AHRQ Innovations Exchange | Recent Events | Vermont Blueprint for Health: Working Together for Better Care
Vermont Blueprint for Health: Working Together for Better Care
AHRQ's Health Care Innovations Exchange held a Webcast titled Vermont Blueprint for Health: Working Together for Better Care on September 25, 2012.
This event featured a video presentation about successful linkages among primary care, public health, and clinical community resources in the state of Vermont. Vermont's Blueprint for Health program provides comprehensive, coordinated care while improving health outcomes and reducing costs.
The video presentation was followed by a panel discussion during which Vermont program staff discussed implementation challenges and potential solutions related to linking clinical care and community resources. The replay of the Webcast, including the panel discussion, will be available shortly.
aportes a la gestión necesaria para la sustentabilidad de la SALUD PÚBLICA como figura esencial de los servicios sociales básicos para la sociedad humana, para la familia y para la persona como individuo que participa de la vida ciudadana.
domingo, 30 de septiembre de 2012
AHRQ Innovations Exchange | Expert Commentary: State-Mandated Tracking and Public Reporting Reduce Incidence and Costs of Common Hospital-Acquired Infections
AHRQ Innovations Exchange | Expert Commentary: State-Mandated Tracking and Public Reporting Reduce Incidence and Costs of Common Hospital-Acquired Infections
| |
Original publication: September 26, 2012.
Original publication indicates the date the profile was first posted to the Innovations Exchange.
Original publication indicates the date the profile was first posted to the Innovations Exchange.
Last updated: September 26, 2012.
Last updated indicates the date the most recent changes to the profile were posted to the Innovations Exchange.
Last updated indicates the date the most recent changes to the profile were posted to the Innovations Exchange.
AHRQ Innovations Exchange: State Health Care Legislation and Statewide Initiatives
AHRQ Innovations Exchange
September 26, 2012 Issue
State Health Care Legislation and Statewide Initiatives
This issue includes
Next issue: Increasing Patient Involvement in Health Care
September 26, 2012 Issue
State Health Care Legislation and Statewide Initiatives
Innovations:
QualityTools:
RFA-HS-13-002: AHRQ Patient Centered Outcomes Research (PCOR) Pathway to Independence Award (K99/R00)
RFA-HS-13-002: AHRQ Patient Centered Outcomes Research (PCOR) Pathway to Independence Award (K99/R00)
AHRQ Announces New Patient-Centered Outcomes Research Pathway to Independence Award
AHRQ is seeking applications for the new Patient-Centered Outcomes Research (PCOR) Pathway to Independence Award programThe primary purpose of this program is to increase and maintain a strong cohort of new and talented AHRQ-supported independent investigators trained in comparative effectiveness methods to conduct patient care outcomes research. The program is designed to facilitate a timely transition from a junior non-tenure track faculty or a postdoctoral research position (or their equivalents) to a stable independent research career. It targets investigators early in their careers to support their development in new sophisticated methodological comparative effectiveness research skills, interdisciplinary perspectives, and capabilities in PCOR. Deadline to submit an application is December 17. Select to access the announcement.
AHRQ Centers for Primary Care Practice-Based Research and Learning
AHRQ Centers for Primary Care Practice-Based Research and Learning
AHRQ Awards Eight Institutions to Support Collaborative Centers for Primary Care Practice-Based Research
AHRQ has announced grant awards to eight institutions to support collaborative centers for primary care practice-based research. For over a decade, AHRQ has invested in primary care practice-based research networks (PBRNs) - groups of ambulatory medical practices devoted principally to the primary care of patients that join to conduct and disseminate research to improve the practice of primary care. While AHRQ has supported PBRNs with as few as 15 primary care practices, each Center created through this program has a minimum of 120 member practices and several have more than 500. Many of the Centers are collaborations between smaller well-established PBRNs. By leveraging common resources, these Centers are expected to improve productivity and to develop the ability to plan and conduct independent research projects more quickly and produce results that are more generalizable than they would as separate PBRNs. Select to read more about the new Centers.
AHRQ Innovations Exchange | Innovations & QualityTools
AHRQ Innovations Exchange | Innovations & QualityTools
AHRQ’s Health Care Innovations Exchange Focuses on Workforce Development and the Role of Community Health Workers
The September 12 issue of AHRQ’s Health Care Innovations Exchange features two profiles related to policies that support the development and expansion of the health care workforce to leverage community members and health workers. One of the policies created a new staff position within primary care clinics and hospitals that was filled by community members with experience as caregivers. Known as “Grand-Aides,” these new members of the health care team completed a rigorous training and certification process before performing a variety of tasks intended to streamline and reduce the costs of patient care, and assist health care teams in providing appropriate care to patients. Though their work varied depending on the setting (primary care or transitional care after discharge), Grand-Aides typically had face-to-face interactions and/or telephone conversations with patients, focusing on assessment of needs, education on preventive and self-care, ongoing monitoring, and followup in two pilot sites, Grand-Aides reduced unnecessary physician visits and demonstrated the potential to generate significant cost savings. This new health workforce role is currently being tested and spread to sites in California, Pennsylvania, Virginia, and Texas. Select to read more innovation profile related to community health workers on the Health Care Innovations Exchange Web site, which contains more than 725 searchable innovations and 1,500 QualityTools.
Medicaid Providers Face Common Barriers to Meaningful Use
Medicaid Providers Face Common Barriers to Meaningful Use
A new AHRQ report examines challenges Medicaid providers face in achieving Meaningful Use (MU) of health information technologies. The report finds barriers to adoption and MU of Electronic Health Records (EHRs) were not associated with serving a predominantly Medicaid-insured population. However, providers such as dentists, pediatricians, and nurse midwives who were only eligible under the Medicaid program reported some difficulty finding a certified EHR appropriate for their specialty, and that some required measures, such as blood pressure, were irrelevant due to the age of the patient groups they serve. The reported barriers to adoption and achievement of MU were consistent with those cited in past studies, including limited awareness of the Medicaid EHR Incentive program, difficulty in selecting and functionality of EHRs and limited ability to implement core measures of Stage 1 MU. The report recommended greater collaboration between all stakeholders to provide more targeted technical assistance tools and development of a body of knowledge to address the socio-cultural, technical, and training needs of Medicaid providers. Select to access the full report.
Closing the Quality Gap Series: Quality Improvement Interventions To Address Health Disparities - Research Review - Final | AHRQ Effective Health Care Program
Closing the Quality Gap Series: Quality Improvement Interventions To Address Health Disparities - Research Review - Final | AHRQ Effective Health Care Program
Research Review - Final – Aug. 27, 2012
Research Review - Final – Aug. 27, 2012
Closing the Quality Gap Series: Quality Improvement Interventions To Address Health Disparities
Formats
- View PDF (PDF) 2.6 MB
Two New Quality Reports: Impact of Bundled Payments and Interventions to Reduce Disparities
AHRQ has released two reports that are part of a larger initiative, Closing the Quality Gap: Revisiting the State of the Science, and build on an earlier AHRQ series of evidence reports, Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies. One report prepared by AHRQ’s RAND Evidence-based Practice Center found that the introduction of bundled payments to reimburse providers for the expected cost of related health care services reduced health care spending and use. But the evidence for the effect of bundled payments on quality measures was inconsistent and generally had small effects. The researchers found the overall evidence to be low because most of the studies examined bundled payment for single institutions and many had quality concerns. The lead researcher Peter S. Hussey, Ph.D., says the report provides policymakers some support that bundling payment is likely to be an effective strategy, and while the method’s effects on quality are less certain, the evidence does not support the worst concerns about potentially adverse effects. Select to access the report, “Bundled Payment: Effects on Health Care Spending and Quality.” The other report in this series, AHRQ’s Vanderbilt University Evidence-based Practice Center researchers led by Melissa L. McPheeters, Ph.D., found that, as a whole, quality interventions to reduce health care disparities have not been shown to be effective, although they did find a few studies showing that quality improvement interventions affected health care disparities in certain disadvantaged populations. Select to access the report, “Quality Improvement Interventions to Address Health Care Disparities.”
