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