We are in the midst of exchange implementation-the centerpiece of the affordable care act-and it seems a good time to take stock of where we are and need to go. The ACA has validated and spurred on existing efforts. We are making progress on many fronts but fundamental changes are still needed to deliver on the promise of better value.
The authors describe a quality improvement intervention that focuses on directly scheduling mammogram appointments for women who lack adherence despite written outreach letters.
An Internet-based telehealth intervention for elderly heart failure patients found no discernible incremental impact on morbidity or mortality compared with case management alone.
Better outpatient medication adherence reduces the likelihood of readmission after a recent myocardial infarction.
New statin prescriptions at the Veterans Health Administration were reviewed using a cross-sectional study design. Statins were frequently prescribed outside of guideline recommendations.
In patients with type 2 diabetes, compliance and persistence were generally low for both statin and antihyperglycemic therapy, but they were significantly lower with statin therapy.
Proton pump inhibitors are often overused without documented valid indications. Their inappropriate use is associated with substantial cost expenditure and the potential for adverse events.
Data from a national survey of Veterans Health Administration specialists indicate that referral templates may improve the appropriateness, clarity, and completeness of primary care–specialty care referrals.
Use of bioimpedance spectroscopy to aid in post“breast cancer assessments for lymphedema can be cost saving for healthcare organizations in the United States.
In an integrated health system, human immunodeficiency virus and hepatitis C telemedicine clinics are associated with improved access, high patient satisfaction, and reduction in health visit“related time.
Extended-duration thromboprophylaxis (>14 days) for total hip replacement/total knee replacement was associated with significantly lower risk for thromboembolic and bleeding events than short-duration thromboprophylaxis.
Despite universal access to HER2 testing in Ontario, variability in reporting by region and disease severity presents challenges for program evaluation and quality improvement initiatives.