Three Minnesota hospitals receive Top Hospital Award

All Minnesota hospitals should make this same commitment to patient safety

There is good news and bad news when it comes to patient safety in hospitals. The good news: Since the Institute of Medicine, (IOM) released its report in 1999 that detailed the cause of 100,000 needless deaths in hospitals due to medical mistakes, hospitals have made improvements in public reporting of outcomes and implementing quality improvement practices. The bad news: We still have a long way to go and in some cases, we have lost ground.

One form of public reporting that occurs in Minnesota hospitals is the reporting of "never events." Never events are 27 things that should never happen when you’re in the hospital. The list includes things like surgery being performed on the wrong body part, death associated with contaminated drugs, an infant who is discharged to the wrong person, and patient falls. Never events are puplicly reported annually at the state level in a report from the Minnesota Department of Health as “adverse events.” While this information is critically important to improving the quality of care in hospitals, it takes a retrospective look at what has gone wrong. Although it’s important to learn from mistakes so they are never repeated, more information should be provided to individual health care consumers so they can understand what hospitals are doing right, based on what is important to them, as patients.

In 2000, the Leapfrog Group was established by health care purchasers in an effort to use available evidence to help real people understand what is actually being done by hospitals to prevent mistakes before they happen. With the assistance of purchaser organizations like the Buyers Health Care Action Group (BHCAG), Leapfrog conducts an annual survey of hospital patient safety procedures and outcomes, with a focus on what hospitals are doing right. Twelve hundred hospitals across the country complete the survey and their results can be found at www.leapfroggroup.org. Unlike other hospital quality and safety reports, the Leapfrog Group reports on processes and outcomes that matter to a broad spectrum of the general public and delivers that information in a way that real people can understand. Hospitals complete many different surveys each year, some required by regulatory bodies, some required by health plans, some required by accrediting agencies. However, the Leapfrog survey is the only purchaser developed and requested survey.

Minnesota hospitals have historically scored very well on the Leapfrog survey, and 2010 is no exception. This year, three Minnesota hospitals were recognized with the Leapfrog Group’s Top Hospital Award. Those hospitals are: Children’s Hospitals and Clinics-St. Paul, Children’s Hospitals and Clinics-Minneapolis, and Mayo Clinic Rochester-St. Mary’s. Less than 6 percent of all hospitals that report to Leapfrog receive Top Hospital status.

Children’s Hospitals and Mayo Clinic stand apart from other hospitals because they have been able to successfully make patient safety and reporting a regular part of their workflow and to balance the investment of resources that reporting often requires with their responsibility to care for patients.

All hospitals across the state should take note of the commitment and approach shown by Children’s Hospitals and the Mayo Clinic to re-engage with reporting tools like the Leapfrog Survey and dedicate resources to re-energizing their reporting efforts.

Why? Because aside from these three top-performing hospitals, fewer Minnesota hospitals are participating in voluntary patient safety reporting efforts like the Leapfrog survey. In fact, participation by Minnesota hospitals in this survey has decreased over the past 10 years. In 2010, just 22 of the 136 Minnesota hospitals completed the survey. And although Minnesota hospitals are making progress against many patient safety measures, overall scores are declining in key areas like heart attack and pneumonia.

The exception to that trend is Children’s Hospitals and Mayo Clinic. At Children’s Hospitals, patient safety initiatives have helped the hospital achieve one of the lowest rates of hospital-acquired infections in the nation, and their use of electronic medical records has helped further reduce patient complications and to improve patient care.

Mayo Clinic’s receipt the Top Hospital ranking is due largely to that organization’s continued efforts to develop evidence-based improvements and to adopt cutting edge, high standards of patient care across the organization. For example, every employee⎯from office staff, care providers, all the way up to the CEO⎯are encouraged to participate in the Mayo Quality Fellows Program or take individual and team courses at Mayo's Quality Academy to improve quality, safety and efficiency in their work area.

From the purchaser perspective, the Leapfrog survey is the most comprehensive survey of hospital patient safety. The survey reports on three key areas that are important to health care consumers: 1) how patients fare in a particular hospital, 2) the resources that hospital uses to care for patients, and 3) hospital management practices that promote safety. When it comes to investing in reporting that consumers can actually use, the Leapfrog Survey effectively connects hospital performance with consumer information needs.