Closing the Quality Gap Series: Bundled Payment: Effects on Health Care Spending and Quality - Research Review - Final | AHRQ Effective Health Care Program
Closing the Quality Gap Series: Bundled Payment: Effects on Health Care Spending and Quality - Research Review - Final | AHRQ Effective Health Care Program
Research Review - Final – Aug. 24, 2012
Two New Quality Reports: Impact of Bundled Payments and Interventions to Reduce Disparities
AHRQ has released two reports that are part of a larger initiative, Closing the Quality Gap: Revisiting the State of the Science, and build on an earlier AHRQ series of evidence reports, Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies. One report prepared by AHRQ’s RAND Evidence-based Practice Center found that the introduction of bundled payments to reimburse providers for the expected cost of related health care services reduced health care spending and use. But the evidence for the effect of bundled payments on quality measures was inconsistent and generally had small effects. The researchers found the overall evidence to be low because most of the studies examined bundled payment for single institutions and many had quality concerns. The lead researcher Peter S. Hussey, Ph.D., says the report provides policymakers some support that bundling payment is likely to be an effective strategy, and while the method’s effects on quality are less certain, the evidence does not support the worst concerns about potentially adverse effects. Select to access the report, “Bundled Payment: Effects on Health Care Spending and Quality.” The other report in this series, AHRQ’s Vanderbilt University Evidence-based Practice Center researchers led by Melissa L. McPheeters, Ph.D., found that, as a whole, quality interventions to reduce health care disparities have not been shown to be effective, although they did find a few studies showing that quality improvement interventions affected health care disparities in certain disadvantaged populations. Select to access the report, “Quality Improvement Interventions to Address Health Care Disparities.”
Research Review - Final – Aug. 24, 2012
Closing the Quality Gap Series: Bundled Payment: Effects on Health Care Spending and Quality
Formats
- View PDF (PDF) 1.0 MB
- Help with Viewers, Players, and Plug-ins
Interventions to Improve Adherence to Self-ad... [Ann Intern Med. 2012] - PubMed - NCBI
Interventions to Improve Adherence to Self-ad... [Ann Intern Med. 2012] - PubMed - NCBI
Ann Intern Med. 2012 Sep 11. doi: 10.7326/0003-4819-157-11-201212040-00538. [Epub ahead of print]
Interventions to Improve Adherence to Self-administered Medications for Chronic Diseases in the United States: A Systematic Review.
Viswanathan M, Golin CE, Jones CD, Ashok M, Blalock SJ, Wines RC, Coker-Schwimmer EJ, Rosen DL, Sista P, Lohr KN.
Abstract
BACKGROUND:
Suboptimum medication adherence is common in the United States and leads to serious negative health consequences but may respond to intervention.PURPOSE:
To assess the comparative effectiveness of patient, provider, systems, and policy interventions that aim to improve medication adherence for chronic health conditions in the United States.DATA SOURCES:
Eligible peer-reviewed publications from MEDLINE and the Cochrane Library indexed through 4 June 2012 and additional studies from reference lists and technical experts.STUDY SELECTION:
Randomized, controlled trials of patient, provider, or systems interventions to improve adherence to long-term medications and nonrandomized studies of policy interventions to improve medication adherence.DATA EXTRACTION:
Two investigators independently selected, extracted data from, and rated the risk of bias of relevant studies.DATA SYNTHESIS:
The evidence was synthesized separately for each clinical condition; within each condition, the type of intervention was synthesized. Two reviewers graded the strength of evidence by using established criteria. From 4124 eligible abstracts, 62 trials of patient-, provider-, or systems-level interventions evaluated 18 types of interventions; another 4 observational studies and 1 trial of policy interventions evaluated the effect of reduced medication copayments or improved prescription drug coverage. Clinical conditions amenable to multiple approaches to improving adherence include hypertension, heart failure, depression, and asthma. Interventions that improve adherence across multiple clinical conditions include policy interventions to reduce copayments or improve prescription drug coverage, systems interventions to offer case management, and patient-level educational interventions with behavioral support.LIMITATIONS:
Studies were limited to adults with chronic conditions (excluding HIV, AIDS, severe mental illness, and substance abuse) in the United States. Clinical and methodological heterogeneity hindered quantitative data pooling.CONCLUSION:
Reduced out-of-pocket expenses, case management, and patient education with behavioral support all improved medication adherence for more than 1 condition. Evidence is limited on whether these approaches are broadly applicable or affect long-term medication adherence and health outcomes.PRIMARY FUNDING SOURCE:
Agency for Healthcare Research and Quality.- PMID:
- 22964778
- [PubMed - as supplied by publisher]
Closing the Quality Gap Series: Medication Adherence Interventions: Comparative Effectiveness - Executive Summary | AHRQ Effective Health Care Program
Closing the Quality Gap Series: Medication Adherence Interventions: Comparative Effectiveness - Executive Summary | AHRQ Effective Health Care Program
Executive Summary – Sept. 11, 2012
Poor medication adherence is relatively common.3,4 Studies have shown consistently that 20 to 30 percent of medication prescriptions are never filled and that, on average, 50 percent of medications for chronic disease are not taken as prescribed.5,6
This lack of adherence to medications is not only prevalent, but also has dramatic effects on individual and population-level health.5,7-16 Nonadherence has been estimated to cost the U.S. health care system between $100 billion and $289 billion annually in direct costs.3,5,17-20 Strong evidence suggests that benefits attributable to improved self-management of chronic diseases could result in a cost-to-savings ratio of approximately 1:10.21-27
Executive Summary – Sept. 11, 2012
Closing the Quality Gap Series: Medication Adherence Interventions: Comparative Effectiveness
Formats
- View PDF (PDF) 433 kB
- Help with Viewers, Players, and Plug-ins
Table of Contents
- Background
- Scope and Key Questions
- Methods
- Results
- Discussion
- Conclusions
- References
- Full Report
- For More Copies
Background
Achieving the goal of quantitatively improving the quality and effectiveness of health care for all Americans requires both knowledge and tools. Although medical researchers have demonstrated many efficacious medical treatments to improve health outcomes, a recent Institute of Medicine report identified a disquieting discrepancy between present treatment success rates and those thought to be achievable.1 This gap has been attributed partly to barriers that providers face in implementing best practice guidelines.1,2 Patients’ adherence to treatment, however, provides an additional explanation for the incongruity between recommended treatment and actual treatment outcomes.Poor medication adherence is relatively common.3,4 Studies have shown consistently that 20 to 30 percent of medication prescriptions are never filled and that, on average, 50 percent of medications for chronic disease are not taken as prescribed.5,6
This lack of adherence to medications is not only prevalent, but also has dramatic effects on individual and population-level health.5,7-16 Nonadherence has been estimated to cost the U.S. health care system between $100 billion and $289 billion annually in direct costs.3,5,17-20 Strong evidence suggests that benefits attributable to improved self-management of chronic diseases could result in a cost-to-savings ratio of approximately 1:10.21-27
National Health IT Week
National Health IT Week
National Health IT Week 2012 has been scheduled for September 10-14, 2012. Start planning your organization's participation today! Click on the "Toolkit" tab above for activity ideas.
