to care, increase health system efficiency, make the system more equitable, and improve quality of care. The document may be accessed by clicking The Path Through Graduate School A new report from the national Center for Education Statistics (NCES) uses longitudinal data from the 1992–93 Baccalaureate and Beyond Study (B&B:93/03) to examine the characteristics related to graduate degree enrollment, persistence, and completion among 1992–93 bachelor's degree recipients. About 40 percent of 1992–93 bachelor's degree recipients had enrolled in a graduate degree program by 2003. On average, most students waited between two and three years to enroll for the first time in a graduate degree program, and among those who enrolled between 1993 and 2003, some 62 percent had earned at least one graduate degree by 2003. Master's degree students took an average of three years to complete their degree, first-professional students took about four years, and doctoral students took more than five years. After controlling for a wide range of relevant variables, several enrollment characteristics retained a significant relationship with graduate degree persistence and completion. Rates of persistence and completion were higher among students who entered graduate school immediately after earning a bachelor's degree, who attended full time and enrolled continuously, and who enrolled in multiple graduate degree programs. The report may be accessed by clicking http://nces.ed.gov/pubs2007/2007162.pdf . How Many Doctors Does It Take to Treat A Medicare Patient Medicare patients see so many physicians that it could be difficult to determine which physician should qualify for additional payment under a pay-for-performance program, according to a new study by the Center for Studying Health System Change. Based on the study of Medicare claims for patients treated in 2000-02 by a nationally representative sample of 12,000 physicians, the typical Medicare patient sees seven doctors in four medical practices in a given year, while patients with chronic conditions see even more. The authors suggest Medicare consider assigning patients to physicians and practices to establish clearly which providers would be held accountable for coordinating patients' care in a pay-for-performance program. This procedure would limit patient and physician choice, but “have the benefit of aligning physician, patient and payer expectations of care relationships.” The study may be accessed by clicking http://content.nejm.org/cgi/content/full/356/11/1130 . Substance Abuse At Colleges And Universities Forty-nine percent of full time college students binge drink or abuse prescription and illegal drugs, according to Wasting the Best and the Brightest: Substance Abuse at America's Colleges and Universities , a new report issued by The National Center on Addiction and Substance Abuse (CASA) at Columbia University. The study found that 1.8 million full-time college students (22.9 percent) meet the medical criteria for substance abuse and dependence, two-and-one-half-times the 8.5 percent of the general population who meet these same criteria. The report finds that from 1993 to 2005, there has been no real decline in the proportion of students who drink (70 to 68 percent) and binge drink (40 to 40 percent), however, the intensity of excessive drinking and rates of drug abuse have jumped sharply. These figures are truly staggering. The report may be accessed by clicking http://www.casacolumbia.org/absolutenm/articlefiles/380-College%20II%20Final.pdf . 56 Million Americans Lack Access To Basic Health Care The State Of Aging And Health In America A new report entitled The State of Aging and Health in America 2007 was released recently by the Centers for Disease Control and Prevention (CDC) and The Merck Company Foundation at the 2007 Joint Conference of the American Society on Aging and the National Council on Aging in March 2007. The United States population is rapidly aging. By 2030, the number of Americans aged 65 and older will more than double to 71 million older Americans, comprising roughly 20 percent of the U.S. population. In some states, fully a quarter of the population will be aged 65 and older. An enhanced focus on promoting and preserving the health of older adults is essential to address the health and economic challenges of an aging society. The cost of providing health care for an older American is three to five times greater than the cost for someone younger than 65. By 2030, the nation's health care spending is projected to increase by 25% due to demographic shifts unless improving and preserving the health of older adults is more actively addressed. The report presents the most current national data available on 15 key health indicators for older adults related to health status, health behaviors, preventive care and screening, and injuries. The “State-by-State Report Card” provides similar information for each of the 50 states and the District of Columbia and enables states to see where they are on each indicator as well as in relation to other states. American Community Survey Of U.S. Asians This report from the U.S. Census Bureau presents a portrait of the Asian population in the United States. It is part of the American Community Survey (ACS) report series. Information on demographic, social, economic, and housing characteristics in the tables and figures are based on data from the 2004 ACS Selected Population Profiles and Detailed Tables. The data for the Asian population are based on responses to the 2004 ACS question on race, which asked all respondents to report one or more races. The report may be accessed by clicking http://www.census.gov/prod/2007pubs/acs-05.pdf . American Community Survey Of U.S. Hispanics This report from the U.S. Census Bureau presents a portrait of the Hispanic population in the United States. It is part