With all the negative and conflicting reports on the state of patient safety across the country, Minnesotans should be proud that they have three top-performing hospitals in their midst. Not only have these hospitals made a long-term commitment to improving patient safety, but equally important, they have committed to publicly reporting on their processes and outcomes based on what the purchasers want. Without this information, individuals cannot make informed decisions about where they receive care based on understandable and useful information.

Patient safety is not a competition, but rather something that every hospital should strive to achieve. Not only is improving patient safety essential for improved health outcomes, but it also addresses the overall problem of ever-increasing health care costs. The health care industry cannot expect purchasers⎯whether individuals or employer purchasers⎯to continue to foot the bill for care that is inefficient and of poor quality.

As health care reform initiatives are implemented in the coming years, employers and individual consumers will be driven to make purchase decisions based on factors other than cost. Patient safety outcomes are likely to be at the top of that list. As employer purchasers, health care decision makers and industry leaders, we need to work together to increase participation in the Leapfrog survey by Minnesota hospitals, because it is this level of public reporting that will truly make a difference in improving patient safety for all Minnesotans.

In the spirit of collaboration,

Carolyn Pare

President & CEO

Buyers Health Care Action Group

Patient Safety: What will it take to move the needle?

The answer is in transparency, public reporting and collaboration.

During a recent Community Dialogue sponsored by the Buyers Health Care Action Group (BHCAG), four health care industry leaders discussed patient safety, including:

• Where we're at with efforts to improve patient safety.
• How Minnesota compares to national patient safety outcomes.
• What is needed to truly move the needle on this important issue.

Guest speakers included Leah Binder, CEO of The Leapfrog Group; Jennifer Lundblad, CEO of Stratis Health; Lawrence Massa, president of the Minnesota Hospital Association; and Dr. Phil Kibort, vice president of medical affairs and chief medical officer at Children’s Hospital. Between these four leaders, there exists a wealth of knowledge and experience in the area of patient safety. So, what did these thought leaders have to say on the subject? In short:

• We can't expect employers to continue paying for health care that is inefficient and of poor quality.
• In order for public reporting to work, the data must be meaningful to consumers and individuals must actively use the data that hospitals are reporting to decide where to receive care.
• Collaboration and communication are necessary if reporting efforts are to be successful.
• Patient safety is not a competition, but rather something that every hospital should achieve.
• Data reporting is essential to demonstrate the quality of care provided to patients.

Where we're at with efforts to improve patient safety

Our guest speakers agreed that, by and large, the health care industry has improved since the original Institute of Medicine report in 1999 that illustrated the impact to patients of poor patient safety efforts. Yet, we still have a long way to go. All hospitals need to make patient safety and public reporting a regular part of their workflow. Organizations like BHCAG and The Leapfrog Group continue to work with hospitals to make balancing the investment of resources that reporting often requires with the organization’s responsibility to care for patients.

How Minnesota compares to national outcomes

As for Minnesota, hospitals locally continue to score better than those in other states; however, our health care ranking is declining and we don’t see much improvement against the national average in many publicly reported measures. Minnesota hospitals need to re-engage with reporting tools like the Leapfrog Survey and re-energize their reporting efforts. The Leapfrog Survey reports on three key areas that are important to consumers: how patients fare in a particular hospital, the resources that hospital uses to care for patients, and hospital management practices that promote safety. When it comes to investing in reporting that consumers can actually use, the Leapfrog Survey effectively connects hospital performance with consumer information needs.

What will it take to move the needle?

At the risk of repeating myself, three things need to happen in order for patient safety to continue to improve:

1. All hospitals need to make patient safety a priority and commit to this effort on an ongoing basis.
2. Hospitals need to commit to publicly reporting the outcomes that are important to purchasers and consumers and to working with organizations like BHCAG and The Leapfrog Group to report their patient safety efforts.
3. We all need to work together to educate consumers about how to use public data to make decisions when receiving care and why this is such an important step in the process.

We all play a part in making our health care system safe. And, as the focus on health care costs and outcomes continues to intensify, now is the time to work together to create long-lasting improvements.

In the spirit of collaboration,

Carolyn Pare

President & CEO

Buyers Health Care Action Group

Strength in numbers

Coalitions connect local health care needs and strengths with national agenda to create change

When someone has a problem, often the first thing they do is find other people who are in a similar situation. Why? For one thing, finding a solution to a complicated situation is easier when you have more people to lend their expertise and perspective. Two heads are better than one, right? But, joining forces with others also gives you more leverage and a greater ability to influence key decision makers and leaders who might be more inclined to listen to a group of consumers versus a single person.

