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OCTOBER - NOVEMBER 2009 Program Evaluation And Effective Interventions [November 30, 2009] Solutions To Challenges Facing Primary Care Medicine [November 25, 2009] U.S. Lags In Access, Quality, And Use Of Health Information Technology [November 24, 2009] Senate Health Care Overhaul Bill Contains Allied Health Workforce Provisions [November 23, 2009] Research Insights Briefs Available [November 20, 2009] Hospital CEOs Question Whether There Are Enough Clinicians If Health Reform Is Enacted [November 19, 2009] Employees In Postsecondary Institutions And Salaries Of Full-Time Instructional Staff [November 18, 2009] Controlling U.S. Health Care Spending: Separating Promising From Unpromising Approaches [November 17, 2009] Role And Relevance Of Rankings In Higher Education Policymaking [November 16, 2009] Role Of Cost Effectiveness In Coverage Decisions[November 13, 2009] BLS Spotlight On Health Care Statistics [November 12, 2009] Health System Reform And Antitrust Law [November 11, 2009] Doctors Now Spending More Time With Patients [November 10, 2009] Interprofessional Education Assessment And Planning Instrument For Academic Institutions [November 9, 2009] H.R. 3962-- Affordable Health Care for America Act Estimated Spending And Revenue Effects [November 6, 2009] Assessing The Assessments Of Student Outcomes [November 5, 2009] An Emerging Digital Divide Among Hospitals That Care For The Poor [November 4, 2009] ASAHP’s Journal Of Allied Health Ranks High In Being Downloaded [November 3, 2009] Consumer Health Informatics [November 2, 2009] Different Measures For Analyzing Current Proposals To Reform Health Care [October 30, 2009] Analysis Of Comprehensive Health Reform Bills [October 29, 2009] Seeking Tenure "Conversion" [October 28, 2009] Funding Available For Health Impact Project [October 25, 2009] Promoting Excellence In End-Of-Life Care [October 16, 2009] Gates Foundation: Round 4 Of Grand Challenges Explorations Available [October 15, 2009] Results From A State Scorecard On Health System Performance, 2009 [October 14, 2009] CBO Analysis Of The Effects Of Proposals To Limit Costs Related To Medical Malpractice ("Tort Reform") [October 13, 2009] Side-By-Side Comparison Of Major Health Reform Proposals [October 12, 2009] State Scorecard On Health System Performance [October 9, 2009] CBO Analysis Of Senate Finance Committee Health Reform Bill [October 8, 2008] Comparative Effectiveness Research [October 7, 2009] U.S. Branch Campuses Abroad [October 6, 2009] Reinventing Health Care Delivery [October 5, 2009] Erosion Of Empathy In Medical College [October 2, 2009] Public Health Studies [October 1, 2009]
Program Evaluation And Effective Interventions Solutions To Challenges Facing Primary Care Medicine According to a monograph entitled “Solutions to Challenges Facing Primary Care Medicine, “ the demand for primary care in the United States is expected to grow at a rapid rate, while the nation’s supply of primary care physicians is dwindling and interest of U.S. medical school graduates in pursuing careers in primary care specialties is steadily declining. The reasons behind this decline in primary care physician supply are multifaceted and complex. Key factors include the rapid rise in medical education debt, decreased income potential for primary care physicians, and increased administrative hassles that have caused great dissatisfaction with the current practice environment. The monograph can be accessed by clicking http://www.acponline.org/advocacy/where_we_stand/policy/solutions.pdf. U.S. Lags In Access, Quality, And Use Of Health Information Technology A new Commonwealth Fund survey of primary care physicians in 11 countries reveals that the United States lags far behind other countries in key areas of access, quality, and use of health information technology—undermining doctors' efforts to provide timely, high-quality care. Additional information about survey findings can be accessed by clicking http://www.commonwealthfund.org/~/media/Files/Publications/In%20the%20Literature/2009/Nov/1336_Schoen_survey_primary_care_MDs_11_countries_HA_WebExcl_11052009_ITL_v2.pdf. Senate Health Care Overhaul Bill Contains Allied Health Workforce Provisions Senate Majority Leader Harry Reid introduced a behemoth health care overhaul reform bill consisting of 2,074 pages. The document served as a basis for an important procedural vote that occurred on November 21. The Association of Schools of Allied Health Professions (ASAHP) was responsible for the inclusion of allied health components pertaining to the workforce, geriatrics education and training, and area health education