of the American Community Survey (ACS) report series. Information on demographic, social, economic, and housing characteristics in the tables and figures are based on data from the 2004 ACS Selected Population Profiles and Detailed Tables. The data for the Hispanic population are based on responses to the 2004 ACS question on race, which asked all respondents to report one or more races. The report may be accessed by clicking http://www.census.gov/prod/2007pubs/acs-03.pdf . AHRQ Health Services Research (R01) The Agency for Healthcare Research and Quality (AHRQ) has priority interests for ongoing extramural grants for research, demonstration, dissemination, and evaluation projects to: Support improvements in health outcomes, strengthen quality measurement and improvement, and identify strategies to improve access, foster appropriate use, and reduce unnecessary expenditures. T he Research Project Grant (R01) award mechanism will be used . For additional information, click http://grants.nih.gov/grants/guide/pa-files/PA-07-243.html . Cross-Cohort Differences In Health On The Verge Of Retirement Baby Boomers have left a unique imprint on US culture and society in the last 60 years and it might be anticipated that they will also put their own stamp on retirement, the last phase of the life cycle. Yet, because Boomers have not all fully retired, it cannot be judged how they will fare as retirees. Instead, the investigators focus on how this group compares with prior groups on the verge of retirement, that is, at ages 51-56. Accordingly, this item from the National bureau of Economic Research evaluates the stock of health which Early Boomers bring to retirement and compare it with the circumstances of two prior cohorts at the same point in their life cycles. Using three sets of responses from the Health and Retirement Study, the raw evidence indicates that Boomers on the verge of retirement are in poorer health their counterparts 12 years ago. Using a summary health index designed for this study, those born 1948 to 1953 share health risks with the War Baby cohort. This suggests that most of the health decline instead began before the late 1940's. A more complex set of health conclusions emerges from the specific self-reported health measures. Boomers indicate they have relatively more difficulty with a range of everyday physical tasks, but they also report having more pain, more chronic conditions, more drinking and psychiatric problems, than their HRS earlier counterparts. This trend portends poorly for the future health of Boomers as they age and incur increasing costs associated with health care and medications. Using the health index, only those at the 75th percentile or higher are likely to be characterized as having good or better health. The paper may be accessed by clicking http://papers.nber.org/papers/w12762 . American Community Survey Report of U.S. Blacks This report from the U.S. Census Bureau presents a portrait of the Black or African-American population in the United States. It is part of the American Community Survey (ACS) report series. Information on demographic, social, economic, and housing characteristics in the tables and figures are based on data from the 2004 ACS Selected Population Profiles and Detailed Tables. The data for the Black population are based on responses to the 2004 ACS question on race, which asked all respondents to report one or more races. The report may be accessed by clicking http://www.census.gov/prod/2007pubs/acs-04.pdf . The traditional Fulbright Scholar Program sends 800 U.S. faculty and professionals abroad each year. Grantees lecture and conduct research in a wide variety of academic and professional fields.The Fulbright Program is sponsored by the United States Department of State, Bureau of Educational and Cultural Affairs. Under a cooperative agreement with the Bureau, the Council for International Exchange of Scholars (CIES) assists in the administration of the Fulbright Scholar Program for faculty and professionals. The application deadline for Fulbright traditional lecturing and research grants worldwide is Wednesday, August 1. U.S. citizenship is required. ASAHP Among Health Groups Urging Congress To Provide Adequate Funding The Association of Schools of Allied Health Professions (ASAHP) was one of more than 400 health organizations signing a letter urging Congress to restore funding for programs in areas such as health professions education. Although the Section 755 Allied Health & Other Programs under Title VII of the Public Health Service Act currently is funded, the allied health portion is not as of FY 2006. The President's budget for FY 2008 continues to underfund or fail to furnish support for a wide variety of programs. Organizations signing the letter urge Congress to increase funding through the Function 550/discretionary budget allocation in Fiscal Year 2008 by an amount that will restore funding cuts to public health programs enacted in FY 2006 and restore lost purchasing power. It is estimated that an additional $4 billion, 7.8 percent, will be needed in FY 2008 to meet that goal and reverse the erosion of support for the continuum of biomedical, behavioral and health services research, community-based disease prevention and health promotion, basic and targeted services for the medically uninsured and those with disabilities, health professions education, and robust regulation of the nation's food and drug supply. “Continuity" As An Organizing Principle For Clinical Education Reform An article in the February 22, 2007 issue of The New England Journal of Medicine notes that iIf the ultimate purpose of medical education — to meet the health needs of society — is to be achieved, the primary goal of undergraduate medical education should be to produce students who are broadly skilled in the core competencies that transcend all disciplines of medicine. The challenge is how to accomplish this goal in a clinical learning environment fragmented by increasing specialization and demands for clinical productivity and constrained by a prevailing culture in which education must compete with research and clinical practice for medical school resources. Nation's Report Card On 12th-Grade Reading And Mathematics Achievement AHRQ 2007 Summer Internships Available Summer internships are available at the Agency for Healthcare Research and Quality (AHRQ). The Agency, a component of the Department of Health and Human Services, provides national leadership to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. It accomplishes its mission through establishments in clinical and health systems practices, including the prevention of diseases and other health conditions. The hourly salary range is $18.04 - $28.68 for a limit of 89 days. For additional information, click http://jobsearch.usajobs.opm.gov/getjob.asp?JobID=54036015 . Colleges Raised Record $28 Billion Last Year Contributions to colleges and universities grew 9.4 percent to a record $28 billion in the last academic year according to a report released yesterday by the Council for Aid to Education. Just over half of the $28 billion raised in 2006 came directly from individuals. Alumni giving—the traditional base of higher education giving—grew by 18.3 percent in 2006, while individuals other than alumni increased their giving by 14 percent. The top fund-raiser was Stanford University with $911.6 million, the largest amount ever raised by a U.S. university in a single year. Harvard University, which raised $595 million, placed second. Rounding out the top ten were Yale University ($433.46 million), the University of Pennsylvania ($409.49 million), Cornell University ($406.23 million), the University of Southern California ($405.75 million), Johns Hopkins University ($377.34 million), Columbia University ($377.28 million), Duke University ($332.03 million), and the University of Wisconsin-Madison Federal Health Care Spending Is Unsustainable Staff at the Government Accountability Office (GAO) recently testified on Capitol Hill about the challenges involved in financing health care. GAO has been particularly concerned about the federal government's long-term fiscal sustainability and the contribution of health care spending to this troubling picture. In just a few decades, the government will face a serious fiscal imbalance driven by known demographic trends and escalating health care cost growth. Over the next several decades, growth in spending on federal retirement and health entitlements will encumber an escalating share of the government's resources. These entitlement programs primarily include Social Security, which provides, among other things, retirement income to individuals aged 62 and older; Medicare, which provides health care coverage primarily for individuals 65 and older; and Medicaid, which is a joint federal-state program providing health care and long-term care for low-income individuals. Congress's concern about the challenges involved in financing health care is consistent with the fact that certain spending pressures faced by Medicare and Medicaid are faced by all health care payers, including the Departments of Veterans Affairs (VA) and Defense, as well as private payers of health care. To provide an overview of the situation, GAO discussed (1) the long-term outlook for the federal budget and implications for the national economy, (2) health care spending increases system-wide and drivers of spending growth, and (3) cost containment challenges health care payers face now and in the future. The testimony may be accessed by clicking http://www.gao.gov/new.items/d07497t.pdf . Higher Education Act Reauthorization According to an update provided by the Council for Higher Education Accreditation (CHEA), since returning in January 2007, the U.S. Senate has been working on a new bill to reauthorize the Higher Education Act (HEA). The provisions are likely to be similar to the Senate bill (S. 1614) from the last Congress. A new bill may be introduced in March of this year. The House of Representatives appears on track to introduce a bill later in the year, with provisions that differ significantly from the bill that was passed in the prior session (HR 609). Both bills are expected to continue to focus on the same accreditation-related issues as prior bills: student learning outcomes, institution and program performance, transparency, distance learning and transfer of credit. In addition, Congress is monitoring the work of the United States Department of Education (USDE) and its upcoming negotiated rulemaking on accreditation and implications for reauthorization. Allied Health Legislation Introduced In Senate On February 15, the Allied Health Reinvestment Act was introduced in the Senate. Developed by the Association of Schools of Allied Health Professions in collaboration with several professional organizations, the bill is S. 605. Its contents will be posted on the Web by the Government Printing Office sometime in the next few days. The various provisions of the legislation are aimed at addressing: current workforce shortages, projected increases in personnel to meet the needs of an aging population, and insufficient student enrollment in certain academic programs. Aged Patients Fail To Report Problems With Medications An alarmingly high number of America's older patients are not talking to their physicians about problems they are having with prescription medications, including unwelcome side effects, costs, or perceived efficacy, finds a new study supported by The Commonwealth Fund and the Henry J. Kaiser Family Foundation. According to the authors of "Physician–Patient Communication about Prescription Medication Nonadherence: A 50-State Study of America's Seniors” ( Journal