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Explore the next 5 years of NQR/NDR, focusing on policy, practice change, resource allocation, and patient involvement. Address operational issues like release timing and frequency, mechanisms, and media. Dive into impact, increasing healthcare value, and other uses like licensing and competency assessment. Analyze current NQR/NDR and IOM goals. Drive change through accountability and comparative effectiveness at national, state, system, and individual levels. Should AHRQ prioritize areas of change and enable payment and accountability through NQR/NDR? Emphasize meaningful measures for value and trend towards less meaningful ones. Questions?
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Future Directions for the National Quality and Disparities Reports J. James Rohack MD FACC FACP Chair, National Advisory Council to AHRQ Senior staff cardiologist, Scott & White Clinic Director, Center for Healthcare Policy, S&W Medical Director for System Improvement, SWHP Professor of Medicine and Humanities in Medicine, TAMHSC
Future Directions of the NQR/NDR-Next 5 years • Policy makers: where to eliminate barriers • Practitioners: where to focus practice change • Payer: where to put resources • Patient: where to participate in change
Future Directions- Operational Issues • Timing of Release: Same time eg week after New Year’s or week before Super Bowl • Frequency of Release: Annually versus quarterly • Mechanisms: Paper vs Web • Media Face: 60 Minutes vs Oprah
Future Directions - Impact • Passive Reports- react to environment and document change • Active Reports- focus on where change needs to occur to increase Value
Future Directions- Increasing Value in Healthcare • Practical measurement: what can be measured with current systems • Ideal measurement: what change in current systems needed to have measures that will drive improvement of care and decrease in disparities
Future Directions- Other Uses • Accreditation of Systems • Individual Licensure • Assessment of Competency • Differentiation impacting choice and reward
National Quality Report Safe: ++ Patient Centered: + Timely: + Effective: ++++ Efficient: Equitable: National Disparities Report Safe: + ½ Patient Centered: ½ Timely: ½ Effective: +++ ½ Efficient: Equitable: ++++ Current NQR/NDR and IOM Goals: Should the Future be 4+?
Future Directions- Drive Change • System Care Accountability • Individual Accountability (patient, practitioner and provider) • Comparative Effectiveness: adoption of change
Future Directions – Actionable Levels • National • State • System • Individual
Future Directions Summary • Should AHRQ drive change through the NQR/NDR by prioritizing where focus of change should be? • Should the NQR/NDR be used for payment? For accountability? At System or Individual level? • Should the NQR/NDR only focus on what measures are meaningful for Value? Continue trending less meaningful measures?