Report from the National Health Outcomes Conference sponsored by The Health Legacy Partnership

Report to the Board of Directors, Society of Vascular Technology 11/11/00
by Anne M. Jones RN BSN RVT RDMS FSVU

Background
The Health Legacy Partnership is a joint effort between the Agency for Healthcare Research and Quality (AHRQ) and the Kanter Family Foundation. The goal of the Partnership is to ultimately develop a national health outcomes database, by persuading researchers and clinicians too collect health outcomes data and submit this data to a national database. The National Health Outcomes Conference was cosponsored by the Kanter Family Foundation and AHRQ. The funding for this effort between a government agency and private organization, has been initially provided by Joseph Kanter, a successful businessman and leader of philanthropic efforts throughout the United States. His keen personal commitment is due to a personal experience with prostate cancer. During his evaluation and treatment phase, he became aware of the need for a national database to advise physicians and patients of available treatment methods and their outcomes. Prior to his own illness, Kanter was a supporter of efforts to improve public health and established the Kanter Family Foundation to support healthcare research, educational institutions and a variety of other charitable endeavors. It was obvious from his presentation that this HELP effort is a real passion for him-and success is the only acceptable outcome.

Summary of Conference
The National Health Outcomes Conference was held on Monday, October 30, at the National Press Club in Washington, D.C. SVT was invited to attend, we believe, because of our participation in the AHRQ hearing about certification and ultrasound. The attendees included physicians and nurses involved in specialty research, executive directors from a variety of health related organizations, insurance company representatives, drug company executives, and a whole host of other groups and interests. I happened to be seated with a physician from Leigh High Valley Hospital, a physician from the American Society of Geriatric Psychiatry, a clinical researcher from Penn State University in Philadelphia, and several nurse clinicians involved in pharmaceutical research.

The Conference was opened by the Executive Director of the Kanter Family Foundation, Craig Turk. Mr. Turk joined the Foundation in June after serving as Chief Counsel to Sen. John McCain's presidential campaign. A Harvard graduate, he was managing editor of The Public Interest , and has written articles and reviews for The Wall Street Journal, LA Times and The New Republic. Mr. Turk explained the agenda for the day, which included opening remarks from Mr. Kanter, an overview of the needs and the objectives of the project by Dr. Robert Brook, and a summary by Dr. John Eisenberg . The keynote luncheon speaker was Sam Donaldson.

Dr. Brook is Vice President and Corporate Fellow at RAND Corporation, and the director of RAND Health. He led the Health Quality Group on the $80 million RAND Health Insurance Experiment. He was also the co-PI on the Health Services Utilization Study that developed a method to assess appropriateness of care and then applied it to carotid endarterectomy, coronary angiography and endoscopy. He has an interesting cv which includes a number of quality and outcome studies. Brook seems to be held in very high esteem by Kanter and the Foundation. I remember meeting him at some of the carotid endarterectomy meetings while working on the ACAS project, as well as the Medicare Advisory Committee at HCFA last year. No doubt he is knowledgeable and very willing to share his views with the audience. It was comforting to see his views balanced by the input from Dr. Eisenberg.

Dr. John Eisenberg has a presence that is most unusual- he is brilliant, articulate, personable and very committed to promoting the goals of the AHRQ. Dr. Eisenberg has an MD and MBA and is a clinician and researcher. He was previously the Chair of Medicine and Physician in Chief at Georgetown, and Chair of Medicine at the University of PA. He has been the Director of AHRQ for the past three years. AHRQ is the lead federal agency charged with conducting and sponsoring research to enhance the quality, appropriateness and effectiveness of health care services and improve the cost and access to care. Dr. Eisenberg provided a global overview of outcomes research and the need for such, as well as efforts currently under way at AHRQ. He stressed the need for the national database so that decisions about treatment could be based on data rather than anecdotal experience. Certainly, his discussion was in keeping with discussions held throughout medicine.

Sam Donaldson was quite an amusing and animated speaker. He shared his personal experience related to a bout with lymphoma. He reinforced the need for available, accessible and accurate data so that decision-making during a time of crisis could be based on facts, not feelings. Mr. Donaldson shared many amusing stories, and is obviously a friend of Mr. Kanter's.

Conclusion
There was a fair amount of discussion during the day, and audience members suggested a variety of approaches, from a very focused initiative evaluating a specific disease process to a global approach. It was clear that there was support for a national database, but reluctance to just give data away. Clearly research ownership issues arose, and the there needs to be considerable discussion after the initial ideas were presented.

Will SVT have a role in this project? It would seem that because we are not a research based organization, that our actual input of data would be negligible. However, given the research and clinical interests of our members, we can certainly disseminate this information to them and encourage participation by individuals. I believe we should volunteer to work with the Foundation to promote the effort and share the goals of this project with our members, professional colleagues and pharmaceutical/ manufacturing colleagues. Certainly there are several areas of specific interest to vascular disease that need more outcomes data.

I believe we should send an affirmative message to the Kanter Family Foundation and offer to assist them with this effort.

Respectfully submitted,

Anne M. Jones
11/11/00

The National Health Outcomes Conference was held on Monday, October 30, at the National Press Club in Washington, DC. This is a report from that conference.

Read the inaugural copy of The Kanter Letter handed out at the conference