• Obtaining the best available comparative information on safety, effectiveness, and availability of care and providers, and using that information to guide treatment decisions.

  • Maximizing patient decision making and involvement in the selection of treatments and providers.

The infrastructure needed to measure, analyze, publicly report, and improve the quality of M/SU health care is less well developed than that for general health care. As a result, there has been less measurement and improvement of M/SU health care than of general health care (AHRQ, 2003; Garnick et al., 2002). A related issue is that methods used to disseminate evidence-based practice to providers have not always been evidence-based themselves. To build a stronger infrastructure to support the delivery of high-quality care, the committee recommends a five-part strategy: (1) more coordination in filling gaps in the evidence base; (2) a stronger, more coordinated, and evidence-based approach to disseminating evidence to clinicians; (3) improved diagnosis and assessment strategies; (4) a stronger infrastructure for measuring and reporting the quality of M/SU health care; and (5) support for quality improvement practices at the sites of M/SU health care.

Recommendation 4-1. To better build and disseminate the evidence base, the Department of Health and Human Services (DHHS) should strengthen, coordinate, and consolidate the synthesis and dissemination of evidence on effective M/SU treatments and services by the Substance Abuse and Mental Health Services Administration; the National Institute of Mental Health; the National Institute on Drug Abuse; the National Institute on Alcohol Abuse and Alcoholism; the National Institute of Child Health and Human Development; the Agency for Healthcare Research and Quality; the Department of Justice; the Department of Veterans Affairs; the Department of Defense; the Department of Education; the Centers for Disease Control and Prevention; the Centers for Medicare and Medicaid Services; the Administration for Children, Youth, and Families; states; professional associations; and other private-sector entities.

To implement this recommendation, DHHS should charge or create one or more entities to:

  • Describe and categorize available M/SU preventive, diagnostic, and therapeutic interventions (including screening, diagnostic, and symptom-monitoring tools), and develop individual procedure codes and definitions for these interventions and tools for their use in administrative datasets approved under the Health Insurance Portability and Accountability Act.

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