centers in the following sections: Sections 5001-5002 Pages 1,266-1,267 Section 5101 Pages 1,278-1,289, 1,290 and 1,295 Section 5305 Pages 1,359-1,366 and 1,368 Section 751 Pages 1,418 and 1,421 The bill can be accessed by clicking http://democrats.senate.gov/reform/patient-protection-affordable-care-act.pdf. TOP Research Insights Briefs Available AcademyHealth, an organization based in Washington, DC, has just released two new Research Insights briefs based on presentations at the 2009 Annual Research Meeting. The first looks at addressing disparities through Public Health Systems and Services Research while the second tackles issues surrounding medical homes and accountable care organizations. The briefs can be accessed by clicking http://www.academyhealth.org/files/publications/PHSRDisparitiesbrief.pdf and http://www.academyhealth.org/files/publications/RschInsightMedHomes.pdf. Hospital CEOs Question Whether There Are Enough Clinicians If Health Reform Is Enacted The survey can be accessed by clicking http://www.amnhealthcare.com/pdf/09CEOSurvey.pdf. Employees In Postsecondary Institutions And Salaries Of Full-Time Instructional Staff The National Center for Education Statistics (NCES) presents data from the Winter 2008-09 Integrated Postsecondary Education Data System (IPEDS), including data on the number of staff employed in Title IV postsecondary institutions in fall 2008 by primary function/occupational activity, length of contract/teaching period, employment status, salary class interval, faculty and tenure status, academic rank, race/ethnicity, and gender. The report can be accessed by clicking http://nces.ed.gov/pubs2010/2010165.pdf. Controlling U.S. Health Care Spending: Separating Promising From Unpromising Approaches Slowing the growth in U.S. health care spending will most likely require adoption of an array of strategies as well as an improved approach to moving promising strategies into widespread use, according to a new analysis by the RAND Corporation. The most promising option for curbing health care spending is changing the way doctors and hospitals are paid to provide care, but implementing such a system must overcome significant obstacles in order to be successful, according to the study published online by the New England Journal of Medicine. Hussey et al indicate that other promising approaches to slow health care spending include adoption of electronic health records, programs to better-manage chronic diseases, strengthening patients' use of primary care and encouraging wider use of lower-cost providers such as nurse practitioners and settings such as retail health clinics. Role And Relevance Of Rankings In Higher Education Policymaking Role Of Cost Effectiveness In Coverage Decisions An issue brief from the California HealthCare Foundation examines public and industry attitudes toward cost-effectiveness analysis (CEA) as a component of decisions about what services should be covered in public and private health plans. CEA is a method for weighing the value of different health care options relative to their cost. Rather than identifying the lowest-cost option, CEA measures health benefits from the standpoint of the "quality-adjusted life year" -- or QALY -- to assign value to patients' quality of life and longevity. Although the conventional wisdom holds that Americans will not accept cost factors in coverage decisions, three studies suggest more openness to their use. The authors suggest that Medicare is well-placed to provide leadership in CEA application, thereby easing technical and policy barriers that have slowed industry progress in ensuring the "best bang for the buck" in health care services. The issue brief can be accessed by clicking http://www.chcf.org/documents/policy/CostEffectivenessAnalysis.pdf. BLS Spotlight On Health Care Statistics Health System Reform And Antitrust Law Antitrust law rests on the philosophy that the economy functions best when markets thrive and when purchasers, armed with information, are able to make decisions that yield both quality and value. Thus, the overarching aim of antitrust law is to advance free and open markets in which competition can flourish. Even though medical care itself represents the single largest part of the economy, it is different from buying televisions and how to adapt health care buying and selling to the law of markets has proven to be a complex undertaking. A policy brief from The Robert Wood Johnson Foundation addresses antitrust considerations that arise in health system transformation aimed at producing greater clinical integration and greater levels of information about the quality and cost of care. It focuses on those