EM Projects

With its focus on improving quality of life, advanced illness and/or post-acute care are distinct from care intended to cure an illness or condition, although it can be delivered concurrently with curative therapies. Advanced illness care focuses on medical care for people living with a serious illness. It aims to address the symptoms or stress related to the illness and improve the overall experience and/or quality of life for patients, caregivers, and family members. Advanced illness care may also include palliative and hospice care, which includes comprehensive care that addresses medical, emotional, spiritual, and social needs during the last stages of a person’s terminal illness.

Post-acute care includes medical or supportive care provided to individuals after leaving an acute care setting, such as a hospital, but they are not ready to return home. This includes rehabilitation and even palliative care services.

The Advanced Illness and Post-Acute Care committee considers measures that address post-acute care and advanced illness, including cancer and end-stage disease (e.g., end-stage renal disease). Subtopics may include advanced illness management, the assessment of physical, emotional, social, psychological, and spiritual aspects of care, access to and timeliness of care, patient and family experience with care, patient and family engagement, care planning, hospice care, palliative and end-of-life care, chemotherapy, rescue, and intensive care unit (ICU) care.

As health care expenditures continue to grow, it is crucial to understand how resources are utilized to maximize quality in the health care system. Health care cost measurement continues to be a critical component in assessing the United States (U.S.) health care system. Measures in the Cost and Efficiency portfolio are essential to evaluate the efficiency of care (i.e., higher quality, lower cost) and improve value through changes in practice. Improving U.S. health system efficiency can simultaneously reduce cost growth and improve the quality of care provided.

The Cost and Efficiency committee considers measures that focus on total health care spending for a health care service or group of services associated with a specified patient population, time period, and/or unit of clinical accountability. Measures in this topic area include broadly focused measures, such as per capita measures, which address total health care spending or resource use per person, to those with a narrower focus, such as measures dealing with the health care spending or resource use of an individual procedure (e.g., a hip replacement). The Cost and Efficiency portfolio of measures contributes to the national priority of making health care more efficient, accessible, and affordable for individuals, families, purchasers, and payers.

Timely recognition and diagnosis of certain conditions can lead to the use of effective treatments that work best at early stages of illness and overall improved management of disease.

The Initial Recognition and Management committee considers measures that address early signs and symptoms of conditions and diseases, initial recognition and management of a change in a person’s health status, and the experience, patient safety, and/or harm related to detection, diagnosis, or recognition of a condition. Measures in this topic area may include perinatal health, patient satisfaction with care, appropriate use of diagnostic tools, timeliness of care, care coordination, and monitoring.

Disease management focuses on improving quality of life for individuals with acute and chronic conditions by minimizing or preventing the disease effects through quality care.

The Management of Acute Events, Chronic Disease, Surgery, and Behavioral Health committee considers measures that address the management of acute or chronic disease, management of behavioral health conditions, pre-operative care, post-operative care, complications, functional status and impairments, patient safety, never events, morbidity, and mortality. Measures in this portfolio may also focus on improving health care system care coordination.

Primary prevention seeks to prevent disease or injury before it occurs. This can be achieved by altering unhealthy or unsafe behaviors that can lead to disease or injury and increasing resistance to disease should exposure occur.

The Primary Prevention committee considers measures that address preventive care, education and counseling, health promotion, and screening measures. Subtopics may include health-related lifestyle behaviors, observable risk factors (e.g., age, obesity), and vaccination. Additionally, measures that address mental health screenings (e.g., depression, other psychiatric conditions), alcohol and drug use, comorbidities, and suicide risk screening are also included.