The Agency for Healthcare Research

The Agency for Healthcare Research and Quality (AHRQ) grew out of its predecessor, the Agency for Healthcare Policy and Research (AHPR), when Congress restructured the agency in 1999. The Omnibus Budget Reconciliation Act of 1989 originally formed AHPR as a constituent unit of the Public Health Service (PHS), HHS. Other healthcare research predecessors include:1

• PHS’s Department of Health, Education, and Welfare (HEW) (1968–1979) and HHS (1979–1989)
• National Center for Health Services Research and Development,
Health Services and Mental Health Administration (1968–1973)
• Bureau of Health Services Research, Health Resources Administration
(HRA) (1973–1975)
• National Center for Health Services Research, HRA (1975–1978)
• National Center for Health Services Research, Office of the
Assistant Secretary for Health (OASH) (1978–1985)
• National Center for Health Services Research and Health Care
Technology Assessment, OASH (1985–1989)

Today, AHRQ serves as one of the public health services agencies operating under HHS. Other sister agencies include the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the Federal Drug Administration (FDA), and the Health IT initiatives. Leading American universities and institutions act as major sources of funding and technical assistance for health research. They also act as sci- ence partners, working with the public and private sectors to build the knowledge base for what works (and does not work) and to translate this knowledge into everyday practice and policymaking.2 The AHRQ focuses its research efforts for HHS in several areas, including:

• Bio-medics
• Quality improvement and patient safety
• Outcomes and effectiveness of care
• Clinical practice and technology assessment
• Healthcare organization and delivery systems
• Primary care (including preventive services)
• Healthcare costs and sources of payment

Auditors should monitor and incorporate each of these research areas into their e-health information review strategy. In addition, auditors should also pay attention to AHRQ’s activities when assessing how a particular e-health environment incorporates research and the most cur- rent information at the patient’s bedside. Research regarding evidence- based medicine is of particular of importance. In one study, researcher E. Andrew Balas discovered that, on average, it takes as long as 17 years for research to be used in patient care. Balas’s study further cited clinical access to the numerous articles as one of the fundamental lags between research and actual implementation. Balas’s study prompted a number of further studies by AHRQ designed to improve integration of research directly into healthcare delivery systems.3 E-health will help narrow that gap between research and implementation. Auditors can trace ongoing agency efforts at www.ahrq.gov.

Auditors should also keep on their radar the Health IT component of AHRQ that aims to help bring healthcare information technology into the twenty-first century. This subgroup of AHRQ has set numerous goals and initiatives pertaining to issues such as the use of technology in day-to-day clinical practice, electronic medical records, privacy initiatives and controls, and infrastructures that will help prevent waste, fraud, and abuse. Auditors can track major market initiatives at healthit.ahrq.gov.4
Exhibit 2.6 provides a sample auditor’s list of IT topics that will help form the necessary background information required for reviewing an e-health environment. Auditors should evaluate the impact that the primary HCC, secondary HCC, and IC have on each of the key topics identified.
Exhibit 2.7 presents a list of coding systems used in many healthcare information transactions and communications. The significance of each of these coding systems varies. For example, the National Drug Classification (NDC) is the national classification of all drugs registered and approved by the Food and Drug Administration (FDA) and acts as a reference to ver- ify the approval of a particular medication. Another example, the Current Procedural Terminology (CPT) coding system, is used in clinical research

•  PHS’s Department of Health, Education, and Welfare (HEW) (1968–1979) and HHS (1979–1989)
• National Center for Health Services Research and Development,
Health Services and Mental Health Administration (1968–1973)
• Bureau of Health Services Research, Health Resources Administration
(HRA) (1973–1975)
• National Center for Health Services Research, HRA (1975–1978)
• National Center for Health Services Research, Office of the
Assistant Secretary for Health (OASH) (1978–1985)
• National Center for Health Services Research and Health Care
Technology Assessment, OASH (1985–1989)

Today, AHRQ serves as one of the public health services agencies operating under HHS. Other sister agencies include the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the Federal Drug Administration (FDA), and the Health IT initiatives. Leading American universities and institutions act as major sources of funding and technical assistance for health research. They also act as sci- ence partners, working with the public and private sectors to build the knowledge base for what works (and does not work) and to translate this knowledge into everyday practice and policymaking.2 The AHRQ focuses its research efforts for HHS in several areas, including:

• Bio-medics
• Quality improvement and patient safety
• Outcomes and effectiveness of care
• Clinical practice and technology assessment
• Healthcare organization and delivery systems
• Primary care (including preventive services)
• Healthcare costs and sources of payment

Auditors should monitor and incorporate each of these research areas into their e-health information review strategy. In addition, auditors should also pay attention to AHRQ’s activities when assessing how a particular e-health environment incorporates research and the most cur- rent information at the patient’s bedside. Research regarding evidence- based medicine is of particular of importance. In one study, researcher E. Andrew Balas discovered that, on average, it takes as long as 17 years for research to be used in patient care. Balas’s study further cited clinical access to the numerous articles as one of the fundamental lags between research and actual implementation. Balas’s study prompted a number of further studies by AHRQ designed to improve integration of research directly into healthcare delivery systems.3 E-health will help narrow that gap between research and implementation. Auditors can trace ongoing agency efforts at www.ahrq.gov.

