Health Care Vision 2020
Aligning Forces for Quality
Initial Clinical Focus Area and Related Issues
(Recommendations from 8/1/07 joint meeting of all AF4Q work groups)
1. It is recommended that the initial clinical focus area for HCV 2020 attention be Diabetes Mellitus.
Rationale:
· Diabetes has a major impact upon W MI residents’ health and the region’s health care providers in terms of prevalence, health care utilization and cost.
· Diabetes is itself a risk factor for other diseases (e.g., heart disease).
· The impact of Diabetes is experienced across all parts of W MI and all population groups (race/ethnicity, sex, age).
· Most Physician Organizations and Physician/Hospital Organizations, with their member physicians, are already engaged in projects and activities designed to improve the quality of care to persons with Diabetes and lessen the burden of this disease, giving HCV 2020 a strong foundation upon which to build—to complement and enhance what is already underway.
· The specific measures of the quality of Diabetes care are some of the most vetted, reliable, accepted and widely used health care performance measures in existence. At least in a relative sense, there should be little controversy over these measures themselves.
2. The initial focus for HCV 2020 Diabetes-related activity is recommended to be at the “all patients” level, followed by analysis by geographic categorization as feasible.
Rationale:
· Given the overall impact and importance of this disease, it is appropriate and necessary that we work to identify and collect information about all persons diagnosed with Diabetes in W MI.
· Race and ethnicity data are not captured reliably or widely within patient records, or from administrative data sources, at the current time.
· In contrast, residence, and thus the capacity for geographically-based analyses, is widely available.
3. It
is recommended that physicians, through W MI Physician Organizations, be asked
for their collective recommendations as to what specific measures of performance
corresponding to the care of persons with Diabetes should be utilized in the
initial work of HCV 2020.
Rationale:
· Since it is physicians’ performance that will ultimately be measured and reported, it is appropriate to seek their input regarding the measures to be used.
· Most, if not all, physician organizations and physicians are familiar with the Diabetes performance measures and can utilize their experience and knowledge to inform HCV 2020 of the pros and cons of specific measures.
· The National Quality Forum Diabetes measures, from which our selection will be made:
a.
Eye exam
b.
Foot exam
c.
Hemoglobin A1c testing
d.
Hemoglobin A1c management/control
e.
Blood pressure management/control
f.
Urine protein screening (related to kidney disease)
g.
Lipid profile (cholesterol)
h.
Lipid management