Such is the case with health care.

In health care, that strength in numbers comes in the form of coalitions like the Buyers Health Care Action Group (BHCAG) and the National Business Coalition on Health (NBCH).

Coalitions exist to unite like-minded groups of people and organizations together under a common goal and to enable them to work together to create change.

In my new role as board chair for the NBCH and through the work that BHCAG is committed to, I’ve seen how influential a group of like-minded organizations can be. But what makes these organizations work is the balance of national and regional influence and perspective they offer.

You’ve heard me say many times that all health care is local, and I believe this truth will hold even as health care reform is enacted in the coming years. How then, you might wonder, does a national organization like NBCH figure into the equation if health care is, at its heart, local?

The answer is simple and clear. The NBCH provides the national perspective and presence in Washington that regional coalitions often can’t fund. The NBCH also provides support services for local coalitions to help them implement reform at the local level. The 60 member coalitions and more than 7,000 employer organizations across the country - including BHCAG members and employer organizations - benefit from the efforts and influence of the NBCH in several ways, including:

• The ability to use NBCH as our collective voice to policy makers in Washington and as a source for information on national health care reform
• Access to research on health care trends, best practices, and employer response to reform
• Partnership and participation in national programs that drive marketplace change, like eValue8, Bridges to Excellence and the Leapfrog survey
• The opportunity to learn from the experience of other markets and coalitions and to share best practices with business leaders through activities like the College for Value Based Purchasing
• Access to events like the Health and Productivity Forum and the National Leadership Council, which address trends in health management and health reform and provide opportunity for both learning and dialog with your peers
• Opportunities to participate in the national, as well as local, legislative process through work groups and task forces as a NBCH and BCHAG member

The guiding principles that have made BHCAG a driving force in health reform and that have made Minnesota a leader in health care for decades are still relevant in the current economy:

• Pay for quality
• Abide by common standards and measures
• Share data publicly
• Use technology to reduce costs and engage the consumer

These principles also align directly with the purchasing principles for which BHCAG advocates and that made the Smart Buy Alliance a successful early model of an accountable care organization. You will see BHCAG and the NBCH continue to advocate for these principles as we collectively pursue payment reform:

• Buy from the best
• Work toward common standards
• Engage the consumer
• Push for health information technology

NBCH member coalitions, like BHCAG, are an integral part of health reform in their own communities and home states, but they are also closely connected to the national work that the NBCH leads. This combination of national presence and local support is unique to the NBCH and differentiates the coalition from other national organizations that merely disseminate information to employer groups, but that do not provide the ongoing support to affect local change.

As the implementation of the health care reform legislation becomes a reality, our ability to unite against a common cause and with a singular focus will produce better quality, more efficiently delivered health care for all Americans. If you are interested in becoming more actively involved in health reform through BHCAG locally or nationally through the NBCH, please contact me and I will answer any questions you might have.

In the spirit of collaboration,

Carolyn Pare

President and CEO

Buyers Health Care Action Group

Reaping rewards for optimal care

Minnesota Bridges to Excellence drives improved care and outcomes for patients

Public reporting of performance data by health care providers has produced startling findings, such as the recent study on safety lapses in same-day surgery centers and the annual Department of Health report on “never events.” But, that same data has also revealed more promising news for patients and the health care industry⎯like the Minnesota Bridges to Excellence results.

Minnesota Bridges to Excellence is a BHCAG program that provides financial rewards for clinics that meet or exceed optimal care measures for patients with diabetes, vascular disease and depression. This year, as we celebrate the 5^th anniversary of Minnesota Bridges to Excellence, we acknowledge the commitment these health care providers have made to data reporting and improving patient care, and we applaud them for their efforts.

Tonight, BHCAG will host a recognition event to pay tribute to 39 medical groups and 124 clinics from various parts of the state who have qualified for “achievement” (meeting or exceeding optimal care guidelines) or “improvement” (did not meet optimal care goals, but showed improvement of 10 percent or more over last year) through the Bridges to Excellence program. We look forward to recognizing their efforts and successes and hope that you will join us for the event.

I’m very pleased and encouraged to report that the number of clinics that qualified for rewards has more than doubled since 2009.