The Seventh Annual National Health IT Week is being held September 10-14, 2012. Join us for this collaborative forum where public and private healthcare constituents will work in partnership to educate industry and policy stakeholders on the value of health IT for the US healthcare system. There is no better time for the health IT community to come together under one umbrella to raise national awareness!
Comprehensive health care reform is not possible without system-wide adoption of health information technology, which improves the quality of healthcare delivery, increases patient safety, decreases medical errors, and strengthens the interaction between patients and healthcare providers.
With Meaningful Use now providing the way forward, eligible providers across the country increasingly understand the benefits for themselves and their patients, and are adopting Meaningful Use compliant electronic health records.
It’s easy to become a Partner in National Health IT Week 2012:
To learn more about how your organization can become involved in National Health IT Week 2012 by sponsoring or participating in a Partner event, please contact us at NHITweek@gmail.com for more information.
National Health IT Week 2012 has been scheduled for September 10-14, 2012. Start planning your organization's participation today! Click on the "Toolkit" tab above for activity ideas.
One Voice, One Vision: Entering the 7th Year of Transforming Health and Care
Last year, 200 organizations participated in National Health IT Week 2011, which was also recognized by President Obama—who issued an official Proclamation of National Health IT Week —and by the U.S. Senate, which passed a Resolution declaring National Health IT Week. We’d be happy to have your organization join this year’s celebrations! Contact NHITweek@gmail.com for more information.
Comprehensive health care reform is not possible without system-wide adoption of health information technology, which improves the quality of healthcare delivery, increases patient safety, decreases medical errors, and strengthens the interaction between patients and healthcare providers.
With Meaningful Use now providing the way forward, eligible providers across the country increasingly understand the benefits for themselves and their patients, and are adopting Meaningful Use compliant electronic health records.
It’s easy to become a Partner in National Health IT Week 2012:
- We need only a logo + a brief (50 words + company URL) company overview to get started
- Email these materials to NHITweek@gmail.com – or let us know if you have further inquiries
- Your information will be posted at www.HealthITWeek.org
To learn more about how your organization can become involved in National Health IT Week 2012 by sponsoring or participating in a Partner event, please contact us at NHITweek@gmail.com for more information.
National Health IT Week: Celebrating HIT as an essential tool | Government Health IT
National Health IT Week: Celebrating HIT as an essential tool | Government Health IT
National Health IT Week: Celebrating HIT as an essential tool
September 10, 2012 | Carolyn M. Clancy, MD, Director, Agency for Healthcare Research and Quality (AHRQ)
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Just as a carpenter finishes his work by making sure that his hammers, chisels and saws are clean, sharp and ready for the next project, so should we take pride in and look after our health IT tools and systems. In essence, that’s what we’re doing at this moment, as the health IT community convenes in Washington, DC, for National Health IT Week.
The purpose of National Health IT Week is to raise awareness of the importance of health information technology. We are grateful to HIMSS and the week’s other co-sponsors, the Institute for e-Health Policy and the College of Healthcare Information Management Executives (CHIME), for leading the activities. This is an important annual event, demonstrating for Federal policymakers that health IT is neither an abstract nor experimental activity.
Instead, health IT is embedded in everything we do.
It has become fundamental to the provision of high-quality, patient-centered health care. IT-enabled innovations including (but not limited to) electronic health records (EHRs), clinical decision support systems, mobile health applications, and e-prescribing have become necessary tools in how we take care of patients each day. Endeavors such as patient-centered outcomes research, healthcare-associated infection (HAI) surveillance, disease and care management, and cutting-edge treatments and lab tests all feature IT-enabled applications as core components. In many instances, the practice of modern medicine could not exist without them.
The best part is, this is hardly news. Health IT is an essential part of how we diagnose, provide, monitor and improve health care services.
The Agency for Healthcare Research and Quality (AHRQ) considers this especially gratifying, because for years AHRQ has supported the evidence base behind health IT. Since its inception in 2004, AHRQ’s Health IT Portfolio has funded projects that show health IT’s impact on improving health care decision-making, supporting patient-centered care, coordinating care across transitions, and using electronic exchange of health information.
AHRQ asserted its belief in the relationship between health IT and quality through the creation of its Health IT Portfolio, which embarked on a series of grants and contracts. To date, more than 300 projects have been supported by the Portfolio and have produced important findings, practical tools, individual and organizational talent, and substantively moved the field forward.
In one project, Emergency Medical Service agencies used a web-based quality reporting system and clinical decision support technology to improve the timeliness of care provided to heart attack patients. Other projects included one in which nursing homes used health IT to improve quality; another featured a network of rural hospitals that implemented an EHR system and simultaneously redesigned many aspects of care delivery to improve patient safety.
Where We’re Going: A Focus on the Patient
Today, much of the health IT community’s attention is appropriately directed to meeting Meaningful Use standards in the adoption of EHRs. AHRQ supports its Federal partners in promoting Meaningful Use and overcoming barriers to EHR adoption.
As this transformation takes place, AHRQ remains focused primarily on identifying and filling gaps in knowledge about health IT to help prepare the field for future innovations. With this in mind, projects funded by AHRQ suggest where the field is headed. Examples of innovative AHRQ-funded work include:
• Project ECHO. Clinicians at the University of New Mexico Health Sciences Center are bringing sophisticated treatment for Hepatitis C to patients in rural New Mexico and across the Nation. ECHO (which stands for Extension for Community Healthcare Outcomes) is wisely using available technology, expert training, and real-time feedback to bring state-of-the-art medical knowledge to primary care providers and nurses. Building on this experience, the project has also initiated telemedicine clinics for other complex conditions.
• Project RED. Project RED (Re-Engineered Discharge) at Boston University Medical Center seeks to correct patient safety problems at one of the most vulnerable points of care—discharge from the hospital. Project RED offers tools to improve the discharge process by preparing patients for discharge from the moment they arrive in the hospital. Elements include a “virtual nurse” who simulates face-to-face interaction between a patient and a nurse, based on the patient’s individual medical data.
• Active Aging Research Center. This center in Madison, Wisconsin aims to keep older adults safe and healthy in their homes and communities by developing an integrated system of health IT for seniors and their caregivers. These tools extend the independence and functioning of older adults, keeping them connected with family and friends and reducing unnecessary hospital visits, while ensuring that patients get timely access to the care they need.
What do these projects have in common?
It isn’t the IT itself. Some projects use very sophisticated, newly developed technologies; others rely on technologies that have been around for years. Instead, these projects leverage technology as a means to achieve patient-centered care—tracking and reducing medical errors, bringing care to vulnerable and complex patient groups, and ensuring that every patient gets care according to his or her wishes.
It is true, of course, that health care stakeholders — including providers, plans, purchasers, and government agencies — have been working toward this goal for years, even decades. Today, we believe that goal is within reach, because stakeholders have greater resources to enhance their efforts. AHRQ supports this goal through patient-centered outcomes research, the identification of health care quality deficiencies and disparities, and the development of performance measures to make sure health care providers deliver the highest quality care possible.
Consistent with that latter goal are three recently released AHRQ products that are of special interest to readers of Government Health IT.
One is the Workflow Assessment for Health IT Toolkit, an AHRQ-developed tool that helps health care providers reorganize and improve workflow, recognizing health IT’s likely impact on both clinical and administrative processes. This toolkit is designed for people and organizations interested or involved in the planning, design, implementation, and use of health IT in ambulatory care.
