Quality Remains at the Core of Health Care During Uncertain Times

The many and varied changes in health care in recent years—including transparency and public reporting, pay for performance and value-based purchasing, health system redesign, and health information technology—can be both exciting and confusing. These changes have converged in the passage of federal legislation in the HITECH Act (2009) and the Affordable Care Act (2010). Just when we were starting to make sense of these many converging forces of health reform, we experience a mid-term election that may dramatically change the political landscape.

The good news from my perspective is that the quality, financing, and delivery system redesign called for in federal and state legislation are not the components being called into question in terms of legal authority or repeal efforts, and appear to be moving forward. We are in uncertain but exciting times in health care quality, and Minnesota has emerged as a leader in testing and experimenting with new approaches to improve quality and value.

Stratis Health is in the thick of this work...

• As a Medicare QIO, we are now working under the leadership of Don Berwick, MD, as the new CMS administrator, focusing on the "Triple Aim"—better care for individuals, better health for populations, and reducing per capita costs.
• As a federally designated health information technology (HIT) regional extension center, a part of Key Health Alliance, we are immersed in helping providers to realize the potential of electronic health records to improve quality and efficiency.
• And as a nonprofit organization committed to our community, we are engaged in collaborative efforts in Minnesota on rural palliative care, shared decision making, patient safety, cultural competence, and more.
  

I've become fond of describing Stratis Health's work in three concentric circles. The inner circle reflects the traditional and current core of our work—improving clinical care and outcomes. In the middle circle, we know that health care is largely delivered in teams within organizations, such that organizational change has become a critical area of focus for Stratis Health, reflected in our efforts to support health care providers in leadership, teamwork, culture, and technology. The outer, most encompassing circle is community— a recognition in our work that health care cannot continue to be viewed in silos, that we must look not only across the continuum of health care, but across the community, to achieve sustainable quality.

The articles in this issue of Quality Update reflect our current efforts related to the Triple Aim and our growing work in the public health arena, where we are helping to bridge the medical model with the community. You'll learn about the challenges of inpatient versus outpatient hospitalization as a microcosm of health reform challenges—the intersection of clinical decision making, payment and reimbursement, patient centeredness, and care transitions.

Thank you for your continued leadership in quality, and your ongoing support and engagement with Stratis Health in these exciting but uncertain times.

Jennifer P. Lundblad, PhD, MBA

President and CEO, Stratis Health