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G Committee Biographies JEROME H. GROSSMAN, M.D., chairing and CEO of New England Medical Center MEMO, has been involved in health care for more than 25 years as a clinician, administrator, reformer, and distinguished health policy researcher. In addition to his position at NEMC, he is professor of medicine at Tufts University School of Medicine. Dr. Grossman received a B.S. degree from the Massachusetts Institute of Technology in 1961, and his MD from the University of Pennsylvania School of Medicine in 1965. He joined the staff of Massachusetts General Hospital in 1966, where he served in a variety of positions including director of Ambulatory Care and assistant professor of medicine at Harvard Medical School. Dr. Grossman Caine to NEMC as president in 1979 and became chairman of its holding company in 1984. He has been active in the HMO movement as an original staff member of Harvard Community Health Plan and a founder of the Tubts Associated Health Plan. Nationally Dr. Grossman has been an active voice for health care reform, holding several leadership positions in the Association of American Medical Colleges' the Council of Teaching Hospitals, the Academic Medical Center Consortium, and the Institute of Medicine. In 1988 he founded The Health Institute at NEMC to pursue research and development of initiatives to improve the organization and financing of medical care to achieve better health outcomes. In addition to his health care activities, Dr. Grossman is very involved in social and economic issues, including jobs and education. ROBERT A. BERENSON, M.D., F.A.C.P., is a board-certified internist in private group practice in Washington, D.C. (currently on leave). Prior to starting his medical practice in 1981, Dr. Berenson, a graduate ofthe Mount Sinai School of Medicine, spent 3~/2 years on the Carter White House Domestic Policy staff, initially as a Robert Wood Johnson Foundation Clinical Scholar. At the White 157

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158 SETTING PRIORITIES FOR CLINICALPRACTICE GUIDELINES House, he worked on national health policy issues, including hospital cost containment and national health insurance. Dr. Berenson recently served as co- chair of two working groups as part of the Clinton White House Task Force on Health Reform, one on malpractice reform, the other on the structure and function of accountable health plans. He was also an advisor to the transition team and was primarily responsible for the transition papers on quality of care and malpractice reform. While practicing, Dr. Berenson has become involved in managed care organization development. With two others, Dr. Berenson helped found National Capital PPO (NCPPO) in July 1987, and is a member of its Board of Directors. NCPPO serves about 150,000 people in the Washington, D.C., area. He has served as co-~nedical director since its inception, and is responsible for fee schedule development, repricing claims, physician recruitment and credentialing, and patient grievance review. On March 1, 1994, Dr. Berenson became national program director of the Improving Malpractice Prevention and Compensation Systems program, funded by the Robert Wood Johnson Foundation arid located in the Center for Health Policy Studies at the Georgetown University School of Medicine. The program will award grants for the demonstration and evaluation of innovative approaches to preventing negligence and compensating injured patients. Dr. Berenson has served as a panel member on three Institute of Medicine studies and currently serves on the health and public policy committees of the American College of Physicians and in that capacity helped author its position on health care reform. He is on the editorial board of Health Affairs. CATHERINE BORBAS, Ph.D., has a doctorate in social science research and a master's degree in public health. She has 22 years of health care experience, 15 years involved in quality of care evaluation. Dr. Borbas has been responsible for building two hospital quality of care consortiums, the Pediatric Cardiac Care Consortium (31 hospitals) arid the Minnesota Clinical Comparison and Assessment Program (53 hospitals). Dr. Borbas is executive director of the Healthcare Education arid Research Foundation (HERF) act independent nonprofit applied research organization in St. Paul, Minnesota. Since 1989, HERF has developed clinical guidelines, undertaken outcomes research, and has fedback information to 53 Minnesota hospitals. Funding for HERF involves a combination of grants and consultants' fees frown local health plans, hospitals, and medical staffs. HERF is the sole subcontractor to the Harvard Medical School for grants from the Agency for Health Care Policy and Research (AHCPR) and the National Cancer Institute, and also has received funding from the Hartford Foundation, Pew Charitable Trusts, arid the Bush Foundation. Dr. Borbas has published extensively and given numerous presentations on guideline application and outcome ~na~agement. She has been involved in several AHCPR workshops on guideline-related issues.