A second is a Toolset for E-Prescribing Implementation in Physician Offices, the purpose of which is to provide physician practices with the knowledge and resources to implement e-prescribing successfully. The toolset includes specific tools to support planning and decision-making, such as surveys to determine whether an organization is ready for e-prescribing, worksheets for planning the implementation and monitoring progress, and templates for communicating the launch to patients.
The third tool, An Interactive Preventive Care Record (IPHR): A Handbook for Using Patient-Centered Personal Health Records to Promote Prevention, offers practical steps for health care professionals to follow when deploying IPHRS as components of EHRs. Sections are targeted for use by practice leaders, informatics staff and practice personnel and provide advice for each team member on selection, implementation and maintenance.
These and other AHRQ health IT products are available for free on our web site, www.ahrq.gov.
A Vision for the Future
HIMSS, CHIME, and the Institute for e-Health Policy all deserve recognition for their leadership in co-sponsoring National Health IT Week. If you are in Washington during the week, we hope that you will join with your colleagues from both the public and private sectors to promote health IT. If policymakers from your area express interest, we hope you will consider inviting them to tour your facility to demonstrate the practical applications of sophisticated technology.
Looking ahead, it’s reasonable to predict that innovation will continue to play a central role in adoption and use of health IT. The private sector will continue to take the lead in searching for ways to use technology to increase quality and lower costs, and AHRQ will continue to support projects that show promise.
Will all of them work? Of course not. The “error” part of trial-and-error is an important part of basic research, and it’s important to learn what doesn’t work on a small scale before implementing new applications on a large scale. But we remain confident that overall, health IT will remain a critically important, and increasingly essential, tool for delivering high-quality health care to individuals and to populations.
Carolyn M. Clancy, MD, is Director of the Agency for Healthcare Research and Quality, Rockville, MD.
The purpose of National Health IT Week is to raise awareness of the importance of health information technology. We are grateful to HIMSS and the week’s other co-sponsors, the Institute for e-Health Policy and the College of Healthcare Information Management Executives (CHIME), for leading the activities. This is an important annual event, demonstrating for Federal policymakers that health IT is neither an abstract nor experimental activity.
Instead, health IT is embedded in everything we do.
It has become fundamental to the provision of high-quality, patient-centered health care. IT-enabled innovations including (but not limited to) electronic health records (EHRs), clinical decision support systems, mobile health applications, and e-prescribing have become necessary tools in how we take care of patients each day. Endeavors such as patient-centered outcomes research, healthcare-associated infection (HAI) surveillance, disease and care management, and cutting-edge treatments and lab tests all feature IT-enabled applications as core components. In many instances, the practice of modern medicine could not exist without them.
The best part is, this is hardly news. Health IT is an essential part of how we diagnose, provide, monitor and improve health care services.
The Agency for Healthcare Research and Quality (AHRQ) considers this especially gratifying, because for years AHRQ has supported the evidence base behind health IT. Since its inception in 2004, AHRQ’s Health IT Portfolio has funded projects that show health IT’s impact on improving health care decision-making, supporting patient-centered care, coordinating care across transitions, and using electronic exchange of health information.
AHRQ asserted its belief in the relationship between health IT and quality through the creation of its Health IT Portfolio, which embarked on a series of grants and contracts. To date, more than 300 projects have been supported by the Portfolio and have produced important findings, practical tools, individual and organizational talent, and substantively moved the field forward.
In one project, Emergency Medical Service agencies used a web-based quality reporting system and clinical decision support technology to improve the timeliness of care provided to heart attack patients. Other projects included one in which nursing homes used health IT to improve quality; another featured a network of rural hospitals that implemented an EHR system and simultaneously redesigned many aspects of care delivery to improve patient safety.
Where We’re Going: A Focus on the Patient
Today, much of the health IT community’s attention is appropriately directed to meeting Meaningful Use standards in the adoption of EHRs. AHRQ supports its Federal partners in promoting Meaningful Use and overcoming barriers to EHR adoption.
As this transformation takes place, AHRQ remains focused primarily on identifying and filling gaps in knowledge about health IT to help prepare the field for future innovations. With this in mind, projects funded by AHRQ suggest where the field is headed. Examples of innovative AHRQ-funded work include:
• Project ECHO. Clinicians at the University of New Mexico Health Sciences Center are bringing sophisticated treatment for Hepatitis C to patients in rural New Mexico and across the Nation. ECHO (which stands for Extension for Community Healthcare Outcomes) is wisely using available technology, expert training, and real-time feedback to bring state-of-the-art medical knowledge to primary care providers and nurses. Building on this experience, the project has also initiated telemedicine clinics for other complex conditions.
• Project RED. Project RED (Re-Engineered Discharge) at Boston University Medical Center seeks to correct patient safety problems at one of the most vulnerable points of care—discharge from the hospital. Project RED offers tools to improve the discharge process by preparing patients for discharge from the moment they arrive in the hospital. Elements include a “virtual nurse” who simulates face-to-face interaction between a patient and a nurse, based on the patient’s individual medical data.
• Active Aging Research Center. This center in Madison, Wisconsin aims to keep older adults safe and healthy in their homes and communities by developing an integrated system of health IT for seniors and their caregivers. These tools extend the independence and functioning of older adults, keeping them connected with family and friends and reducing unnecessary hospital visits, while ensuring that patients get timely access to the care they need.
What do these projects have in common?
It isn’t the IT itself. Some projects use very sophisticated, newly developed technologies; others rely on technologies that have been around for years. Instead, these projects leverage technology as a means to achieve patient-centered care—tracking and reducing medical errors, bringing care to vulnerable and complex patient groups, and ensuring that every patient gets care according to his or her wishes.
It is true, of course, that health care stakeholders — including providers, plans, purchasers, and government agencies — have been working toward this goal for years, even decades. Today, we believe that goal is within reach, because stakeholders have greater resources to enhance their efforts. AHRQ supports this goal through patient-centered outcomes research, the identification of health care quality deficiencies and disparities, and the development of performance measures to make sure health care providers deliver the highest quality care possible.
Consistent with that latter goal are three recently released AHRQ products that are of special interest to readers of Government Health IT.
One is the Workflow Assessment for Health IT Toolkit, an AHRQ-developed tool that helps health care providers reorganize and improve workflow, recognizing health IT’s likely impact on both clinical and administrative processes. This toolkit is designed for people and organizations interested or involved in the planning, design, implementation, and use of health IT in ambulatory care.
A second is a Toolset for E-Prescribing Implementation in Physician Offices, the purpose of which is to provide physician practices with the knowledge and resources to implement e-prescribing successfully. The toolset includes specific tools to support planning and decision-making, such as surveys to determine whether an organization is ready for e-prescribing, worksheets for planning the implementation and monitoring progress, and templates for communicating the launch to patients.
The third tool, An Interactive Preventive Care Record (IPHR): A Handbook for Using Patient-Centered Personal Health Records to Promote Prevention, offers practical steps for health care professionals to follow when deploying IPHRS as components of EHRs. Sections are targeted for use by practice leaders, informatics staff and practice personnel and provide advice for each team member on selection, implementation and maintenance.
These and other AHRQ health IT products are available for free on our web site, www.ahrq.gov.
A Vision for the Future
HIMSS, CHIME, and the Institute for e-Health Policy all deserve recognition for their leadership in co-sponsoring National Health IT Week. If you are in Washington during the week, we hope that you will join with your colleagues from both the public and private sectors to promote health IT. If policymakers from your area express interest, we hope you will consider inviting them to tour your facility to demonstrate the practical applications of sophisticated technology.
