AAFP SAMs or other Modules

[Guest guest]

Hi JimLet's communicate off line to follow through.For all - attached is Wasson's recent description of HYH validation. He's cited the HYH studies on the site and I'll copy & past the bibliography to the end of this email.Gordon

Clinical Development and Testing:

[A] EC, Landgraf JM, Hays RD, Wasson JH, Kirk JW. The functional

status of patients: How can it be measured in physicians' offices? Med

Care 1990;28(12):1111-1126.

EC, Wasson JH, DJ, Hays RD. Dartmouth COOP

Functional Health Assessment Charts: Brief Measures for Clinical

Practice. In: Spilker B, ed. Quality of Life and Pharmacoeconomics in

Clinical Trials. Philadelphia: Lippincott-Raven. 1996:161-168.

[C} Wasson JH, Jette AM, DJ, Mohr JJ, EC. A Replicable

and Customizable Approach To Improve Ambulatory Care and Research. J

Ambulatory Medicine 1997;20(1); 17-27.

[D] Wasson JH, Stukel TA, Weiss JE, et. al. A Randomized Trial of Using

Patient Self-Assessment Data to Improve Community Practices. Effective

Clinical Practice 1999; 2:1-10.

[E] Bronfort G, and Bouter LM. Responsiveness of general health status

in chronic low back pain: a comparison of the COOP Charts and the

SF-36. 1999 Pain 83; 201-209

[F] Wasson JH, Jette AM, J, et.al. Routine, Single-Item

Screening to Identify Abusive Relationships in Women. J. Fam. Pract.

2000;49:1017-1022.

[G] Ahles TA, Seville J, Wasson JH, et.al. Panel-Based Pain Management

in Primary Care: The Journal of Pain And Symptom Management 2001: 22,

584-590.

[H] LG, Wasson JH. An Introduction to Technology for

Patient-centered, Collaborative Care. J Ambulatory Care Manage. 2006;

29(3): 195-198.

Wasson JH, DJ, R, J, et al. Patients

Report Positive Impacts of Collaborative Care. J Ambulatory Care

Manage. 2006; 29(3): 199-206.

[J] Wasson JH, Ahles T, D, Kabcenell A, etal. Resource Planning

for Patient-centered Collaborative Care. J Ambulatory Care Manage.

2006; 29(3): 207-214.

[K] LG, Wasson JH, DJ, Zettek J. The Emergence of Ideal

Micro Practices for Patient-centered, Collaborative Care. J Ambulatory

Care Manage. 2006; 29(3): 215-221.

[L] Wasson J, R. Postscript. Health Disparity and

Collaborative Care. J Ambulatory Care Manage. 2006; 29(3): 233-234.

[M] Wasson J. Technical Notes. When All Things Are Not Equal. J

Ambulatory Care Manage. 2006; 29(3): 235-237.

[N] Ahles TA, Wasson JW, Seville JL, DJ, etal. A Controlled

Trial of Methods for Managing Pain in Primary Care Patients With or

Without Co-Occurring Psychosocial Problems. Ann. of Family Med 2006;

4(3): 341-350

[O] LG and Wasson JH. Ideal Medical Practice: Improving

Efficiency, Quality, and the Doctor- Patient Relationship. Family

Practice Management. 2007; September: 21-24.

[P] Wasson JH, Mackenzie TA, Hall M. Patients Use an Internet

Technology to Report When Things Go Wrong. 2007 Quality and Safety in

Health Care; 2007:16:213-217.

[Q] Wasson JH, DJ, and Macknezie T. The Impact of Primary

Care Patients' Pain and Emotional Problems on their Confidence with

Self-Management. Jamb CareMngmnt. 2008;31: 120-127.

[R] Wasson JH. Who is in charge? Even affluent patients suffer

consequences of fragmented care. JAmb CareMngmnt. 2008;31: 35-36.

Guinn N and LG. Practice Measurement: A new approach for

demonstrating the worth of your work. Family Practice Management 2008:

Feb. 19-22

[T] Wasson JH, DJ,

and Mackenzie T. The Impact of

Primary Care Patients' Pain and Emotional Problems on their Confidence

with Self-Management. Jamb Care Mngmnt. 2008;31: 120-127.

Wasson

JH, Bartels S. CARE Vital Signs Supports Patient-Centered Collaborative

Care. Jamb Care Mngmnt. 2009;32: 56-71.

[V] Wasson JH, Baker NJ.

Balanced Measures for Patient-Centered Care. Jamb Care Mngmnt. 2009;32:

44-51

[W] Yasaitis

L, Fisher ES, Mackenzie T, and Wasson JH. Health Care Intensity is

Associated with Lower HealthCare Quality by Adults. J.AMB.CARE.MGMT.

2009; 32: 226-231

[X] Wasson JH, R,

D, LG, and Mackenzie T. Patient Use the Internet to Enter

the Medical Home. J.Amb.Care.Mgmt. 2011; 34:38-46 32: 299-302. Community/School

Development and Testing:

[A] Wasson JH, Kairys SW, EC, Kalishman N, Baribeau P. A short

survey for assessing health and social problems of adolescents. J Fam

Prac 1994; 38(5):489-494.

Bracken AC, Hersh AL, DJ. A Computerized School-Based

Health Assessment with Rapid Feedback to Improve Adolescent Health.

Clin. Pediatrics 1998;677-683.