activities that can be pursued without running afoul of basic antitrust principles and also describes types of conduct that appear to venture into prohibited-conduct territory in four case scenarios. The report can be accessed by clicking http://www.rwjf.org/files/research/leglabarriersantitrustanalysis.pdf. Doctors Now Spending More Time With Patients Interprofessional Education Assessment And Planning Instrument For Academic Institutions The Association for Prevention Teaching and Research (APTR) recently made available the Interprofessional Education Assessment and Planning Instrument for Academic Institutions. The instrument is designed with an emphasis on prevention and will assist institutions in assessing where they are in the development of Interprofessional Education on their respective campuses. The first part of the instrument measures interprofessional education and the second part measures prevention education. Efforts are being made to track the development and expansion of interprofessional training initiatives across the country. Individuals who wish to obtain a copy of the instrument are asked to provide basic contact information – name, institutional affiliation, and email address. The instrument can be accessed by clicking http://fs7.formsite.com/APTR/form119750449/index.html . H.R. 3962-- Affordable Health Care for America Act Estimated Spending And Revenue Effects The Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) have estimated the direct spending and revenue effects of H.R. 3962, the Affordable Health Care for America Act, as introduced on October 29, 2009, incorporating the manager’s amendment proposed by Rep. John Dingell (D-MI) on November 3, 2009. A letter to Rep. Dingell from Douglas Elmendorf, CBO Director, explaining these effects can be accessed by clicking http://www.cbo.gov/ftpdocs/107xx/doc10706/hr3962Dingell_with_mgr_amendment.pdf. Assessing The Assessments Of Student Outcomes When the country's two major associations of public universities were trying to craft a new accountability system three years ago, they found that many of their member institutions (and especially their faculties) were dead set against the idea of choosing one measure of student learning outcomes. In response, the groups settled on three possible options that institutions could use to fulfill the "student learning outcomes" portion of the VSA (the Council for Aid to Education's Collegiate Learning Assessment, the Educational Testing Service's Measure of Academic Proficiency and Progress, and ACT, Inc.'s Collegiate Assessment of Academic Proficiency), thereby avoiding the single test problem. But it created another potential issue: uncertainty about whether the results on one test (chosen by one institution) would be the comparable to the results for another institution that chose a another of the three tests, and the possibility that institutions would try to game the system by seeking to use a test on which they thought they might perform better. On Tuesday, the groups released a federally funded analysis of a "test validity study" conducted by the makers of the three tests showing that the three tests produced comparable outcomes at the institutional level based on having been administered at a diverse range of 13 institutions, big and small, public and private. In other words, a college that ranked in the 95th percentile for critical thinking using one of the tests would rank in roughly the same place using the critical thinking component of one of the other two tests and vice versa. An Emerging Digital Divide Among Hospitals That Care For The Poor ASAHP’s Journal Of Allied Health Ranks High In Being Downloaded The Association’s quarterly Journal of Allied Health continues to do quite well in the world of scholarly publishing. According to an analysis conducted for the period September 1, 2009 to September 30, 2009 by the firm Publishing Technology plc, of more than 13,000 journal titles on IngentaConnect, the Journal of Allied Health ranks 86th with 1,141 full-text downloads. Ingenta is a British-based company that produces the online version of this publication. For more than a decade, each issue has featured a wide assortment of papers covering matters of interest across a wide spectrum of allied health professions. Previously, the Journal’s offerings included special issues on topics such as gerontology. A recent meeting of the Editorial Board was instrumental in identifying possible topics for future special issues. As a result of that discussion, steps are being taken to produce an issue devoted to interprofessional education. Top authorities on that topic will be requested to submit articles.
