vent individual patient identification, and any users violating data access policies should be subject to severe penalties.

NEED FOR APPLIED HEALTH SERVICES RESEARCH

Steps should be taken to ensure that the health services research agendas developed by the various government programs are complementary, address the needs of the populations served, and advance the capabilities of quality enhancement processes to promote excellence. Given its mission to coordinate the implementation of quality enhancement processes among the six government programs and its representative membership, the QuIC is well positioned to serve as the coordinating entity through which programs would provide input on the research and development agenda. AHRQ should staff the QuIC and provide the organizational locus of QuIC research activity.

RECOMMENDATION 8: The six government health care programs should work together to develop a comprehensive health services research agenda that will support the quality enhancement processes of all programs. The QuIC (or some similar interdepartmental structure with representation from each of the government health care programs and AHRQ) should be provided the authority and resources needed to carry out this responsibility. The agenda for FY 2003–2005 should support the following:

  1. Establishment of core sets of standardized performance measures

  2. Ongoing evaluation of the impact of the use of standardized performance measurement and reporting by the six major government health care programs

  3. Development and evaluation of specific strategies that can be used to improve the federal government’s capability to leverage its purchaser, regulator, and provider roles to enhance quality

  4. Monitoring of national progress in meeting the six national quality aims (safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity)

Formulation of the federal health services research agenda should address the immediate need of the QuIC to establish a core set of standardized performance measures. Efforts should be made to address methodological issues, especially those related to the assessment of quality at the small group or individual clinician level. Attention should also be focused on the design and pilot testing of alternative reporting formats tailored to the needs of various users.



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