Prevention
Long
Term Goal: To translate evidence-based
knowledge into current recommendations for clinical preventive services that
are implemented as part of routine clinical practice to improve the health
of all Americans.
| Measure |
FY |
Target |
Result |
Increase
the quality and quantity of preventive services that are delivered in the
clinical setting especially focusing on priority populations.
Outcome
2.3.1 |
2007 |
Develop
tools to facilitate the implementation of clinical preventive services among
multiple users |
Completed:
Clinicians
- Electronic
Preventive Services Selector (ePSS) tool.
- ACCTION
PACK.
Health Insurance Purchasers
- A
Purchaser's Guide to Evidence-Based clinical Preventive Services: Moving
Science into Coverage (Purchaser's Guide).
Consumers
- 2 new evidence-based checklists.
|
2006 |
Establish
baseline for reach of evidence-based preventive services though use of
products and tools. |
Completed:
- Views
and downloads of electronic content:
- United States Preventive Services Task Force (USPSTF) recommendations: 4,242,074.
- General Preventive services: 1,621,848.
- National Guideline Clearinghouse™ related to USPSTF recommendations: 359,634.1
- Dissemination of published products:
- 2005
Clinical Guide: 18,969.
- Consumer products: 276,531.
- Adult
Preventive Care Timeline: Release in August 2006.
- Journal
publications:
- Pediatrics, 2 publications, circulation 63,000.
- Annals of Internal Medicine, 1 publication, circulation 92,756.
|
2005 |
Establish
baseline quality and quantity of preventive services delivered. |
Completed:
- % of
women (18+) who report having had a Pap smear within the past 3 years—81.3%.
- % of
men & women (50+) report they ever had a flexible
sigmoidoscopy/colonoscopy—38.9%.
- % of
men & women (50+) who report they had a fecal occult blood test (FOBT)
within the past 2 years—33%.
- % of
people (18+) who have had blood pressure measured within preceding 2 years
and can state whether their blood pressure is normal or high—90.1%.
- % of adults
(18+) receiving cholesterol measurement within 5 years—67.0%.
- % of
smokers receiving advice to quit smoking—60.9%.
|
2004 |
Benchmark
best practices for delivering clinical preventive services. |
Completed: Expert
opinions regarding best practices for delivering clinical preventive services
obtained through stakeholder meetings and focus groups. |
Increase
continuing medical education (CME) activities by developing a Train the Trainer program for implementing a
system to increase delivery of clinical preventive services. |
Completed: Developed
Train the Trainer program. |
Improve
the timeliness and responsiveness of the USPSTF to emerging needs in clinical
prevention.
Outcome
2.3.2 |
2007 |
Decrease
by 10% the number of USPSTF recommendations that are five years or older |
Dec '07
Exceeded: As of
January 1, 2007, 20 USPSTF topics were considered out of date by National
Guidelines Clearinghouse™ standards. By September 30, 2007, only sixteen topics
should be out of date, representing a 20% decrease. |
2006 |
Decrease
the median time from topic assignment to recommendation release |
Four
topics released to date in FY 2006, time from assignment to release ranged
from 14 to 30 months, median time 25 months. |
2005 |
Establish
baseline measures for timeliness and responsiveness. |
Completed:
- 9
recommendations released.
- 78%
current within
National Guideline Clearinghouse™ standards (reviewed within 5 years).
- 100%
of recommendations related to Institute of Medicine (IOM) priority areas for preventive care current within National
Guideline Clearinghouse™ standards.
- Developed new topic criteria, submission,
review, and prioritization processes with new USPSTF topic prioritization
workgroup.
|
2004 |
N/A2 |
N/A2 |
Increase
the number of partnerships that will adopt and promote evidence-based
clinical prevention.
Outcome
2.3.3 |
2007 |
Three new
partners will adopt and/or promote USPSTF-based tools |
Dec-07
Exceeded:
- Interagency Agreement (IAA)
with Veterans Administration/National Center for Health Promotion &
Disease Prevention.
-
Partnerships with the Veterans Administration and Dept of Defense (Air Force)
distribution of USPSTF-based Adult Timeline prevention wall-charts to
clinics.
-
Contract with National Business Group on Health for marketing and promotion
of new Purchaser's Guide to Clinical Preventive Services: Moving Science
into Coverage.
-
Addition of nurse practitioner and osteopathic professional organizations to
the USPSTF Partnership group, resulting in active promotion of the USPSTF
recommendations to these clinical provider audiences.
|
2006 |
Increase
the number of partnerships promoting evidence-based clinical prevention by 5% |
Completed:
AHRQ has
an IAA with the Centers for Disease Control and Prevention (CDC) to support Steps to a Healthier US through technical
assistance to Steps grantee communities to facilitate linkages between
clinical prevention and public health efforts focused on healthy behaviors.
National
Business Group on Health partnerships include development of Purchaser's
Guide to Clinical Preventive Services (including coverage for colorectal cancer screening),
and an assessment of the integration of employer supported prevention
efforts.
