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The U.S. is in the midst of an evolutionary period of enhanced health care quality and effectiveness, and physician leaders are spurring excitement about potential systemwide improvement, according to Carolyn M. Clancy, director of the Agency for Healthcare Research and Quality (AHRQ).
But "the real issue for people who need the system is, `How good is my health care?'" Clancy says. "At this point, I'm not sure we have an answer for most Americans."
Clancy hit on the role of information technology (IT) in quality improvement and patient-centered medicine in her keynote address to attendees of Internal Medicine 2007, the annual meeting of the American College of Physicians (ACP), held April 19–21 in San Diego. The quality improvement and patient-centered themes permeated sessions on research and ongoing initiatives involving the clinical care of obesity, diabetes, and cardiovascular disease.
One of the central challenges for primary care physicians in improving patient-centered care, according to Clancy, is tracking what others are doing for their patients, particularly those with complex chronic conditions.
Health IT can serve as an information nervous system that makes "the right thing the easy thing to do," she says. However, it is really just a means to that end. She points out a variety of ways "health IT can help us apply the professionalism we cherish to transform care for our patients":
AHRQ's annual reports on health care quality and disparities use identical measures of health care quality, such as indicators of effectiveness, safety, timeliness, and patient centeredness (see www.ahrq.gov/qual/measurix.htm). The 2006 reports show that the U.S. health care system is improving about 3% a year. At this rate, Clancy says, it would take 20 years to close the gap between the best quality care and what we receive today.
"I'm sure none of us wants to wait that long," she says. She acknowledges that start-up and maintenance costs for health IT are high and can seem out of reach for small practices, noting that most practices in the U.S. have <5 physicians.
Clancy urges ACP to expand its efforts to redesign training for internal medicine and to provide financial help for small practices that want to incorporate health IT.
AHRQ already has worked with the college on one such endeavor—a 3-year project that developed and tested a team-oriented, practice-based continuing medical education program for chronic disease care improvement. Another major team-based project on the diabetes front is the ACP-ACP Foundation Diabetes Initiative funded by Novo Nordisk ("ACP Launches Diabetes Guides for Patients and Practitioners," see page 1).
Clancy encourages providers to engage patients who ask questions.
"The currency of our work with patients every day is information and
communication," she says. 
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DOC News 2007 4: 1-21.
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| DOC News | Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |
