Thursday, June 17, 2010
1. Round table discussion
2. Discussion of Kairn's F31 proposal development for August submission
Lessons of the day:
- If you select the worst cases to study, you will see improvement no matter what the intervention. (Regression to the mean) RCTs avoid over-interpreting this improvement by comparing the amount of change between groups.
- Don't conflate marketing with evidence.
- Design research that answers the question you intend to ask.
Action for Kairn: evaluate the existing evidence for Fast ForWord intervention before deciding which question to ask.
Next Week: Run Charts (Control Charts) discussion led by Abby. Ben requests that all attending bring a sequence of measures over time for demonstration. Could be your weight, the temperature at noon... anything where the collection method was the same each time. The data could be in Excel or on a piece of paper!
Wednesday, June 16, 2010
AHRQ encourages published researchers to apply in two areas: Scientific Contributions and Policy Impact. Graduate students can only apply for the scientific contribution award.
Tuesday, June 15, 2010
From: Liz Chen
To: Liz Chen
Sent: Tue Jun 15 15:17:16 2010
Subject: Informatics Grand Rounds - Tuesday, June 29th 4PM-5PM
An inaugural "Informatics Grand Rounds" will be held on Tuesday, June 29th, 2010 from 4 PM to 5 PM in UVM/FAHC Medical Education Center Room 300. This monthly series is a joint initiative between the University of Vermont (Center for Clinical and Translational Science – Informatics Unit, Continuing Education, and Dana Medical Library), Fletcher Allen Health Care, and the State of Vermont.
Please feel free to forward the below announcement (or following URL) to others who may be interested:
If you have any questions or wish to be removed from this mailing list, please let me know (email@example.com or 802-656-8286).
INFORMATICS GRAND ROUNDS
"Bioinformatics and Health Informatics Across the State of Vermont"
Tuesday, June 29th, 2010
4:00 PM – 5:00 PM
UVM/FAHC Medical Education Center Room 300 (Reardon Classroom)
Indra Neil Sarkar, PhD, MLIS (University of Vermont)
James D. Michelson, MD (University of Vermont and Fletcher Allen Health Care)
Hunt Blair (Office of Vermont Health Access)
The University of Vermont (Center for Clinical and Translational Science – Informatics Unit, Continuing Education, and Dana Medical Library), Fletcher Allen Health Care, and the State of Vermont are pleased to introduce a monthly Informatics Grand Rounds series that will provide a venue for learning about concepts and activities across the spectrum of biomedical informatics, from bioinformatics to clinical informatics to public health informatics. This series will feature the latest research and applications in informatics by local, regional, national, and international speakers.
Biomedical Informatics has become a core element across the spectrum of biomedicine, from bench biology to medicine to public health. This transdisciplinary and integrative field combines biomedicine and health care with computer science, management and decision science, cognitive and social science, biostatistics, engineering, and information and communication technology. Recent national emphasis on personalized medicine, clinical and translational science, electronic health records, health care reform, public health surveillance, and global health has further highlighted the value and need for advancing informatics methods and applications.
In this inaugural session, the speakers will provide a brief history of biomedical informatics and its sub-disciplines (e.g., bioinformatics, clinical informatics, and public health informatics) and discuss the role of informatics in the context of: (1) Translational Medicine, (2) Electronic Health Records (EHR), and (3) Health Care Reform (specifically, Health Information Technology [HIT] and Health Information Exchange [HIE]).
Indra Neil Sarkar is Director of Biomedical Informatics at the Center for Clinical and Translational Science, Assistant Professor of Microbiology & Molecular Genetics, and Assistant Professor of Computer Science at the University of Vermont. His work is dedicated to furthering a biomedical informatics research agenda across the entire spectrum of biomedicine, from molecules to populations. Specific research involves the development and use of a range of computational techniques (including knowledge gathering and discovery methods, phylogenetics, information theory, ontology development, semantic indexing, and natural language processing) to facilitate the analysis and linking of molecular and public health data. Ultimately, Dr. Sarkar's research aims to enable the creation of testable models of disease and provide a framework to enable the assessment of comparative hypotheses across the spectrum of biomedicine and health care.
James D. Michelson is Professor of Orthopaedics and Rehabilitation at the University of Vermont, Medical Informaticist at Fletcher Allen Health Care, and a practicing Orthopaedic Surgeon. He has been a primary leader in the development and successful implementation of electronic health record systems at Johns Hopkins and Fletcher Allen Health Care. As the Medical Informaticist at Fletcher Allen Health Care, a large part of Dr. Michelson's responsibility is to identify and develop opportunities in clinical research using the EHR. His primary interests currently include developing effective surveillance methodologies for adverse medical events (including medication errors, post-surgical infections, and mortality), with the further goal of developing risk stratification models based on those data.