Auditors should also keep on their radar the Health IT component of AHRQ that aims to help bring healthcare information technology into the twenty-first century. This subgroup of AHRQ has set numerous goals and initiatives pertaining to issues such as the use of technology in day-to-day clinical practice, electronic medical records, privacy initiatives and controls, and infrastructures that will help prevent waste, fraud, and abuse. Auditors can track major market initiatives at healthit.ahrq.gov.4
Exhibit 2.6 provides a sample auditor’s list of IT topics that will help form the necessary background information required for reviewing an e-health environment. Auditors should evaluate the impact that the primary HCC, secondary HCC, and IC have on each of the key topics identified.
Exhibit 2.7 presents a list of coding systems used in many healthcare information transactions and communications. The significance of each of these coding systems varies. For example, the National Drug Classification (NDC) is the national classification of all drugs registered and approved by the Food and Drug Administration (FDA) and acts as a reference to ver- ify the approval of a particular medication. Another example, the Current Procedural Terminology (CPT) coding system, is used in clinical research

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The Agency for Healthcare Research and Quality (AHRQ) grew out of its predecessor, the Agency for Healthcare Policy and Research (AHPR), when Congress restructured the agency in 1999. The Omnibus Budget Reconciliation Act of 1989 originally formed AHPR as a constituent unit of the Public Health Service (PHS), HHS. Other healthcare research predecessors include:1• PHS’s Department of Health, Education, and Welfare (HEW) (1968–1979) and HHS (1979–1989)• National Center for Health Services Research and Development,Health Services and Mental Health Administration (1968–1973)• Bureau of Health Services Research, Health Resources Administration(HRA) (1973–1975)• National Center for Health Services Research, HRA (1975–1978)• National Center for Health Services Research, Office of theAssistant Secretary for Health (OASH) (1978–1985)• National Center for Health Services Research and Health CareTechnology Assessment, OASH (1985–1989)Today, AHRQ serves as one of the public health services agencies operating under HHS. Other sister agencies include the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the Federal Drug Administration (FDA), and the Health IT initiatives. Leading American universities and institutions act as major sources of funding and technical assistance for health research. They also act as sci- ence partners, working with the public and private sectors to build the knowledge base for what works (and does not work) and to translate this knowledge into everyday practice and policymaking.2 The AHRQ focuses its research efforts for HHS in several areas, including:• Bio-medics• Quality improvement and patient safety• Outcomes and effectiveness of care• Clinical practice and technology assessment• Healthcare organization and delivery systems• Primary care (including preventive services)• Healthcare costs and sources of paymentAuditors should monitor and incorporate each of these research areas into their e-health information review strategy. In addition, auditors should also pay attention to AHRQ’s activities when assessing how a particular e-health environment incorporates research and the most cur- rent information at the patient’s bedside. Research regarding evidence- based medicine is of particular of importance. In one study, researcher E. Andrew Balas discovered that, on average, it takes as long as 17 years for research to be used in patient care. Balas’s study further cited clinical access to the numerous articles as one of the fundamental lags between research and actual implementation. Balas’s study prompted a number of further studies by AHRQ designed to improve integration of research directly into healthcare delivery systems.3 E-health will help narrow that gap between research and implementation. Auditors can trace ongoing agency efforts at www.ahrq.gov. Auditors should also keep on their radar the Health IT component of AHRQ that aims to help bring healthcare information technology into the twenty-first century. This subgroup of AHRQ has set numerous goals and initiatives pertaining to issues such as the use of technology in day-to-day clinical practice, electronic medical records, privacy initiatives and controls, and infrastructures that will help prevent waste, fraud, and abuse. Auditors can track major market initiatives at healthit.ahrq.gov.4Exhibit 2.6 provides a sample auditor’s list of IT topics that will help form the necessary background information required for reviewing an e-health environment. Auditors should evaluate the impact that the primary HCC, secondary HCC, and IC have on each of the key topics identified.Exhibit 2.7 presents a list of coding systems used in many healthcare information transactions and communications. The significance of each of these coding systems varies. For example, the National Drug Classification (NDC) is the national classification of all drugs registered and approved by the Food and Drug Administration (FDA) and acts as a reference to ver- ify the approval of a particular medication. Another example, the Current Procedural Terminology (CPT) coding system, is used in clinical research

