AHCPR1
Enhancing the Consumer Health Experience
J. Michael Fitzmaurice, Ph.D.
Agency for Health Care Policy and Research
April 27, 1999
AHCPR2
Overview
# Government has useful web sites# Quality criteria for site evaluation are
available– HITI -- Science Panel Report -- Deering
article
AHCPR3
AHCPR Web Page
# To get to a government agency’s web site:– www.[agencyinitials].gov– E.G., www.hhs.gov or www.ahcpr.gov
# Health information– AHCPR.GOV– Consumer.gov/health.htm– scipich.org– healthfinder.gov
AHCPR4
ahcpr.gov
# Choosing Quality Health Care# Choosing and Using a Health Plan# Consumer Health# Consumer Assessment of Health Plan
Survey--consumer surveys and reporting# National Guidelines Clearinghouse
– guidelines.gov
# CONQUEST--clinical perf. measures
AHCPR5
hhs.gov# Data Council# Nat. Comm.on Vital and Health Statistics
– Hearings: agenda, testimony, minutes– Reports– Public meeting schedules
# HIPAA Administrative Simplification– P.L. 104-191– Notices of Proposed Rules, and public
comments– FAQs
AHCPR6
consumer.gov
# Aging/Elder Care# Buying Smart# Choosing Quality Health Care# Dieting and Weight Control# Diseases# Exercise and Fitness# Health insurance
AHCPR7
scipich.org
# Learn about evaluating and selecting interactive health communication (IHC) applications
# Evaluation reporting template# Selected resource links# Scientific articles published by the
Panel
AHCPR8
healthfinder.gov# A gateway web site!!# Hot topics
– AIDS, Cancer, Alternative medicine, Food safety, Diabetes, Medicare, Tobacco
# News# Smart Choices
– Prevention and self care, Online healthinfo
– Choosing quality care, Fraud and complaints
# Tools--build your own health web site
AHCPR9
SciPICH Report
# What are the potential risks and benefits of these emerging technologies?
# Ensure high quality and effectivness, how?
# What is the science or evidence base?# Role of health professionals and others?# Nationally, how do we improve health for
all people using these technologies?
AHCPR10
Capabilities Needed
# Ability to assimilate patient outcome information in a meaningful way, about– Individual patients
– Similar patients
– Comparable treatments
– Providers, Institutions, Health plans
# Ability to present information in a meaningful way for medical and personal health decisions
AHCPR11
Strategies
# Privacy– Personal health information (PHI) is
individually identifiable health information– PHI must be protected– The conditions under which PHI may be
received, used, and disclosed must be understood
– May take a Federal privacy law to achieve uniformity and national consensus
AHCPR12
Strategies
# The more uniform the conditions across geographical areas and uses, the more efficient information transfer will be.
# Look for common and innovative security solutions for health– Commerce– Defense
AHCPR13
Strategies
# Promote health data standards development– Medical vocabulary, syntax, codes– Data set content to support common
functions– Billing -- Patient record -- Images– Medical test ordering and results reporting– Emergency data
AHCPR14
Strategies
# Identify priority research areas where necessary information to support private sector investment is lacking– Telemedicine
– Improved medical and cost efficiency
– CPR– Uniform information for patient care, research, public
health, public policy
– CDSS--ADE– Reduced errors in medicine
AHCPR15
Strategies
# Bridge the gap between high-speed computation and advanced networking and health care uses.– Demonstrations, pilot studies– Evaluations – Population research– Disease-based simulations– Modeling State and community uses
– Public Health reporting
– Public program enrollment (1-stop shopping)
AHCPR16
Strategies
# Evaluation– Technical feasibility– Application in the community– Effect on well-being
– Patient health outcome– Productivity at work– Enjoyment of life
– Cost-benefit analyses
AHCPR17
Future
# Laporoscopic Surgery– Nintendo docs
# Cannot train everyone to be an MD, need consumer research summaries
# What information is most useful for:– Improving or maintaining health status– Caring for aging population– Educating care givers
AHCPR18
Challenges
# Privacy, confidentiality, security# Physician productivity# Obtaining comparable health data
– Describing and measuring concepts– Common vocabulary– Collection, storage and retrieval
AHCPR19
Challenges
# Realizing the complexity of medicine– How much is art?– How can we increase the science?
– Evidence-based medicine
– It is hard to describe medical conditions, processes, and patient outcomes
# Training and education in net health infomation use for– Physicians, Patients, Public
AHCPR20
Challenges
# Address errors in medicine– Recent literature:
– Leape -- Bates -- Others
– Adverse Drug Events – Chemotherapy overdoses– Allergic reactions – Amputation of wrong limb
AHCPR21
Challenges
# Measuring patient outcomes– Measures– Cost of collection– Interpersonal comparisons of satisfaction
# Measuring quality– Clinical performance measures– Practice guideline variances– Treatment variation in the population
AHCPR22
Future
# How much PHI are we willing to give up to receive the benefits of– National and regional health data bases– Better purchasing information– Targeted consumer health information
# Good health information, how will we know it is good?
# Role of government?
AHCPR23
Enhancing the Consumer Health Experience
J. Michael Fitzmaurice, Ph.D.
Agency for Health Care Policy and Research
April 27, 1999
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