Hunt Blair is Deputy Director for Health Care Reform in the Office of Vermont Health Access. Active in Vermont health care and Medicaid policy since 1992, he joined the Douglas administration in January 2009 as Deputy Director for the Division of Health Care Reform in the Office of Vermont Health Access. The Division is also the state lead for HIT and HIE policy, planning, and oversight. Previously, Mr. Blair served as Vermont Director of Public Policy at the Bi-State Primary Care Association where he enjoyed "a front row seat" in the Vermont legislature for the creation and refinement of the state's landmark health care reform legislation. He continues to work closely with the legislature in his new role. The New England Rural Health Roundtable awarded Mr. Blair its Leadership Award in 2008 for his work on Vermont health care reform.
Monday, June 14, 2010
Present: Abby Crocker, Kairn Kelley (by phone), Rodger Kessler, Ben Littenberg, Carole McBride, Charlie McLean, Connie van Eeghen
1. Round Table: Following up on Rodger’s May 5 discussion about his upcoming study
2. Rodger’s Discussion:
a. The discussion focused on a figure to support questions of the perceptions regarding improvement in care and change in cost from the experiences of practice, patient, and system in making a change to the behavioral health access, identification, and treatment.
i. Inquiring into health status: can have a narrow interpretation, implying specific metrics
ii. Inquiring into outcomes: broad interpretation, includes clinical and cost changes. Past models agree on three basic groups from Peek (2008) and Berwick (2008):
4. Other candidates: patient centeredness, social justice…
b. What is the focus of our communication? It depends on the clarity of:
i. The Audience
ii. The Medium (e.g. graphic)
iii. The Message
c. Collaborative Care Metrics: how do the measures line up with the three perspectives listed above?
i. Access (needs specification)
1. Score distribution
2. % completing screens
3. % positive screens
4. disposition of docs when high score
5. 6 month follow up scores [code whether BH only or also CHT]
1. RVU’s month
2. distribution of time codes( type and length of visits)
3. payer mix
1. % ref'd out
2. % ref'd out where we have evidence of outside tx initiation
3. % ref’d out with evidence of communication from clinician
4. % with chronic disease co morbidity & distribution
5. prior treatment episodes
7. time from referral to 1st visit
8. average time between visits
9. no show rate
a. No show 1st appointment, no show by # of sessions
10. average # of sessions
v. From the three perspectives (per Charlie)
1. What was the patient experience
a. Number seen (characterize the population)
b. What was the intervention (staff, method, practice)
c. What was it like (perception)
2. Later: What are the trends over time
3. Much later: determine the details of costs and the population specific outcomes
vi. Analytic planning
1. What tool (EMR) and collection (data queries)
2. What assessment (run charts-with outcomes over time) based on numbers, scores, or numerators that can be turned into rates or ratios
3. What are the input values to DocSite
d. Next steps: Clean up the measures, present to Randy Messier, select best, find sources by 10/10
3. Next Fellows Meeting(s): Wednesday, 2:00 – 3:30 p.m., at Given Courtyard Level 4
a. June 16: Kairn – fellowship proposal for Aug submission (no Connie, Matt, Rodger, Amanda)
b. June 23: Abby: run charts (no Connie or Matt or Amanda or Kairn)
c. June 30: Rodger: mixed methods article (no Connie)
d. July 7: (no Abby)
e. July 14:
f. July 21: Carol – data collection/analysis (no Matt through Aug 21)
g. Future agenda to consider:
i. How to predict medical events effectively (Ben)
ii. Future: Review of different types of journal articles (lit review, case study, original article, letter to editor…), when each is appropriate, tips on planning/writing (Abby)
iii. Future: Informed consent QI: Connie to follow up with Nancy Stalnaker, Alan Rubin will follow up with Alan Wortheimer or Rob McCauly
iv. Kairn will ask a librarian to join us for selected issues
4. Fellows document – nothing this time – to be reviewed after trialing Wednesday meeting times, which started May 5, 2010.
Recorder: Connie van Eeghen
Sunday, June 13, 2010
From: Littenberg, Benjamin
Sent: Saturday, June 12, 2010 5:22 PM
To: CCTS Blog (firstname.lastname@example.org); Galbraith,
Richard A.; Peterson, Thomas C; Morin, Frederick C; Messier, Randall S.
Subject: CoNNECT Grant
Congratulations to Rodger Kessler and his colleagues from around the
country for being awarded an R24 grant from AHRQ. The project is called
CoNNECT (Collaborative National Network Examining Comparative
Effectiveness Trials) and includes UVM as well as the University of
Colorado, the American Academy of Family Practice, the Collaborative
Care Research Network (CCRN) and the Distributed Ambulatory Research and
Therapeutics Network (DARTNet). Great work!
Saturday, June 12, 2010
Monday, June 7, 2010
Thursday, June 3, 2010
You are subscribed to Mailing List for MEPS Periodic Digest for Agency for Healthcare Research and Quality (AHRQ).
