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PubMed2006

Toward a national framework for the secondary use of health data: an American Medical Informatics Association White Paper.

Secondary use of health data applies personal health information (PHI) for uses outside of direct health care delivery. It includes such activities as analysis, research, quality and safety measurement, public health, payment, provider certification or accreditation, marketing, and other business applications, including strictly commercial activities. Secondary use of health data can enhance health care experiences for individuals, expand knowledge about disease and appropriate treatments, strengthen understanding about effectiveness and efficiency of health care systems, support public health and security goals, and aid businesses in meeting customers' needs. Yet, complex ethical, political, technical, and social issues surround the secondary use of health data. While not new, these issues play increasingly critical and complex roles given current public and private sector activities not only expanding health data volume, but also improving access to data. Lack of coherent policies and standard "good practices" for secondary use of health data impedes efforts to strengthen the U.S. health care system. The nation requires a framework for the secondary use of health data with a robust infrastructure of policies, standards, and best practices. Such a framework can guide and facilitate widespread collection, storage, aggregation, linkage, and transmission of health data. The framework will provide appropriate protections for legitimate secondary use.

Access to Information↗
PubMed2006

Self-assessment in neurological surgery: the SANS wired white paper.

OBJECTIVE: Periodic self-assessment is an important component of postgraduate medical education and certification. The Self-assessment in Neurological Surgery (SANS) examination has a history of usefulness for neurosurgical written and oral board examination preparation. The SANS Wired test represents a recreation of the original SANS test using an Internet-based platform. Advanced functionality and contemporary content have been added to meet the increasing requirements for demonstration of lifelong learning and self-assessment as part of the Maintenance of Certification (MOC) process. METHODS: A needs assessment was performed before the development of SANS Wired. Postexamination surveys for users obtaining continuing medical education credit were analyzed for user satisfaction with the platform and content. Test-item performance metrics were analyzed based on first-attempt responses. The economic value of SANS Wired as a component of the mandatory MOC process was evaluated. RESULTS: The needs assessment identified a deficiency of available content and mechanisms for neurosurgery-specific self-assessment. As of October 15, 2005, a total of 588 individuals had subscribed to SANS Wired (28 institutional licenses accounted for 229 users). Eighty-eight post-test surveys were analyzed for user satisfaction. Ninety-four percent of responses indicated that learning objectives had been met. Initial performance metrics show an average point-biserial discrimination index of +0.18 for all test items. CONCLUSION: The SANS Wired system seems to be an effective platform for neurosurgical self-assessment and is acceptable to users. The system satisfies, in part, two of the four required components of MOC, namely, periodic self-assessment and demonstration of cognitive expertise. It is endorsed by the American Board of Neurological Surgeons for MOC.

Certification↗
PubMedDate not supplied

White paper: value of specialty certification in pharmacy.

OBJECTIVE: To address the value of Board of Pharmaceutical Specialties (BPS) certification, particularly as perceived by different stakeholders (pharmacists, employers, government, and academia), and to draw a parallel between specialization and certification in pharmacy and in medicine. DATA SOURCES: Electronic databases (Medline, International Pharmaceutical Abstracts, Sociological Abstracts), associations/health care organizations Web sites, outside reports, and clinical pharmacists involved in certification processes. STUDY SELECTION: Studies and reports that addressed the value of specialty certification were selected by the authors. DATA EXTRACTION: By the authors. DATA SYNTHESIS: Pharmacists with specialty certification report enhanced feelings of self-worth, improved competence, and greater marketability. Other values of certification include increased acceptance by health care professionals, salary increases, and job promotions. Employers have acknowledged board-certified pharmacists through public recognition, increase in responsibility, and some types of monetary compensation. In some governmental organizations, certified pharmacists receive salary raises and are granted prescribing authority. However, the overall value of specialty certification in pharmacy as perceived by the public or payers lags behind when compared with the status of specialty certification in medicine. CONCLUSION: Board-certified pharmacists appreciate the value of pharmacy specialty certification, and in a number of organizations and practice settings, board-certified pharmacists are perceived as valuable. Still, unlike board-certified physicians, board-certified pharmacists are not widely recognized outside or even within the pharmacy profession. To address this challenge, board-certified pharmacists ought to market their services to assure that other stakeholders recognize their value.