In
partnership with Administration on Aging, CDC, and National Council on Aging,
support a project to assist community dwelling older adults maintain
independent living through evidence-based disease and disability prevention
and early detection. AHRQ is supporting linkages between clinical providers
and aging social services and public health programs. |
2005 |
Establish
baseline partnerships within the Prevention Portfolio promoting clinical
prevention |
Federal
partners—10
Non-Federal
partners:
- 10
Primary Care Organizations.
- 2
Health Care Insurance Industry.
- 2
Consumer Organization.
- 3
Employer Organizations.
- 6 Other
organizations.
|
2004 |
Produce
fact sheets for adolescents, seniors, and children. Partner with appropriate
professional societies and advocacy groups |
Completed:
- Pocket
Guide to
Staying Healthy at 50+—revised Nov. 2003 (English and Spanish)—AARP
Partnership.
- Adult
health timeline (for clinicians/patients)—revised Jan. 2004.
- Women:
Stay Healthy at
Any Age—printed Jan. 2004 (English and Spanish).
- Men:
Stay Healthy at Any Age—printed Feb. 2004 (English and Spanish).
- Pocket Guide to Good Health for
Children—revised
May 2004 (English and Spanish).
|
Data
Source: National
Health Quality Report (NHQR); National Healthcare Disparities Report (NHDR); AHRQ—USPSTF/Preventive Services Web site; AHRQ product distribution process; AHRQ
Preventive services databases (internal); Web trends; AHRQ Publications
Clearinghouse; National Guideline Clearinghouse™; electronic Preventive
Services Selector; Evidence-based Practice Center task order documents; Action
Network contracts
Data
Validation: Because
the Prevention Portfolio cannot collect primary quantitative data regarding
healthcare service delivery or quality, it relies on federal partners and
federal public release data sources for these measures, which include the
National Health Quality Report and National Healthcare Disparities Report. As
legislated by Congress, AHRQ produces these reports annually. Data comprising
the reports are drawn from multiple databases (e.g., the Medical Expenditure Panel Survey [MEPS], the Healthcare Cost & Utilization Project [HCUP], Consumer Assessment of Healthcare Providers and Systems [CAHPS®])
supported by AHRQ, in addition to other databases (such as the National Health Interview Survey [NHIS], supported by
CDC). These reports and the databases from which they are drawn are considered
definitive sources of healthcare quality measures. Other data sources (qualitative):
Stakeholder meetings, expert panel meetings, and focus groups. Qualitative data
were gathered primarily by outside contractors. The information obtained was
analyzed, synthesized and reported using established methodology. Because of
the limitations of qualitative data with respect to validity, the results
obtained from these sources were used to identify successful case studies,
themes, and areas for future opportunity. Other data sources (internal):
Database established to
monitor the timeliness of current recommendations. Database established in 2006
to track partnership development and collaborative activities with public and
private organizations.
Cross
Reference: HHS Goals
and Objectives: 2.3; HP2010-13/14/15/16/18/19/21/22/24/25/27; HHS Priorities:
Prevention.
Care Management
Long
Term Goal: Increase the delivery of
evidence-based treatments for acute and chronic conditions, through research
and research syntheses; development of tools; identification of effective
implementation strategies; and promotion of effective policies.
| Measure |
FY |
Target |
Result |
By 2010,
we will:
- Increase by 15% the proportion of patients with diabetes, coronary heart
disease (including acute myocardial infarction) and asthma who receive
effective treatments.
- Reduce
disparities in effective care delivered to different populations.
(Developmental).
- Increase the proportion of patients with chronic conditions such as diabetes
and asthma who practice self-care. (Developmental).
- Increase the proportion of clinicians who have access to evidence-based tools
to guide treatment decisions. (Developmental).
Outcome
1.3.14 |
2007 |
Complete
2 reports under MMA Section 1013 to inform pharmacy benefits relevant to
chronic disease. Establish survey measures for patient self-management of
chronic disease. |
Completed |
2006 |
Begin
interventions through partnerships with Federal and State agencies,
professional societies, plans and purchasers. |
Completed |
2005 |
Develop
partnerships with 2-4 large delivery systems (States, health plans,
purchasers) to improve outcomes and reduce disparities for 1 to 3 specific
chronic diseases. |
Completed |
2005 |
Synthesize
evidence on interventions, burden of disease, gaps in care and costs; agree
on outcome measures to be tracked. |
Completed |
2005 |
Establish
trends in National Quality Report categories |
Completed |
2004 |
Report on
progress in core measure set in National Quality Report and National
Disparities Report. |
Completed |
2004 |
Identify
private sector data to be used in future reports. |
Completed |
2004 |
Synthesize
evidence on interventions on improving diabetes and hypertension care. |
Completed |
Data
Source: National
Health Care Quality Report; National Healthcare Disparities Report; RFC
Healthplan Disparities Collaboratives; Effective Healthcare Program reports
Data
Validation: Measures
in the NHQR and NHDR are based on validated surveys conducted by HHS Agencies
including AHRQ and CDC and private partners such as the National Committee for Quality Assurance (NCQA).
