Town Hall Meeting at the 2007 AHRQ annual meeting

Transcript of the question-and-answer (Q&A) session with the panelists at the public meeting at the 2007 AHRQ annual meeting.

Carolyn Clancy:

Well thanks to an amazing panel, but now we get to the page where you need to ask questions. I have to tell you all, the Ministry knows that we are writing these times for those who wish to register for this conference and we will say, “Not this year, but stay tuned for our AHRQ. -A -Palooza. So each of the researchers asked a question.

As you gather your thoughts, let me share a few things that I heard. First off, Dan, I mean, maybe you’re giving the simplest definition here, “touch up in splendor” and “wonderfully mediocre”. I think these are the phrases that should really be used on a full track. I think we heard some really important topics about social cohesion, cognitive skills, and information, cognitive skills as well as one of the challenges. I think we all understand that clients and working patients can be groundbreaking, but of course, it is misleading to involve people in the problem and have the information they can access and understand. We hear a lot, especially from Tom, about the power of learning. I think we also heard these five people talk about their ability to say, “Well, there’s no way, but we’re going to do the same thing. I think this is an experience that most of us will share, and I think the next big change we’re trying to figure out is how to wire some of this, so Jeff, it’s my best interest time, time, it seems to have happened outside of our system, the question is, “How is this type of business capital ultimately?” Because it’s our business.

I’ve seen a lot of people standing so I’m going to turn the microphone on here. If you can identify yourself.

Barbara Fahmy:

Hello, my name is Barbara Fahmy. He was with the Colorado Department of Labor. And I have to stand on tiptoe a bit here. I have a suggestion for a Marriott spokesperson … I’m sorry I didn’t get your name. [DR. Clancy: Jill Berger.] No? [DR. Clancy: Jill Berger.] Suggestions my advice is that when hiring new employees, try to see each employee as someone who can be patient, as well as the work process when people are very enthusiastic. Watch your work and watch, find simple preventative measures for something like this to take care of yourself so that you can take care of it yourself. For example, problems like overeating. When you go to the doctor or nurse, it’s a good idea to have a list of questions and answer them. Handicap training to lift successfully and demonstrate the ability to lift successfully. This can be great for the hotel staff. And not just where to go if you injure yourself at work, but what should you do? What does the incident look like? What should I report? When this injury etc did it happen? So this can be a great way to attack it first. So this is my suggestion.

Jill Berger:

Super suggestion, thank you.

Ann Barber:

Hi, I’m Ann Barber from Providence Hospital. Thanks for what you say about understanding, but can you give us some tips to get us started? For example, there are Asian ideas about the face mask, as well as me and about how to do it, how I can protect myself. Any manifestation of anger, and how does this help anyone understand the value of clear understanding? Many Thanks.

Carolyn Clancy:

Dan?

Dan Varga:

This is a great question and I think I speak on behalf of some members of the local community. After planning this in the two areas I worked in, we took on the health workers. The first thing we clarified was that no one was telling a related story and health was a team game.  It is a combination of medical treatments and complex systems of capital and technology that are brought together by industry and others. It will be a collective story.  No one is notified. To be fair, to be honest, since we didn’t have to use a lot of IDTs in either case to create the report, we had to add the data capacity to meet the needs of nurses and doctors, doctors asking questions about them have personal data so they can see and see how they fit together, how they can help increase overall performance. So I think the first thing we do is make it clear that we are dealing with a collective. So there is no “blame” here.

The other is to make sure we understand that we are not selecting an organization for any type of job or performance. Nile Everything we do must be descriptive. What I’m saying, I can tell you that you went through the mask – to deal with that initial fear – it’s easy when you sit back and check that you have Safety Profile n. 13 AHRQ and after sepsis.= times higher than the country. Mmadụ People are uncomfortable with this, but there is also a quick fix to improve the show don’t do anything with it.

Carolyn Clancy:

Over here on this microphone.� Yes.

Joe Carter:

Hi, I’m Joe Carter from Vanguard in Boston and I’m sad to see Dr. Varga asking questions here, but that part, to get what other meetings don’t expect, is to achieve that kind of understanding others who are not investigating the demands of the game or anything else in it, is understanding happening? And second, did it inspire you with the best motivation and performance across the board?