This means that more people who are living with these chronic conditions are receiving better care. As for clinical outcomes, physicians point to a decrease in the number of referrals being processed as a sign that improved care delivery is having a real-life impact on patients. To quote Dr. Kenneth Ripp of the Raiter Clinic in Cloquet, Minn.:

“Prevention is the unsung hero in health care. It’s the heart attack that never happened because a patient’s condition is being appropriately managed. In the end, we know our efforts are making a difference if we’re sending fewer patients to specialists to treat heart attacks and other medical emergencies.”

In addition to an increase in the number of clinics that qualified for rewards, I was also encouraged that more clinics outside of the Twin Cities metro area qualified for rewards this year.

Geography can complicate quality improvement efforts for clinic systems in greater Minnesota, as they attempt to bring disparate clinics together under a unified, systematic quality improvement program. The fact that more clinics in greater Minnesota qualified for Minnesota Bridges to Excellence rewards shows a high level of commitment to their patients and innovation on the part of these clinics.

“Because we’re small, we can do quality in a different way,” said Dr. Ripp. “We can do things on a much more personal level and incent physicians on a personal basis. We’ve found that a little incentive can go a long way to getting people’s attention.”

The value that programs like Minnesota Bridges to Excellence brings to the table is not so much in the financial reward, but in the focus that it lends to quality improvement efforts. Physicians and Minnesota Bridges to Excellence reward winners tell us that the program helped them focus their efforts and got everyone at various clinic locations singing the same song.

“It’s difficult for a mid-level practice to do 14 different quality initiatives really well,” said Dr. Tim Hernandez, Family HealthServices, White Bear Lake, Minn. “Having key initiatives that everyone supports and is aligned with is a huge help to us. And getting public recognition for developing the infrastructure and tools needed to measure outcomes provides valuable reinforcement to our staff.”

While these most recent Minnesota Bridges to Excellence results are encouraging, there is still much progress to be made in the area of care delivery. But the efforts of this year’s winners set a prime example of the dedication and innovation that is needed to improve care and to put the focus in health care on quality instead of quantity. This level of collaboration and leadership is essential to the success of individual clinics and the health care marketplace as a whole.

In the spirit of collaboration,

Carolyn Pare

President and CEO

Buyers Health Care Action Group

Patient safety requires vigilance

Infections in surgery centers show need for ongoing focus on patient safety and quality

You’ve heard the reports of misdiagnoses, botched surgeries, and now, a report from the Centers for Disease Control and Prevention that shows a serious problem with infection control in same-day surgery centers across the country.

The report, which was conducted by the Centers for Disease Control and Prevention and published first in the Journal of the American Medical Association and last week in the Washington Post, reflected unsafe practices that were observed in same-day surgery centers in Maryland, North Carolina and Oklahoma. The safety lapses were very basic, from failure to wash hands or wear gloves, to reusing devices meant for one patient on multiple patients. At the end of the day, 67 percent of the centers in the study had at least one lapse in infection control and 57 percent were cited for deficiencies.

While it is not known whether the safety lapses identified in this study led to infections in patients, we do know that infections in the surgical and hospital settings are a very real, very serious matter. In March 2010, the Leapfrog Group (of which BHCAG is a founding member) released a report on central-line associated blood stream infections, or CLABSIs, which cause at least 30 percent of the estimated 99,000 hospital-infection related deaths in the United States and account for billions of dollars in avoidable health care costs every year.

The Leapfrog report, which targeted 926 hospitals in Minnesota and across the country, was significant not only because of what it revealed about the CLABSI rates in hospitals. It was significant because it demonstrated the real-life value that comes from public reporting of performance data by health care providers. In this case, the public learned of the serious health problems a central-line infection can present and whether their hospital was up to par in preventing them.

However, many hospitals, including six in Minnesota chose not to respond to requests for data regarding their CLABSI rates. This failure to publicly report performance data robs individual health care consumers and health care purchasers of their ability to make informed decisions about where they receive care. It also stunts efforts to transform the health care reimbursement system from one that rewards for quantity of services performed to one that rewards for quality outcomes achieved.

And that’s where the commonality lies between the CDC study and the Leapfrog report. Both examples shine a light on the need for greater patient safety measures in health care facilities. BHCAG and its member organizations believe that patient safety is not a topic that should be pulled off the shelf and paraded around once a year. Patient safety should always be front and center in the health care reform debate.

