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Executive Summary
Pages 1-12

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From page 1...
... This summit was a direct outgrowth and continuation of the recommendations put forth in the 2001 IOM report Crossing the Quality Chasm: A New Health System for the 21st Century. The summit's purpose was to offer specific guidance at both the community and national levels for overcoming the challenges to the provision of high-quality care articulated in the Quality Chasm report and for moving closer to achievement of the patient-centered health care system envisioned therein.
From page 2...
... AND IMPLEMENTING THE QUALITY The committee then identified 6 critical cross cutting topics applicable to all of these priority CHASM VISION areas: measurement, information and As a starting point for translating the above six communications technology, care coordination, aims into clinical reality, the Quality Chasm patient self-management support, finance, and report recommended focusing on a set of community coalition building. common chronic conditions that account for the majority of the nation's health care burden and resource consumption (Druss et al., 2002, 2001; 2
From page 3...
... To achieve these objectives, the committee solicited the input and advice of several liaison groups, including the Centers for Disease Control and Prevention; the Institute for Healthcare Improvement; the MacColl Institute for Healthcare Innovation at Group Health Cooperative; and the Agency for Healthcare 1Although performance measurement standards for each condition were called for by the participants -- as noted at a number of points in this report -- the summit itself did not endorse any specific performance measures for the targeted conditions. 2There are many champions of health care quality improvement around the nation.
From page 4...
... - The Pediatric/Adult Asthma Coalition of New Jersey - Philadelphia Department of Health · Depression communities - Intermountain Health Care­Depression in Primary Care Initiative - Mid-America Coalition on Health Care Community Initiative on Depression · Diabetes communities - The Asheville Project - County of Santa Cruz, California - Madigan Army Medical Center - The Washington State Diabetes Collaborative · Heart failure communities - Grand Rapids Medical Education and Research Center - Greater Flint Health Coalition - The Oregon Heart Failure Project · Pain control in advanced cancer communities - Kaiser-Bellflower - Rochester Health Commission 4
From page 5...
... EXECUTIVE SUMMARY Box ES-2. National Champions · Agency for Healthcare Research and Quality · Alliance of Community Health Plans · American Association of Retired Persons · American Board of Internal Medicine · American Cancer Society · American Diabetes Association · American Heart Association · American Hospital Association · American Pain Foundation · America's Health Insurance Plans · Blue Cross and Blue Shield Association · Bridges to Excellence · Centers for Disease Control and Prevention · Centers for Medicare and Medicaid Services · General Electric Company · Grantmakers in Health · Institute for Healthcare Improvement · Institute of Medicine · Joint Commission on Accreditation of Healthcare Organizations · Leapfrog Group · MacColl Institute for Healthcare Innovation at Group Health Cooperative · National Association of Community Health Centers · National Business Coalition on Health · National Business Group on Health · National Cancer Institute · National Center for Healthcare Leadership · National Committee for Quality Assurance · National Quality Forum · Pacific Business Group on Health · Substance Abuse and Mental Health Services Administration · The Robert Wood Johnson Foundation · UnitedHealth Group · URAC · VHA, Inc.
From page 6...
... These areas relevant not only to depression, but to all largely reflect those discussed in the Quality chronic conditions. Examples included lack of Chasm series of reports, with one exception- a well-coordinated care plan, poor community coalition building, added to reflect communication among multiple clinicians the interests and needs of summit participants involved in a patient's care, and failure to from communities.
From page 7...
... infrastructure to reduce the burden of data collection Box ES-4. Information and · Focusing on longitudinal change Communications Technology: in performance and patient- Key Strategies centered outcomes in addition to point-in-time measures · Using standardized systems · Improving public reporting by effectively disseminating results · Leveraging federal leadership to to diverse audiences accelerate the adoption of electronic health records · Creating a public utility that Measurement holds data at the local level Summit participants called for national organizations, accrediting agencies, and Information and Communications appropriate subspecialty providers to agree on a Technology defined, well-validated set of performance measures for the 5 chronic conditions featured The importance of patients' access to and at the summit, subsequently to be expanded to control of their health records was reiterated the other 15 priority areas.
From page 8...
... Patient Self-Management including multidisciplinary health Support: Key Strategies professions education, teaching of care coordination principles in · Identifying and disseminating academic settings, and evidence-based self development of care teams management practices · Instituting patient-centered · Recognizing the centrality of health records, supported by self-management to good patient information and communications care and incorporating it into technology health care culture · Ensuring accountability and · Developing programs and tools defining roles for care applicable to diverse populations · Providing incentives for the Care Coordination appropriate use of self management supports To address the problem of care coordination not integrated into the delivery of being routinely reimbursed under most payment health care schemes today, participants emphasized the need for a shared vision around an operational · Making better use of all construct -- consistent with the evidence base -- members of the health care defining what good care coordination would be. team Once operationalized, care coordination could then be measured, with the goal of quickly disseminating successful reimbursement Patient Self-Management Support models.
From page 9...
... Finance: Key Strategies right care at the right time. Finally, as discussed by participants addressing care coordination and · Instituting performance-based self-management, reimbursement for these payment models support services will require a shift from the · Implementing evidence-based current piecemeal approach of paying for individual clinician encounters to paying for benefit design elements linked to systems of care involving a · Providing payment for proven team of diverse practitioners.
From page 10...
... Documenting positive outcomes -- and reasons for negative Community Coalition Building ones -- helps coalitions acquire additional support and resources. Coalitions are organizational structures that integrate and support the work of multiple diverse stakeholders on a focused, shared goal.
From page 11...
... Other and communications technology figured communities can learn from and build on those prominently as an enabling tool for data experiences. The summit offered a public collection, decision support, and improved flow forum for "national champions" to step up and of communication across providers.
From page 12...
... can improve health status while reducing Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, hospitalization: A randomized trial. Medical Lucas FL, Pinder EL.


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