Overcoming barriers to quality. An American Hospital Association special roundtable discussion.
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Chief Executive Officers, Hospital↗
Biomedical subjects
Molly Joel Coye
Publications and source records attributed to Molly Joel Coye.
No more procrastinating. Industry must eschew excuses and move fast on electronic health records.
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Ambulatory Care Information Systems↗
Connections between quality measurement and improvement.
BACKGROUND: Measurement is necessary but not sufficient for quality improvement. Because the purpose of the national quality measurement and reporting system (NQMRS) is to improve quality, a discussion of the link between measurement and improvement is critical for ensuring an appropriate system design. OBJECTIVES: To classify approaches to the use of measurement in improvement into two different--although linked and potentially synergistic--agendas, or "pathways." To discuss the barriers encountered in each of these pathways and identify steps needed to motivate improvement in both pathways. RESEARCH DESIGN: Descriptive, conceptual discussion. FINDINGS: The barriers to the use of information to motivate change include, in Pathway I (selection), the lack of skill, knowledge, and motivation on the part of those who could drive change by using data to choose from among competing providers, and, in Pathway II (change in care delivery), the deficiencies in organizational and professional capacity in health care to lead change and improvement itself. CONCLUSIONS: Neither the dynamics of selection nor the dynamics of improvement work reliably today. The barriers are not just in the lack of uniform, simple, and reliable measurements, they also include a lack of capacity among the organizations and individuals acting on both pathways.
Delivery of Health Care↗
Improving America's health care system by investing in information technology.
Large-scale investment in health care information technology (IT) infrastructure will not take place without leadership by the federal government. But how the federal government supports the financing of health care IT is critical. Health care IT development has multiple aspects, but it is fundamentally a problem of community infrastructure development. A policy approach that has had consistent success in financing our country's essential physical infrastructure in transportation and environmental protection will be well suited to fostering health care IT infrastructure as well. We propose the creation of a health care IT revolving loan fund program to invest public dollars in health care IT infrastructure projects through community-level nonprofit lending agencies.
Capital Financing↗