1. AHCPR 1 Enhancing the Consumer Health Experience J. Michael Fitzmaurice, Ph.D. Agency for Health Care Policy and Research April 27, 1999

2. AHCPR 2 Overview # Government has useful web sites # Quality criteria for site evaluation are available – HITI-- Science Panel Report -- Deering article

3. AHCPR 3 AHCPR Web Page # To get to a government agencys 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

4. AHCPR 4 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

5. AHCPR 5 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

6. AHCPR 6 consumer.gov # Aging/Elder Care # Buying Smart # Choosing Quality Health Care # Dieting and Weight Control # Diseases # Exercise and Fitness # Health insurance

7. AHCPR 7 scipich.org # Learn about evaluating and selecting interactive health communication (IHC) applications # Evaluation reporting template # Selected resource links # Scientific articles published by the Panel

8. AHCPR 8 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

9. AHCPR 9 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?

10. AHCPR 10 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

11. AHCPR 11 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

12. AHCPR 12 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

13. AHCPR 13 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

14. AHCPR 14 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

15. AHCPR 15 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)

16. AHCPR 16 Strategies # Evaluation – Technical feasibility – Application in the community – Effect on well-being – Patient health outcome – Productivity at work – Enjoyment of life – Cost-benefit analyses

17. AHCPR 17 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

18. AHCPR 18 Challenges # Privacy, confidentiality, security # Physician productivity # Obtaining comparable health data – Describing and measuring concepts – Common vocabulary – Collection, storage and retrieval

19. AHCPR 19 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

20. AHCPR 20 Challenges # Address errors in medicine – Recent literature: – Leape-- Bates -- Others – Adverse Drug Events – Chemotherapy overdoses – Allergic reactions – Amputation of wrong limb

21. AHCPR 21 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

22. AHCPR 22 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?

23. AHCPR 23 Enhancing the Consumer Health Experience J. Michael Fitzmaurice, Ph.D. Agency for Health Care Policy and Research April 27, 1999