New in the Journal: A System of Care for Children in Underserved Atlanta Neighborhoods


December 18th, 2014

The GrantWatch section of Health Affairs’ December 2014 thematic issue on children’s health contains “Healthy Beginnings: A System of Care for Children in Atlanta,” by Ryan Chao of the Annie E. Casey Foundation, in Baltimore; Susan Bertonaschi of the foundation’s Atlanta Civic Site in Atlanta; and Julie Gazmararian of Emory University Rollins School of Public Health.

For more than ten years, the Casey Foundation, which focuses its funding on children, has been investing in a “comprehensive community change strategy” in five mostly African American neighborhoods near downtown Atlanta. Casey has chosen to “make a long-term, open-ended commitment to improve conditions for low-income families” in these communities.

Its wide-ranging strategy focuses on (1) improving educational outcomes for kids; (2) encouraging family economic success by working with adult family members; and (3) “positively transforming” the physical environment of a community, says the article.

The foundation believes that results are better when these efforts “are bundled together so that families benefit from multiple programs simultaneously.” Also, it aims to involve area “residents as partners and key decision makers.”

Recently, the foundation decided to integrate health into its “community and family-strengthening strategies.” Read the rest of this entry »

Peterson Foundation Announces $200 Million Commitment for Its New Center on Healthcare


December 11th, 2014

Gail R. Wilensky is the senior fellow at Project HOPE and a member of the Peterson Center on Healthcare’s Advisory Board.

On December 4, the Peterson Center on Healthcare, created by the Peter G. Peterson Foundation with an initial commitment of $200 million, announced three major initiatives to advance its objective of transforming health care in the United States to a system that delivers high-quality care at lower costs.

The center is focusing on identifying strategies that already “work” (that is, they produce high-quality health care at lower costs), validating the strategies, and then replicating them. The center aims to identify effective strategies that are already in existence and to give them additional momentum, rather than to fund research to create new activities that are not currently being undertaken.

The three initiatives that received initial commitments of funding are (1) identifying high-performing primary care practices (through a grant to Stanford University’s Clinical Excellence Research Center); (2) tracking the performance of the U.S. health care system (through a grant to the Henry J. Kaiser Family Foundation [KFF]); and (3) improving data transparency and usability (through a grant to the National Quality Forum).

The aim of the grant to Stanford’s Clinical Excellence Research Center, for the first initiative, was to identify and validate high-performing primary care practices in the United States. Based on an analysis of commercial insurance data and using forty-one Healthcare Effectiveness Data and Information Set (HEDIS) measures, researchers found that fewer than 5 percent of the 15,000 practice sites reviewed ranked in both the top quartile for quality as well as in the lowest quartile for spending (on a risk-adjusted basis).

They also found that ten features seemed to distinguish these practices from other practices. These features included the following: the practices are always “on-call,” follow quality and clinical guidelines, solicit patient feedback, “in-source” tests and procedures, keep in close contact with specialty referrals, engage in patient follow-up, encourage staff to work to the top of their licenses, promote open work environments, balance compensation incentives (that is, physicians are not paid just by the volume of services and revenue they individually produce), and invest in staff, according to a press release.

What was perhaps most interesting is that these “positive outliers” for cost and quality are not nationally known practices. They include such places as Banner Health Clinic in Phoenix, Arizona; Family Physicians Group in Kissimmee, Florida; and St. Jude Heritage Medical Group in Yorba Linda, California. Read the rest of this entry »

Improving the Accuracy of Wikipedia’s Medical Information


December 9th, 2014

Editor’s Note: On December 11, because of an editing error, a sentence in the ninth paragraph of this post was corrected to make clear that the $176,670 grant to Consumers Union was awarded by the New York State Health Foundation, not the ABIM Foundation.

Every day, at every hour, billions of people go online for information. In fact, the Internet has become the first place that millions of Americans go to learn about specific health conditions, problems, and treatment options. According to a report from the Pew Research Center, one in three Americans have used the Internet to try to diagnose a medical condition, and 72 percent of Internet users have looked more generally for health information online within the past year.

And among all websites, Wikipedia has emerged as one of the leading sources for health care information. It is the seventh most-visited website, and its 26,000 health care articles are requested by Web users 178 million times a month. Wikipedia typically had much higher placement in search results than other sources of health information, including the Mayo Clinic, WebMD, MedlinePlus, e-Medicine.com, and all .gov domains.

Surprisingly, Wikipedia is increasingly consulted by doctors and other health care providers, sometimes to get a quick take on an issue or as a springboard to additional sources in the footnotes. A report by the IMS Institute for Healthcare Informatics found that 50 percent of doctors surveyed reported using Wikipedia for information on specific conditions!

Recognizing Wikipedia’s growing dominance as a health information resource, the New York State Health Foundation funded a two-year collaboration between Consumers Union and New York State medical schools to launch the Wikipedia Medical School Project, a pilot that uses medical students as fact checkers and editors to improve the quality and accuracy of Wikipedia’s health information. Read the rest of this entry »

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