Looking ahead, it’s reasonable to predict that innovation will continue to play a central role in adoption and use of health IT. The private sector will continue to take the lead in searching for ways to use technology to increase quality and lower costs, and AHRQ will continue to support projects that show promise.
Will all of them work? Of course not. The “error” part of trial-and-error is an important part of basic research, and it’s important to learn what doesn’t work on a small scale before implementing new applications on a large scale. But we remain confident that overall, health IT will remain a critically important, and increasingly essential, tool for delivering high-quality health care to individuals and to populations.
Carolyn M. Clancy, MD, is Director of the Agency for Healthcare Research and Quality, Rockville, MD.
Changing BMI categories and healthca... [Obesity (Silver Spring). 2012] - PubMed - NCBI
Changing BMI categories and healthca... [Obesity (Silver Spring). 2012] - PubMed - NCBI
Obesity (Silver Spring). 2012 Jun;20(6):1240-8. doi: 10.1038/oby.2011.86. Epub 2011 Apr 28.
Changing BMI categories and healthcare expenditures among elderly Medicare beneficiaries.
Source
West Virginia University School of Pharmacy, Department of Pharmaceutical Systems and Policy, Morgantown, West Virginia, USA. twilkins@hsc.wvu.eduAbstract
To examine the association between changes in BMI categories and health-care expenditures among elderly Medicare beneficiaries using longitudinal data of the Medicare Current Beneficiary Survey (MCBS) 2000-2005. Changes in BMI were (i) Stayed Normal: individuals with a normal BMI at baseline and follow-up; (ii) Stayed Overweight individuals with overweight BMI at baseline and follow-up; (iii) Stayed Obese individuals with obese BMI at baseline and follow-up; (iv) Normal-Overweight: individuals with normal BMI at baseline and overweight BMI at follow-up; (v) Overweight-Obese: individuals with overweight BMI at baseline and obese BMI at follow-up; (vi) Overweight-Normal: individuals with overweight BMI at baseline and normal BMI at follow-up; (vii) Obese-Overweight: individuals with obese BMI at baseline and overweight BMI at follow-up. Ordinary Least Squares (OLS) models on logged Year 3 expenditures were used to analyze changes in expenditures between BMI categories. Overall, 35% Stayed Normal, 34% Stayed Overweight, 18% Stayed Obese, 4% gained weight from Normal-Overweight BMI, 3% gained weight from Overweight-Obese BMI, 5% lost weight from Overweight-Normal BMI, and 3% lost weight from Obese-Overweight BMI. Adjusted models revealed those who Stayed Obese had increased total and multiple expenditure types that were significantly higher than Stayed Normal including total (11%), outpatient (25%), prescription (9%), and medical provider (4%). Compared to Stayed Normal, total expenditures were both 26% higher for Obese-Overweight and Overweight-Obese. The current findings highlight the importance of maintaining a normal BMI in the elderly.- PMID:
- 21527898
- [PubMed - indexed for MEDLINE]
Impact of FDA drug risk communications on health ca... [Med Care. 2012] - PubMed - NCBI
Impact of FDA drug risk communications on health ca... [Med Care. 2012] - PubMed - NCBI
Med Care. 2012 Jun;50(6):466-78.
Impact of FDA drug risk communications on health care utilization and health behaviors: a systematic review.
Source
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.Abstract
OBJECTIVE:
To review literature on the impact of The Food and Drug Administration (FDA) drug risk communications on medication utilization, health care services use, and health outcomes.DATA SOURCES:
The authors searched MEDLINE and the Web of Science for manuscripts published between January 1990 and November 2010 that included terms related to drug utilization, the FDA, and advisories or warnings. We manually searched bibliographies and works citing selected articles and consulted with experts to guide study selection.STUDY SELECTION:
Studies were included if they involved an empirical analysis evaluating the impact of an FDA risk communication.DATA EXTRACTION:
We extracted the drug(s) analyzed, relevant FDA communication(s), data source, analytical method, and main outcome(s) assessed.RESULTS:
Of the 1432 records screened, 49 studies were included. These studies covered 16 medicines or therapeutic classes; one third examined communications regarding antidepressants. Most used medical or pharmacy claims and a few rigorously examined patient-provider communication, decision making, or risk perceptions. Advisories recommending increased clinical or laboratory monitoring generally led to decreased drug use, but only modest, short-term increases in monitoring. Communications targeting specific subpopulations often spilled over to other groups. Repeated or sequential advisories tended to have larger but delayed effects and decreased incident more than prevalent use. Drug-specific warnings were associated with particularly large decreases in utilization, although the magnitude of substitution within therapeutic classes varied across clinical contexts.CONCLUSIONS:
Although some FDA drug risk communications had immediate and strong impacts, many had either delayed or had no impact on health care utilization or health behaviors. These data demonstrate the complexity of using risk communication to improve the quality and safety of prescription drug use, and suggest the importance of continued assessments of the effect of future advisories and label changes. Identifying factors that are associated with rapid and sustained responses to risk communications will be important for informing future risk communication efforts.- PMID:
- 22266704
- [PubMed - indexed for MEDLINE]
- PMCID:
- PMC3342472
- [Available on 2013/6/1]
An evaluation of stroke education in AVAIL r... [J Neurosci Nurs. 2012] - PubMed - NCBI
An evaluation of stroke education in AVAIL r... [J Neurosci Nurs. 2012] - PubMed - NCBI
J Neurosci Nurs. 2012 Jun;44(3):115-23.
An evaluation of stroke education in AVAIL registry hospitals.
Source
Neuroscience/Stroke, at Long Beach Memorial Medical Center, Long Beach, CA, USA.Abstract
The purpose of this study is to explore factors associated with recall of medication education and satisfaction with healthcare provider communication in patients with acute stroke or transient ischemic attack. This is an analysis of data from the AVAIL (Adherence Evaluation of Acute Ischemic Stroke Longitudinal) study. At 3 months after discharge, 2,219 stroke patients from 99 sites were interviewed and asked about their perceptions of education and communication with their healthcare providers as well as their current medication use and knowledge. Results show that less than 2% of the respondents reported not understanding how to take their medications, 4% did not know how to refill their medications, and 5% did not know the reason they were taking them. A vast majority (92%) of participants reported high levels of satisfaction in their communications with healthcare providers after discharge. Although overall understanding and satisfaction was high, older subjects were less likely to recall receiving medication information at discharge or to understand their medications. Similarly, African Americans and patients discharged from an academic hospital were less likely to report receiving a written medication list. This report highlights the success of education efforts and potential areas for additional improvement.- PMID:
- 22555348
- [PubMed - indexed for MEDLINE]
New paradigms for measuring clinical ... [Int J Qual Health Care. 2012] - PubMed - NCBI
New paradigms for measuring clinical ... [Int J Qual Health Care. 2012] - PubMed - NCBI
Int J Qual Health Care. 2012 Jun;24(3):200-5. Epub 2012 Apr 6.
New paradigms for measuring clinical performance using electronic health records.