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APPENDIX G 159 FRANCIS J. CROSSON, M.D., is associate executive director of the Permanente Medical Group, a professional corporation of 3,500 physicians in Northern California that serves the 2.5 million members of the Kaiser Permanente Medical Care Program. Dr. Crosson is responsible for health care quality, utilization management, medical legal affairs, research, and government relations activities. He received his undergraduate degree in political science and his M.D. from Georgetown University. He completed a residency in pediatrics at Tufts-New England Medical Center and a fellowship in infectious diseases at the Johns Hopkins University Hospital. Dr. Crosson has been with Kaiser Permanente for 17 years. He serves as a member of the Board of Directors of the Kaiser Permanente Insurance Company. He is a member of the California Academy of Medicine and the California Medical Association Council on Legislation. He is currently a member ofthe Steering Committee ofthe National Committee for Quality Assurance Quality Report Card Pilot Project. SHELDON S. GREENFIELD, M.D., is act internist, having completed his residency at the Beth Israel Hospital in Boston, where he began to work on clinical algorithms for nurse practitioners in the early 1970s. His pioneering research on guidelines has been not only for nurse practitioners, but also for use in quality of care assessment by chart audit, and most recently for physicians. With his Boston colleagues, he performed a series of randomized, controlled trials using algorithms comparing nurse practitioners to physicians with respect to patient outcomes. He then turned to quality of care measurement, devising a method called "criteria mapping," which applies branching logic and decision~naking to retrospective chart review, again using outcomes to validate the method. In recent years, he has been working with others to increase patients participation in care using patient-oriented guidelines, and again, using outcomes to determine the value of that participation. He is currently medical director of the Medical Outcome Study, which seeks to compare systems of care, specialties, various aspects of interpersonal care, arid resource use to outcome, and, in that position, he has become one of the leading clinician outcomes researchers in the country. He is principal investigator of the Type II diabetes Patient Outcomes Research Team. He was chairman of the Quality of Care Committee at UCLA for some years, and was a codirector for the RAND UCLA Center for Health Policy Study. He is former president of the Society of General Internal Medicine. He just finished a 4-year tenure as chairman of the Health Care Technology Study Section for the Agency for Health Care Policy and Research. DAVID H. GUSTAFSON, Ph.D., is a professor of industrial engineering and preventive medicine arid founder of the Center for Health Systems Research and Analysis at the University of Wisconsin-Madison. He is a member of the board of the Institute for Health Care Improvement, an organization dedicated to the promotion of quality management in health care. His quality management research has produced a new strategy for understanding customer needs (now

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160 SETTING PRIORITIES FOR CLINICAL PRACTICE GUIDELINES being applied in a nationwide study of long-ter~n-care patient and family needs), a methodology for measuring and explaining the total burden of illness, an analysis of quantitative evidence of total quality management (TQ~ effectiveness, and the development of a computer systems that currently links 77 health care organizations in the United States, Canada, and Australia in their efforts to implement quality management. Using TQM he developed a computer system (CHESS) for use by people in crisis that has been shown to improve the health status and reduce the healthcare costs of people with AIDS. Studies of its impact on breast cancer patients are in process. Dr. Gustafson directed Wisconsin's Medicaid Management Study Team and redesigned the Long Term Care Regulatory System in Wisconsin. He developed the Quality Assurance Index (QAI), a method for measuring quality of care in nursing hones that has demonstrated reliability and utility. The QAI has been used to measure quality in nearly 200 nursing homes. He is helping a consortium of major employers and payers to develop a system to e used by employees with aging parents to identify and gain access to high-quality nursing homes across the United States. Dr. Gustaison has been a keynote or plenary speaker at several conventions, is the author of over 100 research articles arid books, and is an advisor on several Federal healthcare policy studies. WILLIAM L. MEDD, M.D., is in the full-time practice of general internal medicine in Norway, Maine. He has been in this practice for the last 20 years with four other associates. In addition to his practice, he is chairman of the Claims Committee of Medical Mutual Insurance Company of Maine a physician-owned malpractice carrier. He has been in this position for the last 15 years. He is involved with the American College of Physicians (ACP) and is the current governor for the Maine Chapter. He serves on the National ACE community-based teaching task force. CHRISTINE MIASKOWSKI, R.N., Ph.D., F.A.A.N., is an associate professor and interim chair in the Department of Physiological Nursing at the University of California, Sail Fral~cisco. She has extensive clinical experience in oncology nursing aloud pain management. Dr. Miaskowski's research focuses on understanding mechanisms of opioid-induced analgesia using a rat model, as well as clinical studies focusing on the ~nanagement of pain in oncology patients. She served as a member of the Agency for Health Care Policy and Research (AHCPR) expert panels to develop the Acute Pain Management Guideline and the Cancer Pain Management Guideline. In addition, Dr. Miaskowski served on the AHCPR Workgroup to develop a methodology to translate clinical practice guidelines into medical review criteria, performance measures, and standards of quality. WILLIAM L. ROPER, M.D., M.P.H., is senior vice president and chief medical officer of the Prudential Health Care System. He has overall responsibility for the company's health care operations arid research activities, including the areas of quality improvement, teclu~ology assessment, customer

