National health groups team up for quality
Three major health organizations, the American Cancer Society, American Diabetes Association and American Heart Association/American Stroke Association, have collaborated to create a quality improvement program aimed at improving outpatient care nationwide. Working with electronic health records providers from around the country, the program will provide doctors with the ability to easily gather, access and report on important data that can ultimately lead to improved care and outcomes for patients.
The program, called The Guideline Advantage, targets four of the 10 leading causes of death in the United States today, according to the Centers for Disease Control and Prevention – heart disease, cancer, stroke and diabetes.
Modeled after the American Heart Association/American Stroke Association's Get With The Guidelines quality suite of programs, the program was first launched in 2009 as Get With The Guidelines-Outpatient, and focused on cardiovascular health. Now, as The Guideline Advantage, the program provides the basis for evaluating and improving outpatient treatment for ? and prevention of ? these four diseases, which share many similar risk factors.
The Guideline Advantage measures and compares the quality of care given by doctors and other healthcare providers in practices and clinics outside the hospital setting. The goal is for providers to implement the evidence-based guidelines for caring for patients who have or who are at-risk for these conditions, and help improve the way they provide that care. Through the use of electronic health records, the program will also develop a rich database of information for future heart disease, stroke, cancer and diabetes research.
"The bulk of healthcare in this country is not at hospitals, but rather in the community, at doctors' offices and clinics," said Vincent Bufalino, M.D., the American Heart Association/American Stroke Association's liaison and steering committee chair of The Guideline Advantage.
"In the case of The Guideline Advantage, 'outpatient' refers to the world of office-based medicine, provided by general practitioners, internists, geriatricians, cardiologists, neurologists, oncologists, endocrinologists and the list goes on," said Bufalino, president and CEO of Midwest Heart Specialists in Suburban Chicago, a participating practice in The Guideline Advantage.
He believes that clinicians need a single set of evidence-based, broadly accepted guidelines.
"According to evidence-based guidelines, these are the assessments we should be making; the questions we should be asking; and the screenings we should be recommending," Bufalino said. "Research has proven that, when followed consistently, these guidelines can make a real difference in our fight against these leading killers."
There are tremendous gaps in care of people with diabetes said Carol Wysham, M.D., Chair of the American Diabetes Association Professional Practice Committee and associate clinical professor of medicine at the University of Washington in Spokane.
"Many patients are not reaching targets for control of glucose, lipids and blood pressure ? all of which are important for prevention of the devastating complications of diabetes," Wysham said. "To improve the care of their patients, clinicians need to have a way to measure their success at following guidelines."
She said The Guideline Advantage initiative will take information from clinicians' existing electronic health record data and measure performance against the American Diabetes Association's Standards of Care and similar evidence-based guidelines from the American Cancer Society and American Heart Association/ American Stroke Association.
"In this way, we can help clinicians assess the quality gaps in their practices, which, in turn, helps them identify opportunities to improve the delivery of care to their patients," Wysham said.
"Fragmentation is the enemy to effective care. The public wants clear, consistent health messages," said Richard C. Wender, MD, The Guideline Advantage liaison and past president of the American Cancer Society.
"This extraordinary collaboration lays the groundwork to create unified messaging driven by top thought leaders from across the health spectrum," said Wender, alumni professor and chair of the Department of Family and Community Medicine at Thomas Jefferson University/Jefferson Medical College in Philadelphia. "Age-adjusted cancer mortality is falling; slowly but surely, we are making gains. A great deal of our progress can be traced directly to improvements in prevention and early detection."
Wender added that the program model works, because it allows clinicians to gauge their quality based on benchmark data.
The Guideline Advantage program is supported by Medtronic, Inc.