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Biomedical subjects

John M Eisenberg

Publications and source records attributed to John M Eisenberg.

10 recordsLinked to original sources
PubMed2004

The roles of government in improving health care quality and safety.

BACKGROUND: Discussions surrounding the role of government have been and continue to be a favorite American pastime. A framework is provided for understanding the 10 roles that government plays in improving health care quality and safety in the United States. Examples of proposed federal actions to reduce medical errors and enhance patient safety are provided to illustrate the 10 roles: (1) purchase health care, (2) provide health care, (3) ensure access to quality care for vulnerable populations, (4) regulate health care markets, (5) support acquisition of new knowledge, (6) develop and evaluate health technologies and practices, (7) monitor health care quality, (8) inform health care decision makers, (9) develop the health care workforce, and (10) convene stakeholders from across the health care system. CONCLUSION: Government's responsibility to protect and advance the interests of society includes the delivery of high-quality health care. Because the market alone cannot ensure all Americans access to quality health care, the government must preserve the interests of its citizens by supplementing the market where there are gaps and regulating the market where there is inefficiency or unfairness. The ultimate goal of achieving high quality of care will require strong partnerships among federal, state, and local governments and the private sector. Translating general principles regarding the appropriate role of government into specific actions within a rapidly changing, decentralized delivery system will require the combined efforts of the public and private sectors.

Federal Government↗
PubMed2002

When is "good enough"? The role and responsibility of physicians to improve patient safety.

In September 2001, the Agency for Healthcare Research and Quality (AHRQ) and the ABIM Foundation jointly sponsored an invitational conference entitled "The Role and Responsibility of Physicians to Improve Patient Safety." The goal of the conference was to begin a national conversation focusing on the individual clinician's role and strategies physicians might employ to advance patient safety. The authors summarize the main themes and issues that emerged at the conference. The authors draw from work by the Institute of Medicine (IOM) to support the need for greater emphasis on quality improvement. To date, most of the work in this area has involved a systems-level approach, and physicians are often viewed as obstacles to improvement programs. By contrast, physicians may view population- or systems-based approaches to health care as interfering with the delivery of care to specific patients. The authors argue that physicians, individually and collectively, have a key role in quality improvement efforts, albeit a role that is yet fully defined. After reviewing successful examples involving physicians, the authors explore the major levers to achieve change-removing barriers, creating incentives, emphasizing collaboration, increasing education, and promulgating regulation-and summarize ten recurring themes, including both current and near-term opportunities, for physicians to exercise leadership in quality improvement and patient safety. Finally, they assert that even modest change can lead to substantial improvements, particularly if medical societies and the profession's standard-setting bodies work together.

Education, Medical↗
PubMedDate not supplied

Three decades of research on computer applications in health care: medical informatics support at the Agency for Healthcare Research and Quality.

The Agency for Healthcare Research and Quality and its predecessor organizations-collectively referred to here as AHRQ-have a productive history of funding research and development in the field of medical informatics, with grant investments since 1968 totaling $107 million. Many computerized interventions that are commonplace today, such as drug interaction alerts, had their genesis in early AHRQ initiatives. This review provides a historical perspective on AHRQ investment in medical informatics research. It shows that grants provided by AHRQ resulted in achievements that include advancing automation in the clinical laboratory and radiology, assisting in technology development (computer languages, software, and hardware), evaluating the effectiveness of computer-based medical information systems, facilitating the evolution of computer-aided decision making, promoting computer-initiated quality assurance programs, backing the formation and application of comprehensive data banks, enhancing the management of specific conditions such as HIV infection, and supporting health data coding and standards initiatives. Other federal agencies and private organizations have also supported research in medical informatics, some earlier and to a greater degree than AHRQ. The results and relative roles of these related efforts are beyond the scope of this review.

Databases, Factual↗
PubMedDate not supplied

Globalize the evidence, localize the decision: evidence-based medicine and international diversity.

Even when the evidence about outcomes and effectiveness is clear, local circumstances dictate how that evidence is translated into practice. Opportunities have recently emerged to share evidence globally about the outcomes and effectiveness of health care (globalization) and then translate that evidence into improved health care at the local level (localization). To succeed in globalizing the evidence, policymakers must realize that opportunities to do so will be tempered by three competing core values: choice, efficiency, and equity.

Community Health Planning↗
PubMedDate not supplied

Addressing racial and ethnic barriers to effective health care: the need for better data.

Racial and ethnic disparities in health outcomes and quality of care have been observed among persons with similar health insurance, within the same system of care, and within the same health plan. National efforts to eliminate these disparities are hindered by the lack of race/ethnicity data. Collection of these data by health care providers, coupled with standards for collection, use, and privacy protection, would be a first step toward eliminating disparities. Although no national consensus exists with respect to data collection, the weight of prior research, related public and private efforts, and growing diversity of the U.S. population are likely to increase demand for accurate data on race and ethnicity in health care settings.

Censuses↗