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Suggested Citation:"Appendix A: Glossary." Institute of Medicine. 2013. Toward Quality Measures for Population Health and the Leading Health Indicators. Washington, DC: The National Academies Press. doi: 10.17226/18339.
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A

Glossary

Accountable Care Organizations (ACOs): The Centers for Medicare & Medicaid Services defines ACOs as groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients. ACOs have come to hold an even broader meaning, referring to coordinating activities for health care and health for patients of all kinds (e.g., not just Medicare) and for communities in general, as described by the related concepts of Accountable Care Communities and Accountable Health Communities (Austen BioInnovation Institute, 2012; Magnan et al., 2012).

Healthy conditions: The committee used this term in reference to the Department of Health and Human Services (HHS) definition of quality in public health reference to “conditions in which people can be healthy,” denoting the determinants of health or factors influencing health. These also correspond to intermediate outcomes.

Healthy People 2020: An effort of HHS, Healthy People “provides science-based, 10-year national objectives for improving the health of all Americans. For 3 decades, Healthy People has established benchmarks and monitored progress over time in order to: encourage collaborations across communities and sectors, empower individuals toward making informed health decisions, and measure the impact of prevention activities.”1

Leading Health Indicators (LHIs): Twenty-six metrics organized by 12 topics that represent a key set in Healthy People 2020, drawn from the more than 1,200 Healthy People 2020 objectives.

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1 See http://www.healthypeople.gov/2020/about/default.aspx (accessed June 13, 2013).

Suggested Citation:"Appendix A: Glossary." Institute of Medicine. 2013. Toward Quality Measures for Population Health and the Leading Health Indicators. Washington, DC: The National Academies Press. doi: 10.17226/18339.
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Multisectoral health system: Refers to the array of sectors and entities that influence the health of the population through their activities, ideally in a coordinated manner, as a system, but in practice, operating through occasional and not always sustained collaboration. The system comprises public health agencies, health care delivery organizations, and parts of other sectors (e.g., businesses, schools) and the community (IOM, 2011a). After introducing the term, the report often shortens it to “health system.”

National Priorities Partnership: At the behest of HHS, the National Quality Forum (NQF) convened more than 50 public and private organizations in the National Priorities Partnership, which provides annual input to HHS on the implementation of the National Quality Strategy.

National Quality Forum (NQF): The Forum is a nonprofit membership organization that “operates under a three-part mission to improve the quality of American health care by

  • building consensus on national priorities and goals for performance improvement and working in partnership to achieve them;
  • endorsing national consensus standards for measuring and publicly reporting on performance; and
  • promoting the attainment of national goals through education and outreach programs”2

National Quality Strategy: In 2010, the Affordable Care Act charged HHS with developing a national quality strategy to “improve the delivery of health care services, patient health outcomes, and population health. After engaging both public and private stakeholders and collecting input, the National Quality Strategy was released in March 2011.”3

The nine aims or the nine characteristics: see Quality characteristics

Population health: The health of the public in a geopolitical location; see also Total population health

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2 See http://www.qualityforum.org/About_NQF/About_NQF.aspx (accessed June 27, 2013).

3Healthcare.gov factsheet: http://www.healthcare.gov/news/factsheets/2012/04/national-quality-strategy04302012a.html (accessed June 27, 2013).

Suggested Citation:"Appendix A: Glossary." Institute of Medicine. 2013. Toward Quality Measures for Population Health and the Leading Health Indicators. Washington, DC: The National Academies Press. doi: 10.17226/18339.
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Public health: In the report, this term refers to governmental public health agencies, also known as health departments, and to their work (public health practice and public health activities).

Public health quality: “The degree to which policies, programs, services, and research for the population increase desired health outcomes and conditions in which the population can be healthy” (Public Health Quality Forum, 2008).

Quality characteristics: Shorthand for the nine aims for improvement of quality in public health or characteristics to guide public health practices (Public Health Quality Forum, 2008).

Six drivers: The six priorities for quality improvement in public health (Honoré and Scott, 2010).

Three-Part Aim: The Three-Part Aim is the HHS adaptation of the Institute for Healthcare Improvement’s “Triple Aim,” and is a conceptual triad of (1) better care, (2) lower cost, and (3) healthy people/healthy communities; see also Triple Aim

Total population health: A term developed to distinguish the public health profession’s understanding of population health from the narrower interpretation of population health used in the health care delivery sector. Total population health refers to the population in a geopolitical area, while the term “subpopulations” can be used to describe the populations of patients or insured individuals to which practitioners in health care delivery refer.

Triple Aim: Improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of care.4

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4 See http://www.ihi.org/offerings/Initiatives/TripleAim/Pages/default.aspx (accessed June 13, 2013).

Suggested Citation:"Appendix A: Glossary." Institute of Medicine. 2013. Toward Quality Measures for Population Health and the Leading Health Indicators. Washington, DC: The National Academies Press. doi: 10.17226/18339.
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Suggested Citation:"Appendix A: Glossary." Institute of Medicine. 2013. Toward Quality Measures for Population Health and the Leading Health Indicators. Washington, DC: The National Academies Press. doi: 10.17226/18339.
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Suggested Citation:"Appendix A: Glossary." Institute of Medicine. 2013. Toward Quality Measures for Population Health and the Leading Health Indicators. Washington, DC: The National Academies Press. doi: 10.17226/18339.
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Suggested Citation:"Appendix A: Glossary." Institute of Medicine. 2013. Toward Quality Measures for Population Health and the Leading Health Indicators. Washington, DC: The National Academies Press. doi: 10.17226/18339.
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Suggested Citation:"Appendix A: Glossary." Institute of Medicine. 2013. Toward Quality Measures for Population Health and the Leading Health Indicators. Washington, DC: The National Academies Press. doi: 10.17226/18339.
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Page 98
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The Institute of Medicine (IOM) Committee on Quality Measures for the Healthy People Leading Health Indicators was charged by the Office of the Assistant Secretary for Health to identify measures of quality for the 12 Leading Health Indicator (LHI) topics and 26 Leading Health Indicators in Healthy People 2020 (HP2020), the current version of the Department of Health and Human Services (HHS) 10-year agenda for improving the nation's health.

The scope of work for this project is to use the nine aims for improvement of quality in public health (population-centered, equitable, proactive, health promoting, risk reducing, vigilant, transparent, effective, and efficient) as a framework to identify quality measures for the Healthy People Leading Health Indicators (LHIs). The committee reviewed existing literature on the 12 LHI topics and the 26 Leading Health Indicators. Quality measures for the LHIs that are aligned with the nine aims for improvement of quality in public health will be identified. When appropriate, alignments with the six Priority Areas for Improvement of Quality in Public Health will be noted in the Committee's report. Toward Quality Measures for Population Health and the Leading Health Indicators also address data reporting and analytical capacities that must be available to capture the measures and for demonstrating the value of the measures to improving population health.

Toward Quality Measures for Population Health and the Leading Health Indicators provides recommendations for how the measures can be used across sectors of the public health and health care systems. The six priority areas (also known as drivers) are population health metrics and information technology; evidence-based practices, research, and evaluation; systems thinking; sustainability and stewardship; policy; and workforce and education.

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