Source
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. jweiner@jhsph.eduAbstract
Measures of provider success are the centerpiece of quality improvement and pay-for-performance programs around the globe. In most nations, these measures are derived from administrative records, paper charts and consumer surveys; increasingly, electronic patient record systems are also being used. We use the term 'e-QMs' to describe quality measures that are based on data found within electronic health records and other related health information technology (HIT). We offer a framework or typology for e-QMs and describe opportunities and impediments associated with the transition from old to new DATA SOURCES: If public and private systems of care are to effectively use HIT to support and evaluate health-care system quality and safety, the quality measurement field must embrace new paradigms and strategically address a series of technical, conceptual and practical challenges.- PMID:
- 22490301
- [PubMed - indexed for MEDLINE]
Linking health information technology... [Inform Health Soc Care. 2012] - PubMed - NCBI
Linking health information technology... [Inform Health Soc Care. 2012] - PubMed - NCBI
Inform Health Soc Care. 2012 Jun 1. [Epub ahead of print]
Linking health information technology to patient safety and quality outcomes: a bibliometric analysis and review.
Source
Department of Knowledge Informatics and Translation , Indiana University School of Medicine , IN , USA.Abstract
Objective. To assess the scholarly output of grants funded by the Agency for Healthcare Research and Quality (AHRQ) that published knowledge relevant to the impact of health information technologies on patient safety and quality of care outcomes. Study design We performed a bibliometric analysis of the identified scholarly articles, their journals, and citations. In addition, we performed a qualitative review of the full-text articles and grant documents. Data collection/extraction methods Papers published by AHRQ-funded investigators were retrieved from MEDLINE, journal impact factors were extracted from the 2010 Thompson Reuters Journal Citation Report, citations were retrieved from ISI's Web of Knowledge and Google Scholar. Principal findings. Seventy-two articles met the criteria for review. Most articles addressed one or more of AHRQ's outcome goals and focus priorities. The average impact factor for the journals was 4.005 (range: 0.654-28.899). The articles, and their respective grants, represented a broad range of health information technologies. Conclusions. This set of AHRQ-funded research projects addressed the goals and priorities of AHRQ, indicating notable contributions to the scientific knowledge base on the impact of information system use in healthcare.- PMID:
- 22657387
- [PubMed - as supplied by publisher]
Healthcare-associated infectio... [Infect Control Hosp Epidemiol. 2012] - PubMed - NCBI
Healthcare-associated infectio... [Infect Control Hosp Epidemiol. 2012] - PubMed - NCBI
Infect Control Hosp Epidemiol. 2012 Jun;33(6):539-44. Epub 2012 Apr 16.
Healthcare-associated infection and hospital readmission.
Source
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.Abstract
OBJECTIVE:
Hospital readmissions are a current target of initiatives to reduce healthcare costs. This study quantified the association between having a clinical culture positive for 1 of 3 prevalent hospital-associated organisms and time to hospital readmission.DESIGN:
Retrospective cohort study.PATIENTS AND SETTING:
Adults admitted to an academic, tertiary care referral center from January 1, 2001, through December 31, 2008.METHODS:
The primary exposure of interest was a clinical culture positive for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), or Clostridium difficile obtained more than 48 hours after hospital admission during the index hospital stay. The primary outcome of interest was time to readmission to the index facility. Multivariable Cox proportional hazards models were used to model the adjusted association between positive clinical culture result and time to readmission and to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).RESULTS:
Among 136,513 index admissions, the prevalence of hospital-associated positive clinical culture result for 1 of the 3 organisms of interest was 3%, and 35% of patients were readmitted to the index facility within 1 year after discharge. Patients with a positive clinical culture obtained more than 48 hours after hospital admission had an increased hazard of readmission (HR, 1.40; 95% CI, 1.33-1.46) after adjusting for age, sex, index admission length of stay, intensive care unit stay, Charlson comorbidity index, and year of hospital admission.CONCLUSIONS:
Patients with healthcare-associated infections may be at increased risk of hospital readmission. These findings may be used to impact health outcomes after discharge from the hospital and to encourage better infection prevention efforts.- PMID:
- 22561707
- [PubMed - indexed for MEDLINE]
SALUD EQUITATIVA: DIRECTORIO DE DOCUMENTOS EDITADOS EN SEPTIEMBRE 2012 [*]
Domingo 30 de SEPTIEMBRE de 2012
SALUD EQUITATIVA: DIRECTORIO DE DOCUMENTOS EDITADOS EN SEPTIEMBRE 2012 [*]
SALUD EQUITATIVA - GESTIÓN EN SALUD PÚBLICA
SALUD EQUITATIVA
GESTIÓN EN SALUD PÚBLICA
GRUPO DE BLOGS SALUD EQUITATIVA
► http://saludequitativa.blogspot.com/
▲GESTIÓN EN SALUD PÚBLICA
► http://herenciageneticayenfermedad.blogspot.com/
▲CIENCIAS DE LA HERENCIA
► http://elbiruniblogspotcom.blogspot.com/
▲CIENCIAS MÉDICAS NEWS
Contador Google ►
LECTORES acumulados desde enero 2009 a la fecha: 786.260
LECTORES totales conjuntos (todos los blogs: 3): 4.261.027
Páginas consultadas desde el inicio de los blogs (3): > 87,5 millones
Documentos acumulados en 2012: 7.268
Documentos editados desde el inicio del blog (2008): 21.850
▲ Google indica ►
Páginas vistas en el último mes: 49.876
Páginas vistas (historial completo): 786.260
SALUD EQUITATIVA: DIRECTORIO DE DOCUMENTOS EDITADOS EN SEPTIEMBRE 2012 [*]
SALUD EQUITATIVA - GESTIÓN EN SALUD PÚBLICA
SALUD EQUITATIVA
GESTIÓN EN SALUD PÚBLICA
GRUPO DE BLOGS SALUD EQUITATIVA
► http://saludequitativa.blogspot.com/
▲GESTIÓN EN SALUD PÚBLICA
► http://herenciageneticayenfermedad.blogspot.com/
▲CIENCIAS DE LA HERENCIA
► http://elbiruniblogspotcom.blogspot.com/
▲CIENCIAS MÉDICAS NEWS
Contador Google ►
LECTORES acumulados desde enero 2009 a la fecha: 786.260
LECTORES totales conjuntos (todos los blogs: 3): 4.261.027
Páginas consultadas desde el inicio de los blogs (3): > 87,5 millones
PÁGINAS vistas por países: Discriminadas como sigue:
- ESPAÑA: 175.484
ESTADOS UNIDOS DE NORTEAMÉRICA: 113.729
ALEMANIA: 100.626
ARGENTINA: 75.426
MÉXICO: 48.694
FRANCIA: 68.517
COLOMBIA: 29.883
PERÚ: 22.134
VENEZUELA: 14.662
CHILE: 13.899
ECUADOR: 8.741
RUSIA: 8.913
BOLIVIA: 5.306
Documentos acumulados en 2012: 7.268
Documentos editados desde el inicio del blog (2008): 21.850
▲ Google indica ►
Páginas vistas en el último mes: 49.876
Páginas vistas (historial completo): 786.260
Archivo del blog
▼ 2012 (7288) ▼ septiembre (888)- AHRQ Innovations Exchange | Recent Events | Vermon...
- AHRQ Innovations Exchange | Expert Commentary: Sta...
- AHRQ Innovations Exchange: State Health Care Legis...
- RFA-HS-13-002: AHRQ Patient Centered Outcomes Rese...
- AHRQ Centers for Primary Care Practice-Based Resea...
- AHRQ Innovations Exchange | Innovations & QualityT...
- Medicaid Providers Face Common Barriers to Meaning...
- Closing the Quality Gap Series: Quality Improvemen...
- Closing the Quality Gap Series: Bundled Payment: E...
- Interventions to Improve Adherence to Self-ad... [...
- Closing the Quality Gap Series: Medication Adheren...
