HOW HEALTHY ARE WE?

The call for new mea­sures of pop­u­la­tion health may re­sult in ad­di­tional data de­mands on providers

Modern Healthcare - - Front Page - Jes­sica Zig­mond

For years, pub­lic health of­fi­cials have said the U.S. spends more money on health­care than other coun­tries but lags far be­hind in global health rank­ings. But a re­port from the In­sti­tute of Medicine last week de­liv­ered even more dis­turb­ing news: as a nation, we don’t know how to solve this prob­lem.

That’s be­cause the U.S. doesn’t have a clear strat­egy or the right mea­sure­ment tools to eval­u­ate the so­cial and en­vi­ron­men­tal fac­tors that make Amer­i­cans healthy or sick, ac­cord­ing to the re­port, For the Pub­lic’s Health: The Role of Mea­sure­ment in Ac­tion and Ac­count­abil­ity, which was spon­sored by the Robert Wood John­son Foun­da­tion.

To help the nation change course, the IOM re­port makes seven pri­mary rec­om­men­da­tions, some of which con­cern col­lab­o­ra­tion be­tween med­i­cal-care or­ga­ni­za­tions and gov­ern­men­tal agen­cies to share in­for­ma­tion taken from clin­i­cal data. The idea is to col­lect and man­age health data more com­pletely and ef­fi­ciently, and then make that data mean­ing­ful to im­prove the qual­ity of life.

Sep­a­rately, last week, a pres­i­den­tial com­mit­tee rec­om­mended ways to stan­dard­ize and pro­tect elec­tronic health in­for­ma­tion data (See story, p. 12).

Should HHS fol­low the IOM’s rec­om­men­da­tions, this could mean hos­pi­tals and physi­cians might again have to bol­ster their dat­a­col­lec­tion ef­forts for the fed­eral govern­ment.

“This is a pub­lic good and, there­fore, I would not ex­pect that it’s re­liant on hos­pi­tal con­tri­bu­tions,” Nancy Fos­ter, vice pres­i­dent of qual­ity and pa­tient safety at the Amer­i­can Hos­pi­tal As­so­ci­a­tion, said about the fi­nan­cial re­sources re­quired to achieve the re­port’s ob­jec­tives. “It should be re­sourced through pub­lic means.”

More col­lab­o­ra­tion

For hos­pi­tals, the fifth rec­om­men­da­tion is likely to be the most im­por­tant, Fos­ter said. That rec­om­men­da­tion calls for state and lo­cal pub­lic health agen­cies to col­lab­o­rate with clin­i­cal-care de­liv­ery sys­tems so the pub­lic has greater aware­ness of the ap­pro­pri­ate­ness, qual­ity, safety and ef­fi­ciency of clin­i­cal-care ser­vices in their states and com­mu­ni­ties. It also sug­gests that per­for­mance re­ports on overuse, un­der­use and mis­use—on things such as pre­ven­tive and di­ag­nos­tic tests, pro­ce­dures and treat­ments—be made avail­able for cer­tain in­ter­ven­tions.

“I think hos­pi­tals have to be a part of this, but they’re not the pri­mary group,” Fos­ter said of the re­port’s find­ings and sug­ges­tions. “Given state bud­gets and lo­cal county bud­gets, it’s a pretty daunt­ing task un­less they start with what they have,” Fos­ter said, adding that ex­ist­ing data could be used as a ful­crum to lever­age fur­ther ac­tiv­ity.

The re­port is the first of three on pub­lic health from the IOM. An 18-mem­ber com­mit­tee—which con­vened in Oc­to­ber 2009—will re­lease the sec­ond study, on law, in the first half of 2011. The third and fi­nal re­port, on fi­nanc­ing, is ex­pected in the sec­ond half of next year.

For this first study, which amounted to 170 pages, the com­mit­tee was asked to re­view pop­u­la­tion-health strate­gies, re­lated met­rics and in­ter­ven­tions within the con­text of a re­formed health­care sys­tem. It also was tasked with re­view­ing the role of score cards and other mea­sures, and sum­ma­riz­ing how they could be used to hold govern­ment and other stake­hold­ers ac­count­able. The re­port in­cluded a statis­tic pub­lished this fall in the jour­nal Health Af­fairs that said the U.S. spends more than 17% of its gross do­mes­tic prod­uct on health­care, but

Bet­ter tools would al­low com­mu­ni­ties to en­cour­age be­hav­iors that im­prove the over­all health of their res­i­dents, ex­perts say.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.