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medical information systems to monitor patients and assist health care providers in diagnosing and treating illness.

The new agency continues to support investigator-initiated general health services research. This is a fundamental component of our mission. What sets AHCPR apart from its predecessor is an increased attention to clinical practice and medical effectiveness and an explicit legislative charge to promote improvements in clinical practice and the organization, financing, and delivery of services. This is reflected in our mandate to stimulate the development of clinical practice guidelines and to expand our dissemination activities.

We view the creation of the agency and its expanded mission as an opportunity to make quality assurance an important component of the Public Health Service agenda and to continue collaborative activities with the Health Care Financing Administration, other public and private organizations, and professional and consumer groups. The analyses and recommendations of the IOM report will be very instructive as we go about these tasks.

For the remainder of my time, I would like to review our Medical Treatment Effectiveness Program (MEDTEP) and discuss some planned research and demonstration activities that focus on quality measurement and improvement and on medical liability. MEDTEP, in particular, has already been the beneficiary of helpful guidance and counsel from the IOM. We hope to be able to call upon many of you both individually and collectively for future assistance.


AHCPR is responsible for implementing the Department of Health and Human Service's MEDTEP, which supports research to address fundamental questions about what difference medical care makes. Do patients benefit? What treatments work best? Are health care resources well spent? The goal of MEDTEP is to improve the effectiveness and appropriateness of health care services and procedures through a better understanding of the effects of health care practices on patient outcomes.

MEDTEP is built on studies conducted during the past two decades that reveal wide variations in the type and amount of health care provided to apparently similar patients. Those outcomes analyses, combined with evidence that providers will change their behavior when they are given pertinent information about practice patterns and patient outcomes, support the belief that more effective health care is achievable. Toward this goal, we are working collaboratively with other public and private entities to learn more about the effectiveness of health care and to put the results of that research into practice.

MEDTEP has four components. The first is health services research on the outcomes, effectiveness, and appropriateness of health care services and pro-

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