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APPENDLY G 161 research, information management, and utilization management. Dr. Roper was president of the Prudential Center for Health Care Research from August 1993 to November 1994. Before coming to Prudential he was director of the Centers for Disease Control and Prevention from 1990 until 1993. He previously served as deputy assistant to the President for domestic policy and director ofthe White House Office of Policy Development in 1989 arid 1990. He was administrator of the Health Care Financing Administration (responsible for Medicare and Medicaid), Department of Health arid Human Services, from 1986 to 1989. Earlier, Dr. Roper served in the White House as special assistant to the president for health policy from 1983 to 1986. Dr. Roper received a B.S. form the University of Alabama in 1970, an M.D. from the University of Alabama School of Medicine in 1974, and an M.P.H. from the University of Alabama at Birmingham School of Public Health in 1981. He completed a residency in pediatrics at the University of Colorado Medical Center in 1977. He is board certified in pediatrics (1979) arid in preventive medicine (1982~. LOUISE B. RUSSELL, Ph.D., is research professor of economics and chair of the Health Care Policy Division in the Institute for Health, Health Care Policy, and Aging Research, Rutgers University, and professor in the Department of Economics. Her major area of research is the economics of medical care, especially cost-effectiveness analysis of medical interventions. Before joining the Rutgers faculty in August 1987, Dr. Russell was a senior fellow at the Brookings Institution for 12 years. Dr. Russell has served on a number of advisory groups. She currently co-chairs the Cost Effectiveness Pastel on Clinical Preventive Services of the Department of Health arid Human Services. She served on the Institute of Medicine's Committee on Clinical Practice Guidelines (1990-1991), Committee to Advise the Public Health Services on Medical Practice Guidelines (1990), and the Committee for the Study of the Future of Public Health (1986- 1987~. She was also a member of the U.S. Preventive Services Task Force of the Department of Health and Human Services (1984-1988~. Dr. Russell is a member of the Institute of Medicine. She received her undergraduate degree from the University of Michigan and her Ph.D. in economics from Harvard University. RICHARD N. SHIFFMAN, M.D., M.C.I.S., is an assistant professor of Pediatrics at Yale School of Medicine and a member of the faculty of Yale's Center for Medical Infonnatics. His research has centered on issues related to the development and implementation of clinical practice guidelines and the use of guidelines knowledge for computer-assisted medical decisiomnaking. Before coming to Yale, Dr. Shif&al~ practiced primary care pediatrics in Arvada, Colorado, for 12 years. He served as chief of the Department of Pediatrics at Lutheran Medical Center in Wheatridge, Colorado, and as a member of the Medical Board of the Children's Hospital in Denver. Dr. Shiffman is a member of the Executive Committee of the Section on Computers and Other Technology

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162 SETTING PRIORITIES FOR CLINICALPRACTICE GUIDELINES of the American Academy of Pediatrics. He received his baccalaureate and medical degrees frown the University of Pennsylvania and trained in pediatrics at the Children's Hospital of Philadelphia, the James Whitcomb Riley Hospital for Children in Indianapolis, and the University of Colorado Health Sciences Center. Dr. Shiffman received a master of Computer Infonnation Systems degrees from the University of Denver and trained in medical informatics at the Harvard-MIT Health Sciences Technology Program. LINDA JOHNSON WHITE is director, Department of Scientific Policy of the American College of Physicians, in Philadelphia. She oversees the policy development and research activities of the College, including the clinical privileges project, quality assurance, medical ethics, adult immunization initiatives, other health promotion/disease prevention programs, arid activities in geriatrics, health care organization arid financing. In 1982, when Ms. White became research associate to the Clinical Efficacy Assessment Project of the ACE, she was instrumental in establishing Ellis program as the premiere private sector technology assessment and practice guideline activity in the country. Originally with the Council of Medical Specialty Societies in Lake Forest, Illinois, Ms. White developed Council policies on the Impaired Physician, Consultations, Criteria for Interpreting CT Scans, Guidelines for Physician Advertising, and Effective Peer Review. Ms. White's involvement in medical practice guidelines development began with the initiation of the Medical Necessity Project by the Blue Cross arid Blue Shield Association and the formation of process arid procedures for the Council of Medical Specialty Societies program on Clinical Procedure Review in 1976. She has served on guideline study committees of the Institute of Medicine and is a frequent advisor to other societies that are developing guideline activities. Ms. White is a graduate of Northwestern University.