It is equally important to remember that the key to improving patient safety is public reporting of data, such as shown in these studies. Whether data is voluntarily submitted through programs like BHCAG’s Minnesota Bridges to Excellence initiative, Minnesota Community Measurement, or through reports such as those mentioned here; business leaders, the health care community, and political leaders need to work together to generate greater momentum and compliance for public reporting among health care providers. And, since we’re talking about public reporting, let’s not forget to recognize those health care providers that have been leaders in this area and that have, as a result, realized notable improvements in care delivery and patient outcomes.

Look for more on the topic of rewards for improving care delivery and patient outcomes later this month as we celebrate the fifth anniversary of the Bridges to Excellence program.

In the spirit of collaboration,

Caroyln Pare
President and CEO
The Buyers Health Care Action Group

Closing the quality gap

Patient safety must remain a key component of value-based purchasing

Addressing gaps in the quality of care and outcomes for Minnesota’s hospitals is an issue that BHCAG has been involved in for many years. Since first lending our support to the Minnesota Alliance for Patient Safety in 2000, BHCAG has continued to advocate for transparency at the hospital level by collaborating with employers and other health care organizations to establish The Leapfrog Group (also in 2000). And later, in 2003, BHCAG joined forces with the Minnesota Department of Health to introduce the state’s first adverse events report.

These initiatives have contributed to community and statewide improvements in outcomes and pushed Minnesota to the forefront of public reporting in health care in very meaningful ways:

• BHCAG was a founding member of The Leapfrog Group, collaborating with employers and health care organizations to address a report on medical errors by the Institute of Medicine. The Leapfrog survey, which focuses on specific safety measures that hospitals can take to avoid some of the most common medical errors, is now completed by hospitals in 31 regions of the United States. In addition, this initiative has prompted many hospitals to respond with their own quality initiatives. The Leapfrog survey provides consumers with information about specific steps that hospitals in their community are taking to improve quality and to avoid common medical mistakes.
• The Minnesota Alliance for Patient Safety (MAPS) is a partnership between the Minnesota Hospital Association, the Minnesota Medical Association, the Minnesota Department of Health and organizations, like BHCAG, that are committed to improving patient safety. MAPS strives to promote optimum patient safety through collaborative and supportive efforts among all participants of the health care system in Minnesota. Among other things, MAPS offers awareness campaigns for hospital employees, pilot programs, and tools to assist staff in their quality improvement efforts. BHCAG representatives serve on the MAPS steering committee, which guides the ongoing strategy and direction for this organization.
• Minnesota was the first state to adopt by legislative action all 27 (now 28) of the National Quality Forum’s adverse events. This requires Minnesota hospitals to develop an action plan for improving their performance and holds them accountable for regular reporting of outcomes to the public. BHCAG was instrumental in establishing the adverse events report in Minnesota by providing funding for the development of the reporting protocol. BHCAG also facilitated ongoing discussions with hospitals and health plans to identify ways to improve outcomes and reshape the reimbursement system. By targeting deadly, and avoidable, medical mistakes the adverse events report keeps consumers informed about the performance of providers in their community. This supports individual decision making and gives hospitals an extra incentive to improve.

But there is still much room for improvement. A recent article in the Star Tribune drove this point home by citing the gaps in quality that can exist between hospitals that are part of the same hospital system, much less across different care systems.

Understanding and eliminating these gaps will become even more important in the coming months and years as the new Patient Protection and Affordable Care Act is implemented. The legislation’s focus on increased public reporting will put more emphasis on reporting by all hospitals and will shift the focus for comparing facilities to a value-based purchasing approach.

What to expect from BHCAG

As the details become known for how the new health care legislation will be enacted, BHCAG will continue to bring together employers, health plans and health care providers to push for widespread compliance with patient safety and reporting initiatives like Leapfrog and the adverse events report. More specifically, we will advocate for a universal and standardized reporting format that is meaningful and useful to employers and individual health care consumers. Meanwhile, we will continue our involvement in Aligning Forces for Quality (AF4Q) a grant from the Robert Wood Johnson Foundation that aims to align provider performance, public reporting and quality improvement.

If you are looking for a way to become more involved in patient safety and public reporting, please contact me. And watch for an upcoming BHCAG Community Dialogue session on this topic.

Remember that, together, our collective voice can have a profound influence on the future health care marketplace.

In the spirit of healthy change,

Carolyn Pare
President & CEO

Curing health care calls for transparency and collaboration

Most people wouldn’t buy a car or even a pair of shoes without knowing the price and how the product compares to other, similar products. Yet, when it comes to health care, people make decisions for themselves and their family members every day without fully understanding the implications of those decisions.