Dan Varga:

Of course, I’ll stick with both. I think we’ve all seen the issues with unintended consequences in public coverage, and now that we’ve got to look at the basics, let’s look at antibiotics for pneumonia and the schedule for them. , and so on, but … one of the reasons, to be honest, I think we did the great report was not to say it again, but it keeps you from moving up to a higher level hiring, it was necessary to manage the main indicators. And I think what we ultimately find out with this is that you need to develop some skills by looking at this great metric setup and figuring out how these things are mapped out and where you can get the most benefit from them. And I think it brings a lot more to the process level than to the indicator level. So I think the big report helped us avoid that. Session. We had a cardiovascular disaster in St. Louis and some of the large groups exploded, so we had to “hire” our cardiovascular surgeons to keep the program together. This is a cardiac program of around 1,000 per year, but we receive 50% of the compensation for this cardiac surgery group based on their performance against the STS database and their performance in-house. I haven’t seen a lot of rejection on this. I think this database is very convenient and people are using it well. I think we’re going to see incredible improvements in our cardiovascular surgery program there, but yeah, I think you can reduce that pretty quickly.

Carolyn Clancy:

Here?

Perry Cohen:

Many Thanks. My name is Perry Cohen and I am part of the Parkinson Pipeline Project, local patient advocacy. I’m also a member of the Evidence-Based Health Care Working Group, a coalition of 45 patient organizations that want to get involved in health research and some of the things you talk about. I am grateful to Carolyn for her patient support and, of course, patients as research participants are at the heart of the development of clinical research. But we are more than rats, so we want to be at the table when politics and decisions are made. My question is about the use of information technology for self-help and patient empowerment, and one of the speakers was from Medicaid and mentioned the rebellious population. I want to ask if you think this population group would be prepared or how you would like to approach the issue of IT support for this population group as they may not have a computer or access to the internet or certain things that those of us who those we have empowered have ourselves. Thanks to the internet, have fun with it. Many Thanks.

Carolyn Clancy:

Tom?

Tom Kline:

Well, talking about IT in relation to members is certainly a difficult situation and a challenge for the Medicaid population. When we launched our first disease management program, Asthma, we identified approximately 2,500 members whom we believed were our highest risk, hospitalized, or had emergency room visits, and of those 2,500, we were unfortunately only able to reach about 300 because the phones were available for our population, they were not necessarily the Internet. We tried to write them and wrote 1000 letters and got 18 responses, so communication is a very, very difficult situation for us. Internet: We have an electronic Medicaid in the Medicaid office, a registration system developed in which we provide information to providers. It is not currently available to members, but that would be one of the next steps we would like to take.

Did you really mention anything about behavior problems?

Perry Cohen:

Did I?

Tom Kline:

Well, our behavioral health provider is an offshoot of the Medicaid program and we have access to appointment information, but not necessarily information about behavioral health use. In our particular group of members, I don’t see information technology from a patient or a member’s perspective as a major issue right now.

Perry Cohen:

Okay—thanks.

Carolyn Clancy:

I think I just want to add one based on part of the work that we have funded for people with certain conditions that they need information about and when they are being actively treated. Certainly, we have financed many centers that have welcomed and registered people very similar to their population; People who did not have their own computer, people who often did not have a telephone, etc. But if you are being actively treated for HIV, for example, you are encouraged to participate, so it seems to work in isolation and specific to each project. I think we need to differentiate between an approach that we know can work in, at least in some circumstances, and an evolutionary approach in which everyone realizes that it is part of being informed about their care, and also becoming

Tom Kline:

One of the things we tried was to get our health department to be present in 98 or 99 counties in Iowa and have internet access as well We tried to develop a tool to assess health risks for everyone, and the strategy was regional directorates for involve public health and educate patients about public health so that they can access the internet and information.

Carolyn Clancy:

Thank you. One more question?

Maureen Street:

Hello. My name is Maureen Street, I am the Medical Director of Michigan Community Health Center and I have a question for Dr. Kline. Can you comment on the impact Medicaid HMOs, specifically the Medicaid HMO Benefit, have on your ability to handle cases?

Tom Kline:

Sure. HMOs in the state of Iowa does not have a strong presence. A few years ago we had three managed care organizations serving the Medicaid population and there were about 15,000 total members with about 5,000 members Again, this is a collaborative situation I know the medical director of Medicaid Managed Care very well, and when we launched our disease management program we included many elements of the disease management program so that it was no different and the people Medicaid was constantly caring for Unfortunately or fortunately managed in primary care with the exception of our case management program Care isn’t a big deal in Iowa.

Maureen Street:

Thank you.

Carolyn Clancy:

Well, I am sure you all share my sense of inspiration and I can’t wait to run and catch up on some of the efforts we have heard about here. So I hope you will join me in thanking the panel for such an excellent conference.