- National Health IT Week
- National Health IT Week: Celebrating HIT as an ess...
- Changing BMI categories and healthca... [Obesity (...
- Impact of FDA drug risk communications on health c...
- An evaluation of stroke education in AVAIL r... [J...
- New paradigms for measuring clinical ... [Int J Qu...
- Linking health information technology... [Inform H...
- Healthcare-associated infectio... [Infect Control ...
Archivo del blog
-
▼
2012
(7268)
-
▼
septiembre
(868)
- La Fundación para la Protección Social de la OMC y...
- Expertos apuestan por una ley que obligue a la vac...
- La SEMI presenta una plataforma educativa que ofre...
- El Servicio Murciano de Salud anuncia que los paci...
- Más del 20 por ciento de los europeos y los estado...
- El Sergas convoca una oferta de empleo de 176 plaz...
- La Asociación Española de Pediatría considera “imp...
- La asistencia sanitaria debe ir de la mano de la i...
- Latinoamérica, España y Portugal evalúan estrategi...
- Estratificar pacientes y adaptar las soluciones a ...
- La SEOM advierte del peligro de las medicinas alte...
- Lasquetty sigue al frente de Sanidad :: El Médico ...
- Los sindicatos sanitarios de Asturias convocan otr...
- El futuro de la atención a la dependencia en Españ...
- Aprobado el modelo que privatizará la gestión unif...
- 'En España hay grandes desigualdades en el abordaj...
- Las bonificaciones fiscales por sida y hepatitis C...
- ¿Quién pagará la factura? Los de siempre | Economí...
- “Hay más de 10.000 ecuatorianos en riesgo” | Socie...
- El caos de la exclusión sanitaria | Sociedad | EL ...
- ProMED-mail | ProMED-mail
- Collaborating Centre Connection (September 2012)
- El Consell fracasa en su intento de privatizar tod...
- Montero avisa de que dará prioridad con el rescate...
- Sanidad, la partida más afectada por el tijerazo c...
- Los Ayuntamientos tendrán un 40% menos para atende...
- Todas las claves de unos presupuestos muy restrict...
- Los ajustes que vienen | Sociedad | EL PAÍS
- School Debt, Income Gap Push Med Students Away Fro...
- Hospital Observation Units Could Save Billions in ...
- El 70% de los profesionales sanitarios no se vacun...
- Elección y Uso de un Plan de Salud
- Los estudiantes de medicina de EEUU desconocen la ...
- Nuevo virus no se expande fácilmente entre las per...
- Families Who Adopt Should Use Extra Health Service...
- Spike in heart failures follows Japan's 2011 quake...
- CDC - What's New on the NIOSH Website
- NCQA > HEDIS & Quality Measurement
- National Quality Measures Clearinghouse | Measures...
- National Quality Measures Clearinghouse | "cholest...
- National Quality Measures Clearinghouse | 'atrial ...
- National Quality Measures Clearinghouse | American...
- Institute for Clinical Systems Improvement ► Preve...
- National Committee for Quality Assurance ► Annual ...
- Rural Health Open Door Forum | Centers for Medicar...
- Home Health, Hospice & Durable Medical Equipment O...
- Skilled Nursing Facilities/Long-Term Care Open Doo...
- Hospitals Open Door Forum | Centers for Medicare &...
- Ambulance Open Door Forum | Centers for Medicare &...
- Physicians, Nurses and Allied Health Professionals...
- ProMED-mail | ProMED-mail
- Press Announcements [spanish and english] > La FDA...
- NCHS - 2012 National Conference on Health Statisti...
- EHC Program Update: Draft Report Available for Com...
- 2014 Draft Test Methods: Wave Four Released for Pu...
- New This Week from HealthIT.gov
- La póliza de Mato no cubrirá los medicamentos de l...
- CDC - Blogs - Public Health Matters Blog – Nationa...
- INSCRIPCION ON LINE - QUO VADIS SALUD - 20 DE NOV...
- Maestría en Investigación Clínica - Abierta la In...
- El Consell aprueba el nuevo modelo sanitario de ge...
- El aborto, ¿un debate cerrado? | Sociedad | EL PAÍ...
- Aborto seguro... para no morir | Sociedad | EL PAÍ...
- El calor que trajo la legionela | Cataluña | EL PA...
- Nuestro derecho a decidir | País Vasco | EL PAÍS
- Cuatro generaciones contra la reforma de la ley de...
- ProMED-mail | ProMED-mail
- Accelerating Progress on Adoption and Meaningful U...
- Have You Heard? Facts From The Field - September 2...
- Disaster Preparedness and Health IT
- Cerveza y vino, se anuncian pero no se beben | Nut...
- El cáncer le cuesta a Europa 124.000 millones de e...
- Centers for Medicare & Medicaid Services ► CMS Upd...
- El envejecimiento de la población plantea desafíos...
- Las recetas pediátricas no siempre llegan a la far...
- Creating a New Competitive Marketplace: Affordable...
- Expertos abogan por nuevos enfoques para combatir ...
- El Colegio de Castellón ha registrado 7 casos de a...
- Los profesionales en Electromedicina reclaman raci...
- La FADSP califica de “falsa” la disminución del ga...
- Los grupos políticos exigen al Gobierno de Navarra...
- El CHMP recomienda la aprobación de tadalafilo par...
- Echániz: “Las medidas del Ministerio de Sanidad es...
- El profesor Manuel Díaz-Rubio, elegido Presidente ...
- “El gran problema de la sociedad del conocimiento ...
- “Muchos políticos desconocen el sistema sanitario”...
- SEMERGEN pide una mayor sensibilización política a...
- Los sindicatos asturianos abandonan el encierro y ...
- Llisterri reclama que la Primaria deje de ser "la ...
- Los médicos de la Comunidad Valenciana cobrarán ig...
- Un 13 por ciento menos para la partida de Sanidad ...
- : Secretary Kathleen Sebelius, Department of Healt...
- New Program to Increase Quality in Nursing Facilit...
- HHS continues to support state efforts to build Af...
- Hospitals Open Door Forum | Centers for Medicare &...
- Skilled Nursing Facilities/Long-Term Care Open Doo...
- Rural Health Open Door Forum | Centers for Medicar...
- Home Health, Hospice & Durable Medical Equipment O...
- MMWR - MMWR Weekly ► September 28, 2012 / Vol. 61 ...
- QuickStats: Percentage of Adults Aged 18–64 years ...
- Affordable Care Act funds to enhance quality of ca...
- Del buen investigador a la realidad del mercado - ...
- Con impagos y falta de rentabilidad, las empresas ...
- Products - National Vital Statistics Reports - Hom...
- El contrato en fraude de ley pasa a ser indefinido...
- Mato defiende su implicación en la reforma del abo...
- Recortes y el euro por receta marcan los 21 meses ...
- Otro día de violencia en un hospital bonaerense - ...
- 'Si crece la tasa de pobreza, puede aumentar el cá...
- Nuevas vías sobre la mente | País Vasco | EL PAÍS
- Muchos de los compuestos tóxicos del tabaco no est...
- Health Care Innovations Exchange: State Health Car...
- Products - NHIS Early Releases of Selected Estimat...
- Abbott anuncia el lanzamiento internacional del Di...
- Roche comunicará en ESMO datos de trece terapias q...
- La mitad de los adultos norteamericanos serán obes...
- En 2010 se produjeron en España más de medio milló...
- Fuertes recortes en la convocatoria de las plazas ...
- La consejera de Murcia defiende una "gestión coord...
- La Consejería andaluza cree que la huelga convocad...
