Health Care
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John W. (Jack) Rowe MD, an expert on health care economics and healthy aging, will be the inaugural speaker for the Stanford Center on Longevity Distinguished Lecture Series. Rowe is professor of health policy and management, Columbia University Mailman School of Public Health and former CEO of Aetna Inc.

Rowe’s lecture, “Myths and Realities of an Aging Society,” will be from 6 to 7 p.m. (reception at 5:30 p.m.), Tuesday, April 13.

Frances C. Arrillaga Alumni Center

Columbia University, MSPH
Dept. of Health Policy & Mgmt.
600 West 168th Street, 6th Fl.
New York, NY 10032

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Professor, Department of Health Policy and Management, Joseph Mailman School of Public Health, Columbia University
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Dr. John Rowe is the Julius B. Richmond Professor of Health Policy and Aging at the Columbia University Mailman School of Public Health.  Previously, from 2000 until his retirement in late 2006, Dr. Rowe served as Chairman and CEO of Aetna, Inc., one of the nation's leading health care and related benefits organizations.  Before his tenure at Aetna, from 1998 to 2000, Dr. Rowe served as President and Chief Executive Officer of Mount Sinai NYU Health, one of the nation’s largest academic health care organizations. From 1988 to 1998, prior to the Mount Sinai-NYU Health merger, Dr. Rowe was President of the Mount Sinai Hospital and the Mount Sinai School of Medicine in New York City.

Before joining Mount Sinai, Dr. Rowe was a Professor of Medicine and the founding Director of the Division on Aging at the Harvard Medical School, as well as Chief of Gerontology at Boston’s Beth Israel Hospital.  He was Director of the MacArthur Foundation Research Network on Successful Aging and is co-author, with Robert Kahn, Ph.D., of Successful Aging (Pantheon, 1998). Currently, Dr. Rowe leads the MacArthur Foundation’s Network on An Aging Society .

Dr. Rowe was elected a Fellow of the American Academy of Arts and Sciences and a member of the Institute of Medicine of the National Academy of Sciences. He  serves on the Board of Trustees of the Rockefeller Foundation and is Chairman of the Board of Trustees at the Marine Biological Laboratory in Woods Hole, Massachusetts and the Board of Overseers of Columbia University’s Mailman School of Public Health. He is Chair of the Advisory Council of Stanford University’s Center on Longevity, and  was a founding Commissioner of the Medicare Payment Advisory Commission ( Medpac) and Chair of the board of Trustees of the University of Connecticut. 

Adjunct Affiliate at the Center for Health Policy and the Department of Health Policy
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John (Jack) Rowe Speaker
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(Partner:  Harvard University School of Engineering and Applied Science)

This inter-disciplinary project addresses two formidable health care realities: the growing number of patients with chronic conditions who require coordinated care from multiple medical providers, and a growing chasm between the complexity of health information and individuals’ health literacy. To meet these challenges, researchers are developing the following four computational capabilities that would support parents caring for children with medical complexity:

More than 70 percent of U.S. child health care resources are committed to the 5 percent of children with the most complex of medical conditions.  Fiscal pressures, reforms to the Medicaid program, and implementation of the Affordable Care Act (ACA) provide opportunities to reduce inefficiencies and to expand access to high-quality subspecialty care for these children. 

The Consortium for Healthcare Informatics Research (CHIR) is a multisite project funded by Department of Veterans Affairs Health Services Research and Development (HSR&D). The projects develops methods in natural language processing (NLP) to advance the effective use of unstructured text and other types of electronic health record (EHR) clinical data to improve the health and health care of Veterans. 

Previous research suggests that the emotions people value (“ideal affect”) can help explain cultural differences in health care preferences.  For example, those valuing excitement tend to prefer physicians who promote excitement and medications that induce feelings of excitement. However, the emotions people want to avoid (“avoided affect”) may be just as influential, particularly among older adults and East Asian Americans who tend to be motivated more by avoiding (versus approaching) certain outcomes.

Background: Cancer is the second leading cause of death in the United States and disproportionately affects elderly patient populations. Many describe poor quality of life and experience, unnecessary suffering, and treatment options with little benefit. Additionally, many elderly patients with cancer also are less likely to receive a full diagnosis or engage in shared-decision making. No studies have evaluated the influence of health coaches and shared-decision making tools on patient and caregiver experiences and receipt of goal concordant care.

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Abstract

Context: The Closing the Quality Gap seriesfrom the Agency for Healthcare Research and Quality summarizes evidence for eight high-priority health care topics: outcomes used in disability research, bundled payment programs, public reporting initiatives, health care disparities, palliative care, the patient-centered medical home, prevention of health care-associated infections, and medication adherence.
Objective: To distill evidence from this series and provide insight into the “state of the science” of quality improvement (QI).
Methods: We provided common guidance for topic development and qualitatively synthesized evidence from the series topic reports to identify cross-topic themes, challenges, and evidence gaps as related to QI practice and science.
Results: Among topics that examined effectiveness of QI interventions, we found improvement in some outcomes but not others. Implementation context and potential harms from QI activities were not widely evaluated or reported, although market factors appeared important for incentive-based QI strategies. Patient-focused and systems-focused strategies were generally more effective than clinician-focused strategies, although the latter approach improved clinician adherence to infection prevention strategies. Audit and feedback appeared better for targeting professionals and organizations, but not patients. Topic reviewers observed heterogeneity in outcomes used for QI evaluations, weaknesses in study design, and incomplete reporting.
Conclusions: Synthesizing evidence across topics provided insight into the state of the QI field for practitioners and researchers. To facilitate future evidence synthesis, consensus is needed around a smaller set of outcomes for use in QI evaluations and a framework and lexicon to describe QI interventions more broadly, in alignment with needs of decision makers responsible for improving quality.

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