of General Internal Medicine, January 2007), 40 percent of older individuals responding to a survey reported not adhering to their "doctor's orders" regarding their medication regimens. Among those who gave a cost-related reason for not complying with their drug regimen, 39 percent did not talk to their physicians about it—even though lower-cost alternatives were available. The report may be accessed by clicking http://www.cmwf.org/usr_doc/1005_Wilson_physician-patient_communication_Rx_Nonadherence_JGIM_ITL.pdf . CHEA “Talking Points” On The Value Of Accreditation The Council for Higher Education Accreditation (CHEA) shared “Talking Points” about the value of accreditation this past fall as the U.S. Department of Education (USDE) initiated a series of activities related to the report of the Commission on the Future of Higher Education issued in September 2006. As part of its effort, USDE has scheduled three negotiated rulemaking sessions on accreditation that begin on February 21, 2007. These sessions can result in changes to federal regulations that affect accreditation and, in turn, institutions and programs. The “Talking Points” may be accessed by clicking http://www.chea.org/pdf/CHEA_Talking_Points.pdf . Accounting For The Cost Of Health Care In The U.S. The United States spends more of its income on health care than other developed countries and that share is rising. It is an arresting statistic that the U.S. now spends more on health care than it does on food. In this new report McKinsey Global Institute finds that the United States spends approximately $480 billion ($1,600 per capita) more on health care than other OECD countries and that additional spending is not explained by a higher disease burden. Research shows that the U.S. population is not significantly sicker than the other countries studied. Instead, MGI found that the overriding cause of high U.S. health care costs is the failure of the intermediation system — payors, employers, and government — to provide sufficient incentives to patients and consumers to be value–conscious in their demand decisions, and to regulate the necessary incentives to promote rational use by providers and suppliers. Given the less than optimal access for all U.S. citizens (relative to peer countries), MGI concludes that major opportunities for cost improvement —even if not the full $480 billion—are as possible as they are necessary although no single reform is likely to succeed in achieving the needed rebalancing. To be effective, reform in health care will need to apply sound principles on both the demand and supply side of the system. The report may be accessed by clicking http://www.mckinsey.com/mgi/rp/healthcare/accounting_cost_healthcare.asp . OECD Health Care Quality Indicators Project A supplement of the International Journal for Quality in Health Care , sponsored by the Agency for Healthcare Research and Quality (AHRQ), is devoted to the Health Care Quality Indicators (HCQI) Project. Run by the Organization for Economic Cooperation and Development (OECD), the HCQI Project is the only international, multi-condition project examining quality measurement and improvement issues. AHRQ has provided ongoing technical guidance and leadership on this effort since 2001. This supplement presents eight articles written by international leaders in the field of quality measurement. The OECD brought them together to guide development of a conceptual framework for the HCQI Project as well as develop a set of 85 indicators across five priority condition areas. This framework and these indicators will serve as the basis for the Project's work on improving data systems and tracking quality of care for many years. The articles may be accessed by clicking http://www.ahrq.gov/clinic/oecdqiproj.htm . Barriers To Comparison Shopping For Health Services Even when patients must pay the full cost of medical care out-of-pocket, there's limited comparison shopping for the lowest-cost, highest-quality care, according to a study by researchers at the Center for Studying Health System Change (HSC) published recently as a Web Exclusive in the journal Health Affairs . While markets for self-pay medical procedures such as LASIK (a surgical procedure conducted to reduce a patient's dependency on glasses or contact lenses) and cosmetic surgery are often held up as models of consumer engagement that could help rein in spiraling costs and spur improved quality across the health care system, patients undergoing self-pay procedures typically face significant barriers to effective shopping and instead rely on word-of-mouth recommendations to choose providers, according to the study. The article may be accessed by clicking http://content.healthaffairs.org/cgi/reprint/hlthaff.26.2.w217v1 . Learning From High Performance Health Systems Around The Globe The Commonwealth Fund has produced a series of charts that impart information regarding what can be learned from high performance health systems around the world. The charts may be accessed by clicking Decreasing Health Care Costs By Increasing Educational Attainment An issue Brief from the Alliance for Excellent Education indicates that in general, individuals with lower income, less education, and lower-status occupations and employment have poorer health. Therefore, it would seem that raising educational levels would reduce health-related expenditures for the public sector as well as for individuals. Specifically, research has shown that each student who graduates from high school, instead of dropping out before obtaining a diploma, will save states an average of $13,706 (in 2005 dollars) in Medicaid and expenditures for uninsured care over the course of a lifetime. The Issue Brief may be accessed by clicking http://www.all4ed.org/publications/HandW.pdf . Measuring The Impact Of Health Professions Education Programs A report