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Badan Kesehatan Penelitian dan Kualitas (AHRQ) tumbuh dari pendahulunya, Badan Kebijakan Kesehatan dan Penelitian (AHPR), ketika Kongres direstrukturisasi badan pada tahun 1999. Omnibus Anggaran Rekonsiliasi Act of 1989 awalnya dibentuk AHPR sebagai unit konstituen dari Dinas Kesehatan Masyarakat (PHS), HHS. Pendahulu penelitian kesehatan lainnya termasuk: 1 • Departemen PHS Kesehatan, Pendidikan, dan Kesejahteraan (HEW) (1968-1979) dan HHS (1979-1989) • Pusat Nasional untuk Pelayanan Kesehatan Penelitian dan Pengembangan, Pelayanan Kesehatan dan Mental Administrasi Kesehatan (1968 -1973) • Biro Pelayanan Kesehatan Penelitian, Sumber Daya Kesehatan Administrasi (HRA) (1973-1975) • Pusat Nasional untuk Pelayanan Kesehatan Penelitian, HRA (1975-1978) • Pusat Nasional untuk Pelayanan Kesehatan Penelitian, Kantor Sekretaris Asisten Kesehatan (OASH) (1978-1985) • Pusat Nasional untuk Pelayanan Kesehatan Penelitian dan Perawatan Kesehatan Teknologi Pengkajian, OASH (1985-1989) Hari ini, AHRQ berfungsi sebagai salah satu lembaga pelayanan kesehatan masyarakat beroperasi di bawah HHS. Lembaga adik lainnya termasuk National Institutes of Health (NIH), Pusat Pengendalian dan Pencegahan Penyakit (CDC), Federal Drug Administration (FDA), dan inisiatif Kesehatan IT. Terkemuka universitas dan lembaga-lembaga Amerika bertindak sebagai sumber utama pendanaan dan bantuan teknis untuk penelitian kesehatan. Mereka juga bertindak sebagai mitra ence sci-, bekerja dengan sektor publik dan swasta untuk membangun basis pengetahuan untuk apa bekerja (dan tidak bekerja) dan untuk menerjemahkan pengetahuan ini ke dalam praktek sehari-hari dan policymaking.2 The AHRQ berfokus upaya penelitian untuk HHS di beberapa daerah, termasuk: • Bio-medis • Peningkatan kualitas dan keselamatan pasien • Hasil dan efektivitas perawatan • praktek klinis dan penilaian teknologi • organisasi dan pengiriman Healthcare sistem • perawatan primer (termasuk layanan pencegahan) • Biaya kesehatan dan sumber pembayaran Auditor harus memantau dan memasukkan masing-masing daerah penelitian ini ke dalam strategi ulasan informasi e-kesehatan mereka. Selain itu, auditor juga harus memperhatikan kegiatan AHRQ ketika menilai bagaimana lingkungan e-kesehatan tertentu menggabungkan penelitian dan informasi sewa paling skr di samping tempat tidur pasien. Penelitian mengenai obat berbasis bukti adalah dari tertentu penting. Dalam satu studi, peneliti E. Andrew Balas menemukan bahwa, rata-rata, dibutuhkan selama 17 tahun untuk penelitian yang akan digunakan dalam perawatan pasien. Studi Balas lebih jauh dikutip akses klinis untuk berbagai artikel sebagai salah satu tertinggal mendasar antara penelitian dan pelaksanaannya. Studi Balas ini diminta sejumlah studi lebih lanjut oleh AHRQ dirancang untuk meningkatkan integrasi penelitian langsung ke pelayanan kesehatan systems.3 E-kesehatan akan membantu mempersempit kesenjangan antara penelitian dan implementasi. Auditor dapat melacak upaya lembaga yang sedang berlangsung di www.ahrq.gov. Auditor juga harus terus radar mereka komponen Kesehatan TI AHRQ yang bertujuan untuk membantu membawa teknologi informasi kesehatan ke abad kedua puluh satu. Ini subkelompok AHRQ telah menetapkan berbagai tujuan dan inisiatif yang berkaitan dengan isu-isu seperti penggunaan teknologi di hari-hari praktek klinis, catatan medis elektronik, inisiatif privasi dan kontrol, dan infrastruktur yang akan membantu mencegah pemborosan, penipuan, dan penyalahgunaan. Auditor dapat melacak inisiatif pasar utama di healthit.ahrq.gov.4 pameran 2.6 menyediakan daftar sampel auditor topik IT yang akan membantu membentuk informasi latar belakang yang diperlukan untuk meninjau lingkungan e-kesehatan. Auditor harus mengevaluasi dampak bahwa HCC primer, sekunder HCC, dan IC memiliki pada setiap topik utama yang diidentifikasi. Exhibit 2.7 menyajikan daftar sistem yang digunakan dalam banyak transaksi informasi kesehatan dan komunikasi coding. Signifikansi dari masing-masing sistem pengkodean bervariasi. Sebagai contoh, Klasifikasi Obat Nasional (NDC) adalah klasifikasi nasional semua obat terdaftar dan disetujui oleh Food and Drug Administration (FDA) dan bertindak sebagai referensi untuk menverifikasi persetujuan obat tertentu. Contoh lain, yang Prosedural Terminologi sekarang (CPT) sistem pengkodean, digunakan dalam penelitian klinis

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