Consumer Health Informatics The report can be accessed by clicking http://www.ahrq.gov/downloads/pub/evidence/pdf/chiapp/impactchia.pdf. Different Measures For Analyzing Current Proposals To Reform Health Care Analysis Of Comprehensive Health Reform Bills A new report from The Commonwealth Fund provides an overview of key provisions of the two separate comprehensive health reform bills passed by the five committees of jurisdiction in the U.S. Congress: the Finance Committee and the Health, Education, Labor, and Pensions (HELP) Committee of the Senate, and the Ways and Means, Education and Labor, and Energy and Commerce committees of the House of Representatives. While the general frameworks of the bills are quite similar-all bills include provisions intended to improve and expand coverage and all would create a comprehensive and coherent strategy for improving health care quality-they differ in a few key respects. Most important, the Senate Finance Committee bill does not include a public plan option or a requirement that employers offer coverage nor does it reform for more than one year Medicare's formula for setting physician fees; the House bill includes all of these features. Seeking Tenure "Conversion" Medical School Enrollment
Online Talking Glossary Of Genetic Terms The National Human Genome Research Institute (NHGRI), part of the National Institutes of Health, has launched the next generation of its online Talking Glossary of Genetic Terms. It contains several new features, including more than 100 colorful illustrations and more than two dozen 3-D animations that allow the user to dive in and see genetic concepts in action at the cellular level. Funding Available For Health Impact Project The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, is a national initiative designed to promote the use of health impact assessments (HIAs) as a decision-making tool for policymakers. HIAs are flexible, data-driven assessments that identify the health consequences of new policies to develop practical strategies to enhance their health benefits and minimize adverse effects. The goal is to demonstrate the effectiveness of HIAs and promote their incorporation into local, state, tribal, and federal decision-making. Government agencies, educational institutions and nonprofit organizations are encouraged to apply. Successful applicants will receive grants of $25,000 to $150,000. Promoting Excellence In End-Of-Life Care Gates Foundation: Round 4 Of Grand Challenges Explorations Available Results From A State Scorecard On Health System Performance, 2009 Focused on identifying opportunities to improve, The Commonwealth Fund's State Scorecard on Health System Performance assesses states’ performance on health care relative to achievable benchmarks for 38 indicators of access, quality, costs, and health outcomes. The 2009 State Scorecard paints a picture of health care systems under stress, with deteriorating health insurance coverage for adults and rising health care costs. On a positive note, there were gains in children's coverage as a result of national reforms and improvement in some measures of hospital and nursing home care following federal efforts to publicly report quality data. The scorecard highlights persistent wide variation in performance across states and continued evidence of poor care coordination. The report can be accessed by clicking http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2009/Oct/1326_McCarthy_state_scorecard_2009_full_report_FINAL.pdf. CBO Analysis Of The Effects Of Proposals To Limit Costs Related To Medical Malpractice ("Tort Reform") A letter from Douglas Elmendorf, Director of the Congressional Budget Office (CBO) responds to a request for an updated analysis of the effects of proposals to limit costs related to medical malpractice (“tort reform”). Tort reform could affect costs for health care both directly and indirectly: directly, by lowering premiums for medical liability insurance, and indirectly, by reducing the use of diagnostic tests and other health care services when providers recommend those services principally to reduce their potential exposure to lawsuits. The letter can be accessed by clicking http://www.cbo.gov/ftpdocs/106xx/doc10641/10-09-Tort_Reform.pdf . Side-By-Side Comparison Of Major Health Reform Proposals A comparison of major health reform proposals was developed by the Henry J. Kaiser Family Foundation. The comparison can be accessed by clicking http://www.kff.org/healthreform/upload/healthreform_sbs_full.pdf. State Scorecard On Health System Performance Focused on identifying opportunities to improve, The Commonwealth Fund's State Scorecard on Health System Performance assesses states’ performance on health care relative to achievable benchmarks for 38 indicators of access, quality, costs, and health outcomes. The 2009 State Scorecard paints a picture of health care systems under stress, with deteriorating health insurance coverage for adults and rising health care costs. On a positive note, there were gains in children's coverage as a result of national reforms and improvement in some measures of hospital and nursing home care following federal efforts to report quality data publicly. The scorecard highlights persistent wide variation in performance across states and continued evidence of poor care coordination. The report can be accessed by clicking http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2009/Oct/1326_McCarthy_state_scorecard_2009_full_report_FINAL.pdf. CBO Analysis Of Senate Finance Committee Health Reform Bill The Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) have completed a preliminary analysis of the Chairman’s mark for the America’s Healthy Future Act of 2009, incorporating the amendments that have been adopted to date by the Senate Committee on Finance. That analysis reflects the specifications posted on the committee’s Web site on October 2, 2009, corrections posted on October 5, and additional clarifications provided by the staff of the committee through October 6. CBO and JCT’s analysis is preliminary in large part because the Chairman’s mark, as amended, has not yet been embodied in legislative language. A copy of the letter from the CBO to Senate Finance Committee Chairman Max Baucus (D-MT) can be accessed by clicking http://www.cbo.gov/ftpdocs/106xx/doc10642/10-7-Baucus_letter.pdf . Comparative Effectiveness Research The National Institute for Health Care Management (NIHCM) Foundation has issued a report, Comparative Effectiveness Research: International Experiences and Implications for the United States, which examines how comparative effectiveness programs operate in other countries and offer lessons for U.S. policymakers based on their analysis. It is part of a three-year initiative to expand senior health policy leaders' knowledge of health systems and delivery innovations in other industrialized countries and to promote the use of this knowledge to advance system improvements in the U.S. Published by AcademyHealth with support from NIHCM Foundation and the Kaiser Permanente Institute for Health Policy. U.S. Branch Campuses Abroad Reinventing Health Care Delivery Hamstrung by an increasingly complex, costly, and disorganized system of care, health care organizations are following the lead of the corporate world and embracing innovation as a way to overcome the seemingly intractable problems that have undermined U.S. health care delivery for decades. Today's innovation centers — most of which are affiliated with large hospitals or health systems — range in scope from modest internal programs to large, formalized organizations with dedicated physical space, sizable staffs, and external clients. Key areas of emphasis include facility design, operational efficiency, optimized information technologies, improvements in the patient experience, and care quality. Leaders at health care innovation organizations nationwide were interviewed to learn more about how the centers operate, the objectives they are pursuing, and some of the challenges they face. These notions are discussed in an Issue Brief of the California HealthCare Foundation. The Issue Brief can be accessed by clicking http://www.chcf.org/documents/hospitals/InnovationCenters.pdf . Erosion Of Empathy In Medical College A longitudinal study was designed to examine changes in medical students' empathy during medical school and to determine when the most significant changes occur. The results appear in an article published in the September 2009 issue of Academic Medicine. It is concluded that a significant decline in empathy occurs during the third year of medical school. It is ironic that the erosion of empathy occurs during a time when the curriculum is shifting toward patient-care activities when empathy is most essential. Implications for retaining and enhancing empathy are discussed. The article can be accessed by clicking http://journals.lww.com/academicmedicine/Fulltext/2009/09000/The_Devil_is_in_the_Third_Year__A_Longitudinal.12.aspx TOP The Vol. 11, No. 3 Summer issue of Peer Review, a publication of the Association of American Colleges and Universities, contains several articles on the topic of Liberal Education and Undergraduate Public Health Studies. For additional information on the contents of this issue and how to access it, click http://www.aacu.org/peerreview/index.cfm.
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