from the Government Accountability Office (GAO) indicates that funding for title VII and title VIII programs increased from about $300 million in fiscal year 1999 to more than $450 million in fiscal year 2005, and the overall number of these programs also increased since reauthorization in 1998. From fiscal years 1999 through 2005, funding for title VII programs rose by about one-fourth, while that for title VIII programs more than doubled. The overall numbers of title VII and title VIII programs administered by HRSA increased from 46 in fiscal year 1998 to 50 in fiscal year 2004. The number of title VII programs remained the same, while the number of title VIII programs increased. HRSA has published performance goals for title VII and title VIII health professions education programs but cannot fully assess the programs' effectiveness because the goals do not apply to all the health professions education programs, and the data for tracking progress are problematic. Recognizing the need for a better means of measuring the results of title VII. The report may be accessed by clicking http://www.gao.gov/highlights/d0655high.pdf . Public Reporting And Transparency In Health Care Interest in collecting and publicly reporting information about the cost and quality of health care has been growing. Yet, questions remain about the accuracy of reported price, process, and outcome information; the comparability of results across different populations; and whether and how patients and others use the information to make decisions. Advocates for public reporting argue that it will inject competition into the health system. In addition, it could help providers improve by benchmarking their performance against others, encourage private insurers and public programs to reward quality and efficiency, and help patients make informed choices. Studies of current public reporting efforts have found that public reporting can add value, but that reports must be carefully designed. Research also shows the importance of automated and unobtrusive data collection, as well as collaboration among private and public bodies, and providers and purchasers. The report may be accessed by clicking A Rapid Learning Health System An article published online last week in Health Affairs indicates that private- and public-sector initiatives, using electronic health record (EHR) databases from millions of individuals, could rapidly advance the U.S. evidence base for clinical care. Rapid learning could fill major knowledge gaps about health care costs, the benefits and risks of drugs and procedures, geographic variations, environmental health influences, the health of special populations, and personalized medicine. Policymakers could use rapid learning to revitalize value-based competition, redesign Medicare's payments, advance Medicaid into national health care leadership, foster national collaborative research initiatives, and design a national technology assessment system. The Health Affairs article may be accessed by clicking Health At Top Of List Of Ways The U.S. Could Change The World If the U.S. invests in one thing to make a difference in the world, energy issues/gas prices/alternative fuels (18%) and health care/medicine/cures (16%) top the list, according to a new poll commissioned by Research!America. Seven in 10 Americans (71%) say addressing health problems around the world improves our diplomatic relations and the way other nations see us. Eight in 10 Americans say it's important that the U.S. work to improve health globally. Reasons why Americans think the U.S. should work to improve health globally include:
Most Americans (93%) think infectious and emerging diseases facing other countries will pose a threat to the U.S. in the next few years. A majority (86%) are concerned that contagious disease in other countries can reach the U.S., and more than 70% say health problems around the world could cause economic and national security problems here. Most Americans (76%) think it is a priority for the U.S. government to spend money in the area of improving health around the world. The poll found that 62% think the U.S. spends too little on research to improve health around the world, and of those, 84% think this is true even if spending more would mean slightly higher taxes or less money available for other spending priorities. Poll results may be accessed by clicking Effectiveness Of Continuing Medical Education Despite the broad range of continuing medical education (CME) offerings aimed at educating practicing physicians through the provision of up-to-date clinical information, physicians commonly overuse, under-use, and misuse therapeutic and diagnostic interventions. It has been suggested that the ineffective nature of CME either accounts for the discrepancy between evidence and practice or at a minimum contributes to this gap. Understanding what CME tools and techniques are most effective in disseminating and retaining medical knowledge is critical to improving CME and thus diminishing the gap between evidence and practice. A review was done at the Evidence-Based Practice Center at Johns Hopkins to synthesize evidence regarding the effectiveness of CME and differing instructional designs regarding knowledge, attitudes, skills, practice behavior, and clinical practice outcomes. Despite the low quality of the evidence, CME appears to be effective at the acquisition and retention of knowledge, attitudes, skills, behaviors and clinical outcomes. More research is needed to determine with any degree of certainty which types of media, techniques, and exposure volumes as well as what internal and external audience characteristics are associated with improvements in outcomes. The report may be accessed by clicking http://www.ahrq.gov/downloads/pub/evidence/pdf/cme/cme.pdf .
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