In a recent interview, Robert M. Wachter MD, Chief of Medicine at UCSF Medical Center www.ucsfhealth.org discussed important issues related to the Agency for Healthcare Research and Quality (AHRQ) www.ahrq.gov with Director Andy Bindman M.D. They talked about the progress that AHRQ is making in patient safety.
Dr. Bindman reports that AHRQ Rear Admiral Dr. Jeff Brady the head of patient safety for AHRQ https://psnet.ahrq.gov has been involved in research that AHRQ is continuing to make in specific areas. One of the major achievements in patient safety has been to study associated infections as to risks and how to treat them.
AHRQ now making it possible for patient safety research to reduce infections is now moving into the hands of clinicians and healthcare organizations to produce better outcomes. AHRQ successfully translated this research on controlling infections into practice which has made a difference in the reduction of the number of catheter-associated urinary tract infections and blood-borne infections in the hospital setting.
The next step is to build data systems to monitor the risks of infections and ultimately develop tools to support front line providers, hospitals, and health systems with the knowledge on how to reduce infections.
As for ongoing research and developments in health IT, Dr. Bindman reports that AHRQ is very interested in not just how health IT supports patient care when the patient is in front of the doctor, but also how healthcare professionals can effectively submit understandable data into EHRs. It is important to use the data in the medical records to effectively support decision-making for other patients with similar problems.
Dr. Bindman points out that EHRs with appropriate standardization and appropriate ways to protect information can be mined in a way that could support developing new and more rapid knowledge generation. This would result in improved decision-making when knowledge is combined with outcomes and then shared with patients.
Dr. Bindman realizes that payment models need to be in place to encourage the practice of telehealth and presently, AHRQ is engaged in studying these new models. For example, one project AHRQ supported many years ago that really generated a lot of interest is Project ECHO http://echo.unm.edu.
Project ECHO started in New Mexico and at first focused on hepatitis C to help support rural primary care providers that did not have adequate access to liver specialists in their communities.
AHRQ as an early supporter, was able to see that the program was able to achieve quality outcomes for patients with hepatitis C since the rural patients received the same level of care as those patients going to the specialty clinic at the University of New Mexico.
Today, there is an enormous amount of information coming to providers to evaluate. Dr. Bindman mentioned that AHRQ’s resource called the HCUP database www.hcup-us.ahrq.gov contains virtually the entire country’s hospital claims and most of the country’s emergency department visit claims. Accessing the database enables a way to find out about many of the problems that emergency departments and hospitals deal with 24/7.
Dr. Bindman mentioned that the agency has another very important data source called the “Comparative Health System Performance Initiative” www.ahrq.gov/chsp. The initiative over is going to establish three Centers of excellence and a Coordinating Center to identify, classify, track, and compare health systems and examine how these systems will impact quality of care, cost of care, and value.