Blog | Wednesday, March 3, 2010

Chasms and comparisons covered by Carolyn Clancy

As one would expect from such a diverse group, comparisons were a common topic at the co-located National Medical Home Summit, National Retail Clinic Summit, and Population Health and Disease Management Colloquium this week.

During an opening session, Carolyn Clancy, head of the AHRQ, updated us on some of the comparison work her agency has been doing. Last year's stimulus bill dedicated a lot of funds ($300 mill directly, more through the Secretary of HHS) to the agency's work on comparative effectiveness.

But there's still a long way to go, according to Dr. Clancy. "We're a little bit slow to translate scientific advances into clinical practice," she understated. The good news is that in recent years there have been steady declines in the "quality chasm" between guidelines and care actually provided. If the current pace continues, Dr. Clancy said, "my top statistician tells me it will take 20 years to close the gap between the highest quality care and that which gets delivered."

Her agency's trying to spend that effort along by providing info for patients about evidence-based care, supporting research to gather needed evidence, and scanning the horizon to see what questions are likely to come up next. There's a particular need and effort to figure out the best practices for narrower patient groups (such as the 9% of diabetics with no comorbidities, for example), she said. And for those who worry that comparative effectiveness could lead to rationing, she reassured the audience that the agency's findings are meant to be "descriptive not prescriptive."