Consider the employee who enrolls in an employer-sponsored health plan without understanding what their cost-sharing responsibility will be. Or the patient newly diagnosed with diabetes who does not ask their primary care physician about the diabetes program and outcomes at his or her clinic. And furthermore, the individual who is managing their personal health care needs along with those of their children and aging parents. In any and all of these situations, people are making important decisions based on incomplete data about themselves and their physicians.

With health care, as in many other areas of life, information equals knowledge, and knowledge equals power. Access to information ultimately comes from greater transparency, or sharing of data by health plans and health care providers. In our work at the Buyers Health Care Action Group (BHCAG), we participate in and observe health care reform on both a regional and national level, and are reminded at every turn of the need for greater transparency in all things related to health care.

We believe that in order for real change to occur, the general public and the business community need to have a voice in the debate, and they need access to information and data that can influence the decisions they make about how they purchase health care coverage and services. These essential conversations cannot happen behind closed doors.

Minnesota has historically been at the forefront of change in health care, thanks to the innovative spirit of the health care community, the collaborative nature of our employer base, and the expertise of the medical community. Minnesota has already made great strides in data transparency and serves as a model for national change in many areas. However, we need to continue to work together and push to make more meaningful data available to employers and individual purchasers. The availability and understanding of health care data will contribute to positive health care reform in several key categories, including:

• Improving quality of care and outcomes. Current health care reform calls for improved outcomes and emphasizes pay-for-performance programs and value-based benefit design as a way to reign in spending and create a more sustainable reimbursement system. The Minnesota Bridges to Excellence program, implemented in 2006, was one of the nation’s first employer-led, pay-for-performance programs designed to improve and report on outcomes, at both the clinic and medical system level, for people with diabetes, heart and vascular disease, and depression. By pushing for direct data reporting at the clinic level rather than the system level, health care consumers gain a better understanding of the quality of care and outcomes delivered by individual clinics in different communities.
  
  By accelerating the use of direct data reporting at the clinic level, BHCAG has encouraged greater use of transparency tools across the entire community. In addition, the Bridges to Excellence program has been a driving force behind a shift from process reporting by health care providers to performance reporting. In other words, reporting on the outcomes of the procedures or care that is delivered instead of merely whether something was or was not done.
  
  
• Patient safety. Closely related to the issue of quality is patient safety. BHCAG worked closely with Minnesota employers to help pass legislation in 2003 that required Minnesota hospitals to report on adverse events or medical mistakes, as identified by the National Quality Forum. As a result, Minnesota was the first state to adopt all of the National Quality Forum’s 27 adverse events by legislative action. The push for reporting of outcomes continues through Aligning Forces for Quality (AF4Q), a grant from the Robert Wood Johnson Foundation. AF4Q grants were awarded in 14 communities, including the metro area, with the common goal of aligning provider performance, public reporting and quality improvement.
  
  BHCAG is actively involved in AF4Q and efforts to increase use of the Minnesota Community Measurement Web site as a common source for data. In addition, we are part of a workgroup that has developed http://www.theD5.org, a web site for people with diabetes to help them understand the common diabetes measurements, why they’re important and how local clinics perform against these measures.
  
  
• Health plan performance and accountability. Health plans are at the center of the health care debate, as businesses and individuals are reeling from year after year premium increases and millions of Americans remain uninsured. We have worked steadily with employers and health plans as a founding member of eValue8, a health plan survey tool, to make public information about health plan cost, quality and performance in eight key areas.
  
  
• Personal health information. Giving individual patients access to and control of their own health information, including medical history, test results, coverage limitations and financial information, is key to creating more informed and engaged health care consumers. And, it could be a critical component to how people experience health care in the future. BHCAG believes that personal health information should belong to the individual and should not be tethered to a health plan or provider system. To this end, we continue to advocate for businesses and health care companies to adopt myHealthfolio, a Web-based public health record that is owned by the individual, regardless of where they receive care or who their insurance carrier is.

In the coming months, we will continue to advocate for increased transparency and meaningful change in the availability of data and how employers and individual consumers access health care information. I encourage you to share your thoughts and comments with me via this blog. A healthy dialog is a first step to creating change in the marketplace.

In the spirit of healthy change,

Carolyn Pare

President & CEO