READ in Review: Top 5 Posts from June

READ in Review highlights the top posts on the READ Portal from each month, as determined by how many readers click the link to each article. The following were the top posts for June, 2012:

1. The use of quality indicators to promote accountability in health care: the good, the bad, and the ugly

In this commentary, we hope to stimulate innovation in the field of health care performance measurement. We will discuss several considerations regarding the use of three quality indicators that are commonly used to improve accountability in the Canadian context. Specifically, we will focus on the hospital standardized mortality ratio (HSMR), all-cause urgent readmissions, and emergency department length of stay (ED-LOS; see Textbox 1). We discuss “the good,” “the bad,” and “the ugly” to illustrate both positive and negative consequences related to measurement. We conclude with specific recommendations regarding investments to improve quality measurement.

2. New Mental Health Indicators Provide a Snapshot on Performance of the Mental Health System in Canada

Although the general hospital remains an important place for stabilizing crises, most services for mental illnesses are provided in outpatient/community settings. In the absence of comprehensive data at the community level, data that are routinely collected from general hospitals can provide insights on the performance of mental health services for people living with mental illness or poor mental health. This article describes three new indicators that provide a snapshot on the performance of the mental health system in Canada: self-injury hospitalization rate, 30-day readmission rate for mental illness and percentage of patients with repeat hospitalizations for mental illness.

3. Progress Report 2012: Health care renewal in Canada

Monitoring progress on the accords—the 2003 First Ministers’ Accord on Health Care Renewal1 and the 2004 10-Year Plan to Strengthen Health Care2—is a key element of the Health Council of Canada’s mandate. But the challenge is to determine how the commitments made in the accords have resulted in demonstrable change at the provincial and territorial levels. The accords did not, by and large, set out clear parameters for change, or the type of reporting that would be useful to the jurisdictions to measure such change. First Ministers did establish a series of comparable indicators for the provinces and territories to report on in 2004. However, their reporting only lasted a few years. Since then, the provinces and territories have developed their own indicators to address their respective planning needs. As a result, they do not consistently report on progress in the same manner, particularly in a comparable way that is useful to other governments and the public.

4. Telehealth Benefits and Adoption: Connecting People and Providers Across Canada

The objective of the Telehealth Adoption and Benefits Study was to inform Telehealth stakeholders, including funders of Telehealth programs, health system administrators, clinicians and patients, about the evidence of value of Telehealth activities in Canada. The study focused on the quality, access, and productivity benefits being achieved by these Telehealth activities.

5. Unraveling the IT Productivity Paradox — Lessons for Health Care

Debates about the productivity yield of IT are new to health care but not to other sectors of the economy. During the 1970s and 1980s, the computing capacity of the U.S. economy increased more than a hundredfold while the rate of productivity growth fell dramatically to less than half the rate of the preceding 25 years.1 The relationship between the rapid increase in IT use and the simultaneous slowdown in productivity became widely known as the “IT productivity paradox,” and economists debated whether investing billions of dollars in IT was worthwhile. The Nobel laureate economist Robert Solow observed in 1987 that “you can see the computer age everywhere but in the productivity statistics.”

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