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Fixin' Healthcare

Saturday, January 20, 2007

Transformation Of Healthcare - The Goals Determine The Task

The Director of the Agency for Healthcare Research and Quality (AHRQ), Carolyn M. Clancy, M.D., spoke on September 27, 2006 to the Symposium on Remaking American Medicine. Her remarks noted a close relationship between the themes of Remaking American Medicine and the mission of AHRQ to improve quality, safety, efficiency and effectiveness of health care.

The four themes are:
  • Involving patients and their families in their own care is a key element to improving health care quality.
  • Encouraging health care providers to collaborate and learn from each other how to improve the quality of health care, fostering transparency and inspiring creative solutions.
  • Encouraging partnerships between patients and providers in designing quality health care solutions to help ensure more efficient and effective delivery of health care.
  • Recognizing that nothing can be achieved if the concept of transparency is not fully embraced by health care institutions. This is the cornerstone to remaking American medicine for all.
A survey conducted by the Kaiser Family Foundation and AHRQ reported that more Americans (51%) are dissatified with the quality of health care than those who say they are satisified (41%). Further, more Americans indicated they understand the term "medical error" and 43% say preventable medical errors occur "very often" or "somewhat often" when they seek care from a health professional.

The following points from the survey were presented as evidence that Americans are taking steps to improve the quality of care they receive.
  • 83 percent ask their doctor questions about their health or any treatment that he or she has prescribed.
  • 70 percent report that they check the medication given by their pharmacist against the doctor's prescription.
  • 54 percent bring a list of all their medications to a doctor's appointment.
  • 45 percent report bringing a friend or relative to a doctor's appointment to help ask questions.
  • One in three Americans say they or their family member has created a set of their medical records to ensure that their health care providers have all their medical information.
Dr. Clancy expresses satisfaction that consumers and patients have become more informed and empowered. She adds that patients, families and clinicians need to create a partnership to achieve the best quality care.

The Department of Health Human Services is directing attention to providing useful, understandable information on the quality and price of health care.
  • Connect the System = health information systems that can quickly and securely communicate and exchange data.
  • Measure and Publish Quality = define benchmarks for what constitutes quality care and link process to outcomes.
  • Measure and Publish Price = calculation of cost for the process that constitutes quality care.
  • Create Positive Incentives = reward those who offer and those who purchase high-quality, competitively priced health care.
Dr. Clancy's remarks define some of the essential components involved in "remaking American medicine" to improve the quality of medical care for those who seek assistance with illness, disease and injury. When she uses the term "transforming our nation's health care system" in the same context, she barely scratches the surface of what is needed to accomplish what is a much broader task.

Medical care is far from the most effective, much less efficient, means of achieving and maintaining optimum health status and optimum mental, emotional and physical function. Health promotion, healthy lifestyles, prevention and rehabilitation are the components of health care that are a higher order than medicine for transforming health status in America.

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