California Right Care Initiative: Community Wide Efforts to Prevent Heart Attacks and Strokes
The California Right Care Initiative, funded in part by an NIH grant, is a project designed to help improve the quality of California's health care maintenance organizations. The Initiative has identified two areas of concern: hospital acquired infections and cardiovascular risk factors, where patients receive care half the time then patients in other states.
Graziosi: Improving the quality of America's managed health care organizations one state at a time, beginning with California where the performance rates for many standard chronic care quality measures, such as high blood pressure and high cholesterol rank substantially below those of other states. Dr. Robert Kaplan, Director of the National Institutes of Health's Office of Behavioral and Social Sciences Research has spoken extensively on this subject.
Kaplan: California Right Care Initiative is a program in California to try and improve the quality of care in California managed care organizations. In particular we hope that we can save a significant number of lives by getting people to adhere to the best evidence-based approaches to the prevention of cardiovascular disease and stroke.
Graziosi: The plan, funded in part by NIH, focuses on two areas, hospital acquired infections and the prevention of cardiovascular disease, where Dr. Kaplan says patients have fallen through the cracks because of the extra steps they have to go through to get care.
Kaplan: Cardiovascular disease in particular, we have a lot of epidemiologic evidence suggesting that people who have identified risk factors can benefit if they get those risk factors modified.
Graziosi: Dr. Kaplan says one way of modifying risk factors and reaching patients who are at risk for cardiovascular disease is by redesigning the standard physician practice — and that is by bringing in new technology to reach these patients.
Kaplan: The really good systems — the ones that seem to be doing the best job are ones that are using electronic medical records to identify the people who have these problems and they are much more proactive in getting people in to be evaluated.
Graziosi: Dr. Kaplan stresses that not all of California's managed health care programs are failing; in fact, he points to the Sharp Rees-Stealy Medical Group in San Diego as a practice where technology has proven to be very successful in reaching patients and changing physician performance.
Kaplan: They use information systems to identify people — they provide a rewards system to physicians that provide the right feedback and they have a whole series of behavioral things that they do to make their practices more efficient.
Graziosi: To hear more about Dr. Kaplan speak on this project, visit the website videocast.nih.gov. I'm Cherry Graziosi, the National Institutes of Health, Bethesda, MD.
About This Audio Report
Reporter: Cherry Graziosi
Sound Bite: Dr. Robert Kaplan
Topic: California Right Care Initiative, managed health care organization, HMO, cardiovascular disease, hospital acquired infections, physician practice