Consensus Statement on Electronic Health Predictive Analytics: A Guiding Framework to Address Challenges.

Context: The recent explosion in available electronic health record (EHR) data is motivating a rapid expansion of electronic health care predictive analytic (e-HPA) applications, defined as the use of electronic algorithms that forecast clinical events in real time with the intent to improve patient outcomes and reduce costs. There is an urgent need for a systematic framework to guide the development and application of e-HPA to ensure that the field develops in a scientifically sound, ethical, and efficient manner.

Objectives: Building upon earlier frameworks of model development and utilization, we identify the emerging opportunities and challenges of e-HPA, propose a framework that enables us to realize these opportunities, address these challenges, and motivate e-HPA stakeholders to both adopt and continuously refine the framework as the applications of e-HPA emerge.

Assessing Community Quality of Health Care.

Objective: To determine the agreement of measures of care in different settings-hospitals, nursing homes (NHs), and home health agencies (HHAs)-and identify communities with high-quality care in all settings.

Data Sources/study Setting: Publicly available quality measures for hospitals, NHs, and HHAs, linked to hospital service areas (HSAs).

Study Design: We constructed composite quality measures for hospitals, HHAs, and nursing homes.

Community factors and hospital readmission rates.

Objective: To examine the relationship between community factors and hospital readmission rates.

Data Sources/study Setting: We examined all hospitals with publicly reported 30-day readmission rates for patients discharged during July 1, 2007, to June 30, 2010, with acute myocardial infarction (AMI), heart failure (HF), or pneumonia (PN). We linked these to publicly available county data from the Area Resource File, the Census, Nursing Home Compare, and the Neilsen PopFacts datasets.

Analysis of early accountable care organizations defines patient, structural, cost, and quality-of-care characteristics.

Accountable care organizations (ACOs) have attracted interest from many policy makers and clinical leaders because of their potential to improve the quality of care and reduce costs. Federal ACO programs for Medicare beneficiaries are now up and running, but little information is available about the baseline characteristics of early entrants. In this descriptive study we present data on the structural and market characteristics of these early ACOs and compare ACOs' patient populations, costs, and quality with those of their non-ACO counterparts at baseline.

Hospitals on the path to accountable care: highlights from a 2011 national survey of hospital readiness to participate in an accountable care organization.

Accountable care organizations (ACOs) are forming in communities across the country. In ACOs, health care providers take responsibility for a defined patient popu­lation, coordinate their care across settings, and are held jointly accountable for the quality and cost of care. This issue brief reports on results from a survey that assesses hospitals' readiness to participate in ACOs.

Sharing resources: opportunities for smaller primary care practices to increase their capacity for patient care. Findings from the 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.

Most Americans get their health care in small physician practices. Yet, small practice settings are often unable to provide the same range of services or partici­pate in quality improvement initiatives as large practices because they lack the staff, infor­mation technology, and office systems. One promising strategy is to share clinical sup­port services and information systems with other practices.

Measure, learn, and improve: physicians' involvement in quality improvement.

Payers, accreditors, and consumers are using quality improvement (QI) methods, but little is known about whether physicians do so. The results from this 2003 national physician survey indicate that most do not. Physicians do not routinely use data for assessing their performance and are reluctant to share those data.

Obtaining greater value from health care: the roles of the U.S. government.

The problems of quality and cost in the U.S. health care system are unlikely to be solved without strong leadership from the federal government, which can mobilize action to set national priorities for quality; develop and promulgate standards for care; and stimulate implementation of performance measures and standards for providers.