Accreditation↗
PubMed2004

The critical care medicine crisis: a call for federal action: a white paper from the critical care professional societies.

In the United States, shortages of qualified health-care professionals have created a major threat to the availability and quality of critical care services for seriously ill patients. An unprecedented, and largely unrecognized, shortage of physician intensivists in the near future will deny standard critical care services for large populations of patients with serious illnesses. If the current trend persists, shortages of these specialists, combined with the current shortages of critical care nurses, pharmacists, and respiratory therapists, will become severe by 2007 and will worsen through 2030. Numerous studies demonstrate that critical care services directed by physicians who are formally trained in critical care medicine reduce mortality in the ICU and reduce health-care costs. While people of all ages, from low-birth-weight newborns to senior citizens, benefit from treatment in the ICU, older Americans receive a disproportionate share of ICU services. The demand for ICU services, therefore, will continue to grow as the baby boom generation ages. To address the shortage, the critical care professional societies recommend that steps be taken to improve the efficiency of critical care providers, to increase the number of critical care providers, and to address the demand for critical care services.

Aged↗
PubMed2000

White paper on herbal products. American College of Clinical Pharmacy.

Individuals increasingly are taking a more active role in their health care, and herbal products have emerged as a common choice among self-care therapies. Pharmacists are active participants in the care of patients who are taking herbal products. Currently, most pharmacists are not educated adequately about herbal products and other types of alternative medicine. Furthermore, good information about many of these products is not available. These combined factors present a challenge for pharmacists as they seek to provide optimal care and counseling to patients who use herbs or supplements. We recommend the following actions to place pharmacists in better positions as effective agents protecting public safety: Regulations should be implemented at a federal level to require basic levels of standardization and quality control in the manufacture of herbal products. Indexing terms in medical bibliographic systems should be expanded to target herbal products. Funding should be increased for scientific research evaluating herbal products. Pharmacy schools should include a competency statement in their curricula regarding herbal medicines. Continuing education in herbal products should be available and encouraged for all pharmacists. Pharmacists should approach the use of all therapeutic interventions with scientific rigor, whether they are traditional or complementary in nature. Patients will benefit as more information is known and widely disseminated. By actively embracing the responsibility for counseling individuals on the appropriate use of herbal products, pharmacists will become a recognized source of expert information in this rapidly growing area, yielding important improvements in the quality of care.

Humans↗
PubMed2004

Setting the public agenda for online health search: a white paper and action agenda.

BACKGROUND: Searches for health information are among the most common reasons that consumers use the Internet. Both consumers and quality experts have raised concerns about the quality of information on the Web and the ability of consumers to find accurate information that meets their needs. OBJECTIVE: To produce a national stakeholder-driven agenda for research, technical improvements, and education that will improve the results of consumer searches for health information on the Internet. METHODS: URAC, a national accreditation organization, and Consumer WebWatch (CWW), a project of Consumers Union (a consumer advocacy organization), conducted a review of factors influencing the results of online health searches. The organizations convened two stakeholder groups of consumers, quality experts, search engine experts, researchers, health-care providers, informatics specialists, and others. Meeting participants reviewed existing information and developed recommendations for improving the results of online consumer searches for health information. Participants were not asked to vote on or endorse the recommendations. Our working definition of a quality Web site was one that contained accurate, reliable, and complete information. RESULTS: The Internet has greatly improved access to health information for consumers. There is great variation in how consumers seek information via the Internet, and in how successful they are in searching for health information. Further, there is variation among Web sites, both in quality and accessibility. Many Web site features affect the capability of search engines to find and index them. CONCLUSIONS: Research is needed to define quality elements of Web sites that could be retrieved by search engines and understand how to meet the needs of different types of searchers. Technological research should seek to develop more sophisticated approaches for tagging information, and to develop searches that "learn" from consumer behavior. Finally, education initiatives are needed to help consumers search more effectively and to help them critically evaluate the information they find.

Community Participation↗