AHRQ is pleased to announce the recent release of the following data products and publications:
MEPS HC-116: 2008 Jobs File
Release Date: May 2010
This public use data file contains jobs-level data from the 2008 Medical Expenditure Panel Survey Household Component (MEPS-HC). Released as an ASCII file with SAS and SPSS programming statements and in SAS transport format, this public use file provides information collected on a nationally representative sample of the civilian noninstitutionalized population of the
MEPS HC-115: 2008 Full Year Population Characteristics Data File
Release Date: May 2010
Released as an ASCII file (with related SAS and SPSS programming statements) and a SAS transport dataset, this public use file provides information collected on a nationally representative sample of the civilian non-institutionalized population of the United States for calendar year 2008. This file consists of MEPS survey data obtained in Rounds 3, 4, and 5 of Panel 12 and Rounds 1, 2, and 3 of Panel 13 (i.e., the rounds for the MEPS panels covering calendar year 2008) and contains variables pertaining to survey administration, demographics, employment, health status, quality of care, patient satisfaction, health insurance and person-level medical care use counts. The 2008 Full-Year expenditure and income data will be forthcoming. The HC-115 file is on the MEPS Web site at:
1996-2008 MEPS Link Files to NHIS
Release Date: May 2010
All thirteen (1996-2008) MEPS/NHIS Link Files are included on one CD-ROM. The MEPS/NHIS Link Files CD is available by request only. The 2008 MEPS/NHIS Link File contains a cross-walk that will allow data users to merge the MEPS 2008 Full-Year Population Characteristics public use data file, HC-115, with the NHIS 2006/2007 person-level public use data files. In this linkage file, a record exists for each person in the HC-115 file. Sample persons in NHIS that do not link to any MEPS sample persons are not represented in the linkage file. Sample persons in the HC-115 file who do not link with the 2006 NHIS or 2007 NHIS respondent person sample have a value of 9999 for the NHIS link id. The HC-115 file covers calendar year 2008 and contains data from Rounds 3, 4, and 5 of the MEPS Panel 12 (which uses the 2006 NHIS as its sampling frame) combined with data from Rounds 1, 2, and 3 of the MEPS Panel 13 (which uses the 2007 NHIS as its sampling frame). The 1996-2007 MEPS/NHIS Link Files are constructed similarly. Confidentiality forms must be filled out and submitted to AHRQ before this file can be obtained. See HC-NHIS Link File ordering instructions for more information on how to obtain this file.
MEPS Tabular Data:
State-Level Medical Expenditure Tables for 2007
Release Date: April 2010
The State-Level Medical Expenditure Tables are on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb/data_stats/quick_tables_results.jsp?component=1&subcomponent=0&year=2007&tableSeries=8&searchText=&searchMethod=1&Action=Search
Statistical Brief #282: Percentage of Persons Unable to Get or Delayed in Getting Needed Medical Care, Dental Care, or Prescription Medicines:
Release Date: April 2010
In 2007, approximately 1 in 10 persons in the
Statistical Brief #281: Health Insurance Status of Low Income, Non-Elderly Persons by Demographic Characteristics, 2007
Release Date: March 2010
In 2007, there were 77.8 million persons under age 65 living in families with incomes below 200 percent of the federal poverty threshold. More than one-quarter (25.9 percent) of persons living in these non-elderly low income families were uninsured for the entire year, less than one-third (32.5 percent) had any private insurance coverage during the year, and 41.6 percent had public only coverage. The data is on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Statistical%20Brief&opt=2&id=948
Statistical Brief #280: Expenditures for the Top Five Therapeutic Classes of Outpatient Prescription Drugs, Medicare Beneficiaries, Age 65 and Older, 2007
Release Date: February 2010
This Statistical Brief provides a summary of the top five therapeutic classes of outpatient prescription drugs when ordered by total expense for Medicare beneficiaries age 65 and older. In 2007, the top five therapeutic classes of prescribed drugs purchased by Medicare beneficiaries ages 65 and older (ranked by total expense) were metabolic agents, cardiovascular agents, central nervous system agents, gastrointestinal agents, and hormones. The data is on the MEPS Web site at: http://www.meps.ahrq.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Statistical%20Brief&opt=2&id=947
Statistical Brief #279: Expenditures for the Top Five Therapeutic Classes of Outpatient Prescription Drugs, Adults Age 18 and Older,
Release Date: February 2010
This Statistical Brief provides a summary of the top five therapeutic classes of outpatient prescription drugs for adults age 18 and older when ranked by total expense, as reported by households in the
Statistical Brief #278: The Concentration and Persistence in the Level of Health Expenditures over Time: Estimates for the
Release Date: March 2010
In 2007, health care expenses among the
Statistical Brief #277: Trends in Outpatient Prescription Gastrointestinal Agents Purchases and Expenditures for the
Release Date: January 2010
The estimates are for the
If you have questions about AHRQ's activities, please try to find the answers by checking our Home Page, where we have established links to various topical areas. Also check the News & Information section and Frequently Asked Questions. You may also Search or Browse the Web Site. These features are designed to assist you in obtaining the information you are seeking.
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