[C] Wasson JH, C. Implementation of a Web-based Interaction

Technology to Improve the Quality of a City's Health Care. J. Amb. Care

Managem. 2001;24: 1-12

[D] Luce P, J, R, Wasson JH. Technology to Support

CommunityHealth Alliances. J. Amb. Care Managem. 2004;27: 399-407

Examples of a few key

references can be downloaded and read in PDF format.

View references in support of HowsYourHealth

use in practice

Problem

Solving effectiveness and its fit into

Patient-Centered

Collaborative Care.

Gordon,

I got some response to my questions about hyh as part IV. Two things. Mike says that they were working with Starfield before she died, to determine how to create a part IV, and they want to know if HYH is validated. Secondly, there is a big push to create self-directed improvement modules by the end of the year, so I believe there is reason to think this could happen. Give me more information on validation, and whether you were thinking about this would work as a module. I will pass it on.

________________________________________

From: [ ] On Behalf Of L. Gordon [gmoore@...]

Sent: Tuesday, August 09, 2011 12:36 PM

To:

Subject: Re: AAFP SAMs or other Modules [1 Attachment]

A more important underlying issues is the degree of match between current data sets and overall outcomes.

Most quality measurement focuses on disease and organ systems. This approach can lead to rewarding improvements in organ system management but often fail to address more important outcomes. The hypothesis that disease management translates to overall improvement in care delivery has not been demonstrated. Moreover, there is a wealth of evidence that overall population health improvement is based on good primary care delivery. This is not the same thing as disease management, and in fact our continued quality emphasis on disease states and organ systems keeps our focus narrow while we miss the big picture.

Primary care is defined as the presence of four cardinal components:

First point of contact (access)

Person-focused relationship over time

Comprehensive services

Care coordination

When done well, population health outcomes improve, disease states improve, patient experience improves, total cost of care improves.

The ABFM can help the country re-orient measurement to focus on what really matters. Barbara Starfield laid this out very well in her FPM editorial of 2009<http://www.aafp.org/online/en/home/publications/journals/fpm/opinion.html>.

We don't give up measuring things like A1c, pneumovax, etc, but we cannot let these small measures squeeze out measures of how well we deliver on primary care key performance indicators (access, person-focused relationship, comprehensiveness, care coordination).

The IMP self-assessment recognition program focuses on the broad themes, is accessible to small independent as well as large practices, and is much more aligned with the real value of primary care.

We should not continue to follow a broken paradigm just because it is familiar and touted by experts.

Gordon

1 of 1 File(s)

clinimetricshyhitems.doc

[Guest guest]

Please do resend. I believe it is somewhere in here, but I am no sure where.

From: [ ] On Behalf Of Lynn Ho [lynnhri@...]

Sent: Tuesday, August 16, 2011 6:38 AM

To: practiceimprovement1

Subject: RE: AAFP SAMs or other Modules

Jim

maybe it got lost in the sheer volume of emails that you receive, but I sent you an email with a few attachments showing how HYH would work as a module with demonstration numbers and

explaining the problem with validation " evidence based " as they term it on the application on the application, and asking if you had any ideas as to how to phrase the evidence based parts of the application.

Let me know if I should re send.

thanks

Lynn Ho

To:

From: jim.kennedy@...

Date: Mon, 15 Aug 2011 22:16:39 -0600

Subject: RE: AAFP SAMs or other Modules

Gordon,

I got some response to my questions about hyh as part IV. Two things. Mike says that they were working with Starfield before she died, to determine how to create a part IV, and they want to know if HYH is validated. Secondly, there is a big push to create self-directed

improvement modules by the end of the year, so I believe there is reason to think this could happen. Give me more information on validation, and whether you were thinking about this would work as a module. I will pass it on.

________________________________________

From: [ ] On Behalf Of L. Gordon [gmoore@...]

Sent: Tuesday, August 09, 2011 12:36 PM

To:

Subject: Re: AAFP SAMs or other Modules [1 Attachment]

A more important underlying issues is the degree of match between current data sets and overall outcomes.

Most quality measurement focuses on disease and organ systems. This approach can lead to rewarding improvements in organ system management but often fail to address more important outcomes. The hypothesis that disease management translates to overall improvement

in care delivery has not been demonstrated. Moreover, there is a wealth of evidence that overall population health improvement is based on good primary care delivery. This is not the same thing as disease management, and in fact our continued quality emphasis

on disease states and organ systems keeps our focus narrow while we miss the big picture.

Primary care is defined as the presence of four cardinal components:

First point of contact (access)

Person-focused relationship over time

Comprehensive services

Care coordination

When done well, population health outcomes improve, disease states improve, patient experience improves, total cost of care improves.

The ABFM can help the country re-orient measurement to focus on what really matters. Barbara Starfield laid this out very well in her FPM editorial of 2009<http://www.aafp.org/online/en/home/publications/journals/fpm/opinion.html>.

We don't give up measuring things like A1c, pneumovax, etc, but we cannot let these small measures squeeze out measures of how well we deliver on primary care key performance indicators (access, person-focused relationship, comprehensiveness, care coordination).

The IMP self-assessment recognition program focuses on the broad themes, is accessible to small independent as well as large practices, and is much more aligned with the real value of primary care.

We should not continue to follow a broken paradigm just because it is familiar and touted by experts.

Gordon