- HM Hospitales estrena nueva web para responder a t...
- El Colegio de Cádiz transmite a Salud su inquietud...
- Radiografía a... La Medicina Ambiental :: El Médic...
- Más de 4.000 médicos de Asturias iniciarán la huel...
- Por segundo mes consecutivo, el gasto farmacéutico...
- Mato defiende la reducción del gasto farmacéutico ...
- La FADSP cree que las diferencias en los recortes ...
- AHRQ Health IT Update: Electronic Standing Orders
- ProMED-mail
- CDC - Global Health - Updates from the Field: Stre...
- CDC - Blogs - Public Health Matters Blog – Disease...
- Responsive Design and the New Medicare.gov
- Responsive Design and the New Medicare.gov – Digit...
- EUCERD publica una Recomendación para mejorar las ...
- La OMS indica a los países que vigilen el nuevo vi...
- El gasto público en farmacia descendió un 20% en a...
- NSFG - National Survey of Family Growth Homepage
- NSFG - National Survey of Family Growth Homepage
- Health care law increases number of mental and beh...
- Los mosquitos que transmiten la malaria podrían mo...
- Las Vocalías de Medicina Privada de la OMC, preocu...
- Blanco advierte a los médicos, tras la convocatori...
- Los médicos de AP dispondrán de una herramienta mó...
- Avanzando hacia el desastre. Algunas reflexiones s...
- El presupuesto del Ministerio de Sanidad se reduci...
- Novartis pone en marcha BMJG, un programa de forma...
- Más de 200 médicos reclamaron en agosto al SAS, a ...
- CC.OO Extremadura rechaza la ampliación de jornada...
- El CSIC concede la licencia de la vacuna contra el...
- SEMERGEN teme que la reducción del presupuesto del...
- Los psiquiatras demandan que se invierta más diner...
- “Me preocupa que haya una fuga de nuestros científ...
- Echániz niega que vaya a haber "grandes salidas de...
- Osakidetza rectifica en la atención a los inmigran...
- Uruguay avanza, entre fuertes críticas, hacia la d...
- La regulación del aborto debe dejarse como está | ...
- Sanidad se compromete a bajar el IVA del pan sin g...
- Convocada huelga de médicos en todos los hospitale...
- ¿Se debe permitir que los muertos tengan hijos? | ...
- You Are Invited: Spanish Language Webinars on the ...
- Los supervivientes jóvenes de cáncer señalan que l...
- Por qué calcular la financiación a brochazos y no ...
- La gripe se relaciona con entre 1.400 y 4.000 muer...
- El 62,6% de los españoles opina que los sin papele...
- La demolición programada de la sanidad pública | S...
- El 30% de los fármacos que se venden en algunos pa...
- El PSOE e IU plantan el pacto por la Sanidad | Soc...
- China: 670 millones de hombres ¡y faltan donantes ...
- 'No disparen al farmacéutico' | Noticias | elmundo...
- New PCD App Available for the iPad and iPhone
- Patient Safety Update: AHRQ-Funded Report Shows Pr...
- Comienza el plazo de matriculación en los cursos d...
- El presidente de Cantabria se compromete a que las...
- CESM-Extremadura acepta la propuesta del SES para ...
- Sanidad convoca las plazas MIR 2012/2013 :: El Méd...
- La estratificación supone un gran avance en el pro...
- "El SNS es el mayor logro social de este país: man...
- En 2011 la inversión en I+D de la industria farmac...
- Ana Mato: “Las reformas en Sanidad y Dependencia p...
- Consumer Updates > Scam Alert: Beware of Bogus FDA...
- Disparidades en la atención de la salud - Actualiz...
- Medicare - Actualización
- What You Should Know Before Buying Life Insurance ...
- Public Comment on Draft Recommendation: Screening ...
- Skilled Nursing Facilities/Long-Term Care Open Doo...
- Rural Health Open Door Forum | Centers for Medicar...
- ProMED-mail | ProMED-mail
- Home Health, Hospice & Durable Medical Equipment O...
- Physicians, Nurses and Allied Health Professionals...
- Summary of Benefits and Coverage (SBC) and Uniform...
- Health care law ensures consumers get clear, consi...
- Untreated Food Allergies More Likely in Poor, Mino...
- Hospital shootings uncommon, unpredictable: Medlin...
- New EHC Inside Track: Treatment Comparisons for Me...
- La OMS dice haber encontrado un nuevo virus simila...
- HHS Live Streaming
- Public Health Action in Genomics Is N... [Public H...
- CDC - Blogs - Genomics and Health Impact Blog – Mo...
- Legal Liability and the Uncertain Nat... [Public H...
- Cost-effectiveness of the 21-gene recurrence score...
- PHG Foundation | Do patients have a right to acces...
- IntraMed - Artículos - RCP ARGENTINA (proyecto de ...
- Absolución al no empeorar la paciente tras darle l...
- El Sacyl debe sacar a concurso las comisiones de s...
- Los recortes hacen caer por primera vez la inversi...
- El 'numerus clausus' ha crecido un 62% en seis año...
- La troncalidad y el futuro de los laboratorios, a ...
- La alemana BI solicita vía libre para afanitib en ...
- Lilly afronta una etapa de transición con doce com...
- Los contratos de riesgo compartido se van definien...
- "No hay crisis en la capacidad de los médicos" - D...
- Public health surveillance in the United ... [MMWR...
- El silencioso robo de bebés chinos | Sociedad | EL...
- La industria farmacéutica redujo en 2011 su invers...
- Una ONG holandesa financiará a la clínica abortist...
- Recetas 'marcadas' para pacientes con VIH | Sida y...
- Los suizos seguirán contando con espacios para fum...
- La ciudad, invadida por mosquitos tras el récord d...
- Cuando la violencia le gana a la salud - 24.09.201...
- Genetics and Primary Care Practice
- ProMED-mail | ProMED-mail
- National Center for Medical Home Implementation | ...
- Public health surveillance in the United ... [MMWR...
- Multiple-State Genomics Data | Genetic Conditions
- CDC - Blogs - Genomics and Health Impact Blog – Fe...
- Healthy People 2020 - Improving the Health of Amer...
- Las compañías de genéricos crecerán en detrimento ...
- Básica y clínica se alimentan mutuamente - DiarioM...
- La tasa de mortalidad tras la cirugía duplica las ...
- "Hemos gastado en Dependencia 2.700 millones de má...
- Las intervenciones guiadas por imagen o por isótop...
- La asistencia oncológica demostrará su excelencia ...
- "La calidad de la cirugía oncológica es el factor ...
- Prevenir la mortalidad infantil por medio de estra...
- El sistema de innovación vasco se convierte en tra...
- El Consejo de Enfermería pedirá a Valencia que no ...
- La atención al inmigrante irregular es un asunto c...
- Inhabilitan a una enfermera por medicar sin prescr...
- El Consejo de Enfermería pedirá a Valencia que no ...
- El coste global del Alzheimer llega ya a los 24.00...
- Centers for Medicare & Medicaid Services/The Joint...
- National Quality Measures Clearinghouse | Diagnosi...
- REVISTA MEDICOS | Medicina Global | La Revista de ...
- Research Activities, September 2012: Chronic Disea...
- Research Activities, September 2012: Chronic Disea...
- Research Activities, September 2012: Chronic Disea...
- Research Activities, September 2012: Health Inform...
- Research Activities, September 2012: Health Inform...
- Research Activities, September 2012: Health Inform...
- CDC Features - STRYVE to Prevent Youth Violence
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