Cross
Reference: HHS
Goals and Objectives: 1.3; HP2010-3/4/5/12/13/14/16/21/24; HHS Priorities:
Value-Driven Health Care
Cost, Organization, and
Socio-Economics
Long Term Goal: By 2010, in at least 5 cases,
public or private health care policymakers and decisionmakers will have
used AHRQ findings or tools in the area of:
| Measure |
FY |
Target |
Result |
System
and delivery improvement, payment and purchasers, and/or market forces to
make decisions designed to improve quality, effectiveness, and/or efficiency
of health care by 5%.
Outcome
Financing, access, costs, and coverage to make decisions designed to improve
the efficiency of the U.S. health care system while maintaining or improving
quality, and/or improving access to care or reducing any existing
disparities.
Outcome
1.2.1 |
2007 |
Develop
an evaluation of efficiency measures, including a useful applied taxonomy, an
evaluation of the current published measures and a broad assessment of use. |
Dec-07 |
2007 |
Conduct
or support 15 new projects on research related to financing, access, costs,
coverage, delivery, payment, purchasing of market forces that are
disseminated to health care policymakers and healthcare decisionmakers. |
Dec-07 |
2006 |
Develop
and enhance mechanisms to disseminate and assist with implementation of
findings to health care public policymakers, systems leadership,
purchasers/employers, and health services researchers. |
Completed: Held
conference to present research findings to policymakers |
Conduct
or support 15 new projects on research related to financing, access, costs,
or coverage that is disseminated to health care policymakers. |
Completed |
2005 |
Conduct
or support 12 new projects related to system and delivery improvement,
payment and purchasers, and/or market forces. |
Completed |
2005 |
Conduct
or support 15 new projects related to financing, access, cost, or coverage. |
Completed |
2005 |
Complete
a synthesis of research in a significant area or system and delivery
improvement, payment and purchasers, and/or market forces. |
Completed |
2005 |
Complete
a synthesis of research in a significant area of financing, access, cost, or
coverage. |
Completed |
2004 |
Develop a
data warehouse and vocabulary server to process patient safety event data |
Completed |
Data
Source:
Publications, intramural plans for the Center for Financing, Access and Cost Trends (CFACT) and Center for Delivery, Organization, and Markets (CDOM), grants management tracking
of funded projects, and tracking of all deliverables by the Integrated Delivery System Research Network (IDSRN) project
officer.
Data
Validation: The
CFACT and CDOM intramural plans are maintained and reviewed by senior staff.
Grants are monitored by project staff, and the IDSRN has a senior project
officer.
Cross
Reference: SG-1.2,
4.4;HP2010-17; 500-Day Plan—Value Drive Health Care
Training
Long
Term Goal: By 2010, enhance capacity to
conduct and translate health services research (HSR) by:
| Measure |
FY |
Target |
Result |
Increase
the number of individuals who receive career development support by 30%.
Outcome
4.1.1 |
2007 |
Increase
by 15% from FY 2004 |
9 new grants awarded |
2006 |
Increase
by 10% from FY 2004 |
15 new grants awarded |
2005 |
Increase
by 5% from FY 2004 |
2 new awards (Career development budget was
reprogrammed in FY 2005) |
2004 |
Support
40 career development grants |
49 |
Improve
geographic diversity by increasing the number of States by 5 which have the
capacity to undertake HSR.
Increase the number of institutions serving predominantly minority
populations by 5 which have the capacity to undertake HSR.
Output
4.1.2 |
2007 |
Support
at least 2 new programs |
Dec-07
Expected
to meet pending review completion and funds availability, data not yet
available |
2006 |
Issue new
announcement |
11 new
awards were issued |
2005 |
Support
at least 3 institutions in new States and at least 1 new predominantly
minority serving institution |
No new awards due to reprogramming
of FY 2005 Building Research Infrastructure and Capacity (BRIC) funds |
2004 |
Baseline—support 6 institutions in new States and 9 predominantly minority-serving
institutions |
Completed |
Support 5
institutional programs that develop HSR curricula to address safety/quality,
effectiveness, and efficiency
Output
4.1.3 |
2007 |
Support at
least one new project |
Completed: 2 awards made |
2006 |
Issue
announcement |
Presentation
at annual meeting of Academy Health and AHRQ National Research Service Award (NRSA) Trainee Conference,
followed by journal publication |
2005 |
Support
one pilot project leading to development of cultural competencies in HSR
doctoral training |
Completed
2 projects: small pilot feasibility study and related conference "HSR
competencies for Doctoral Training" |
2004 |
N/A |
N/A |
Data
Source: IMPAC II
Data
Validation: AHRQ
budget data management system used to keep annual track of spending relative to
budget allotment
Cross
Reference: HHS
Strategic Goal and Objective: 4.1; Departmental Objective:16; HP2010-23; HHS
Priorities: Value-Driven Health Care and Personalized Health Care
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