Managed Care - March 2008 - (Page 31) three research projects planned in the next five years: Members of HMO Research Network • Hypertension recognition, treatFallon Community Health Plan/Meyers Primary Care Institute, ment, and control Worcester, Mass. • Quality of care and outcomes of the Geisinger Health System, Danville, Pa. blood thinner warfarin for atrial fibGroup Health Cooperative, Seattle, Wash. rillation and blood clots Harvard Pilgrim Health Care, Boston, Mass. Henry Ford Health System, Detroit, Mich. • Use and outcomes of implantable Health Partners Research Foundation, Minneapolis, Minn. cardiac defibrillators Kaiser Permanente Colorado, Denver, Colo. “We have knowledge of what to do to Kaiser Permanente, Hawaii, Honolulu, Hawaii help people in terms of cardiovascular Kaiser Permanente Northern California, Oakland, Calif. risk, and some of this work is trying to figKaiser Permanente Northwest, Portland, Ore. ure out how to do it better, how to impleKaiser Permanente Southeast, Atlanta, Ga. ment all this great science and do it well,” Kaiser Permanente Southern California, Pasadena, Calif. says Go, co-principal investigator for the Lovelace Clinic Foundation, Albuquerque, N.M. cardiovascular network. Marshfield Clinic Research Foundation, Marshfield, Wis. An overall goal will be to create an inScott and White, Temple, Texas frastructure that allows researchers to create multicenter, pooled data files to address carout whether and how they were treated and how diovascular research questions. well their blood pressure was controlled. “A lot of the effort will be to make these data sysThey will also compare the electronic data to tems harmonize so we can feel confident that we’re the information in paper medical charts to see comparing apples to apples across each of these whether it matches. health plans,” Go says. “That won’t be just for tech“That will give critical information as other nology. It will mean developing the local expertise health plans begin to get electronic data collected to leverage each health plan’s data systems and to on their populations,” Go says. “We will be right in assist in larger and more efficient involvement in front, trying to help figure out what works and key clinical trials.” what doesn’t work.” The first project, which started in late 2007, will The second CVRN project, which will begin this be of interest to all health care purchasers and payyear, will involve 80,000 members from five plans ers: In light of the many medications and interwho are prescribed the blood thinner warfarin. ventions available to treat hypertension, why is optimal control so hard to achieve? Patient registry “Most assessments have been done on limited The third project, scheduled to begin in 2009, surveys, in single health plans, or only in subgroups will make use of a registry of patients who have imlike Medicare,” Go says. “This project will involve planted cardioverter defibrillators. For the past more than a million patients with hypertension, eithree years, the ICD Registry, sponsored by the ther diagnosed or undiagnosed.” American College of Cardiology Foundation and Three of the HMO RN plans will participate in the Heart Rhythm Society, has been asking hospithat project. The researchers will try to determine tals to submit names of patients who have received the factors that drive people to be treated for hyICDs. Medicare, in fact, requires a patient to be pertension and to achieve the levels of control that listed in the ICD Registry for it to pay for the ICD are supported by national guidelines and by the sciimplantation. entific evidence that underpins them. The registry, however, has no way of collecting The project will also attempt to make a signifiinformation about how those patients fared — cant breakthrough in research practice. The blood until now. “We’re going to leverage what Medicare pressure measurements used in the study will have has invested and the American College of Cardiolbeen collected electronically in physician offices, ogy has invested and get a lot more information and the researchers will extract the readings for inabout who’s getting these procedures and what dividuals and review their clinical history to find happens to them over time,” says Go. MC MARCH 2008 / MANAGED CARE 31
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