The Federal Role in Promoting Health Information Technology

Outlines the need to expand adoption of health information technology to improve healthcare quality and efficiency; the financial, technical, and logistical challenges; and providers' concerns. Discusses federal policy options for addressing them

Committed to Safety: Ten Case Studies on Reducing Harm to Patients

Presents case studies of healthcare organizations, clinical teams, and learning collaborations to illustrate successful innovations for improving patient safety nationwide. Includes actions taken, results achieved, lessons learned, and recommendations

The Business Case for Quality: Ending Business as Usual in American Health Care

Examines some of the reasons why establishing a business case for improving health care is so difficult, and considers possible solutions. Includes comments on quality provisions of the Medicare Prescription Drug Improvement and Modernization Act of 2003

Association between physician characteristics and payments from industry in 2015-2017: observational study.

OBJECTIVE:To investigate the association between physician characteristics and the value of industry payments. DESIGN:Observational study. SETTING AND PARTICIPANTS:Using the 2015-2017 Open Payments reports of industry payments linked to the Physician Compare database, we examined the association between physician characteristics (physician sex, years in practice, medical school attended and specialty) and the industry payment value, adjusting for other physician characteristic and institution fixed effects (effectively comparing physicians practicing at the same institution). MAIN OUTCOME MEASURES:Our primary outcome was the value of total industry payments to physicians including (1) general payments (all forms of payments other than those classified for research purpose, eg, consulting fees, food, beverage), (2) research payments (payments for research endeavours under a written contract or protocol) and (3) ownership interests (eg, stock or stock options, bonds). We also investigated each category of payment separately. RESULTS:Of 544 264 physicians treating Medicare beneficiaries, a total of $5.8 billion in industry payments were made to 365 801 physicians during 2015-2017. The top 5% of physicians, by cumulative payments, accounted for 91% of industry payments. Within the same institution, male physicians, physicians with 21-30 years in practice and physicians who attended top 50 US medical schools (based on the research ranking) received higher industry payments. Across specialties, orthopaedic surgeons, neurosurgeons and endocrinologists received the highest payments. When we investigated individual types of payment, we found that orthopaedic surgeons received the highest general payments; haematologists/oncologists were the most likely to receive research payments and surgeons were the most likely to receive ownership interests compared with other types of physicians. CONCLUSIONS:Industry payments to physicians were highly concentrated among a small number of physicians. Male sex, longer length of time in clinical practice, graduated from a top-ranked US medical school and practicing certain specialties, were independently associated with higher industry payments

Evaluation of the Jim Joseph Foundation Education Initiative Year 3 Report

Launched in 2010, the Jim Joseph Foundation Education Initiative supports programs at three flagship Jewish institutions of higher education: Hebrew Union College-Jewish Institute of Religion (HUC-JIR), Jewish Theological Seminary (JTS), and Yeshiva University (YU). As part of this initiative, HUC-JIR, JTS, and YU designed and piloted new programs, enhanced existing programs, and provided financial assistance to additional programs.American Institutes for Research (AIR) is conducting an independent evaluation of the Jim Joseph Foundation Education Initiative. This report is the third in a series of five annual reports that describe progress toward accomplishing the goals of the Education Initiative

Finding k-Dissimilar Paths with Minimum Collective Length

Shortest path computation is a fundamental problem in road networks. However, in many real-world scenarios, determining solely the shortest path is not enough. In this paper, we study the problem of finding k-Dissimilar Paths with Minimum Collective Length (kDPwML), which aims at computing a set of paths from a source s to a target t such that all paths are pairwise dissimilar by at least \theta and the sum of the path lengths is minimal. We introduce an exact algorithm for the kDPwML problem, which iterates over all possible s-t paths while employing two pruning techniques to reduce the prohibitively expensive computational cost. To achieve scalability, we also define the much smaller set of the simple single-via paths, and we adapt two algorithms for kDPwML queries to iterate over this set. Our experimental analysis on real road networks shows that iterating over all paths is impractical, while iterating over the set of simple single-via paths can lead to scalable solutions with only a small trade-off in the quality of the results.Comment: Extended version of the SIGSPATIAL'18 paper under the same titl

Moving Jewish Educators to the Next Stage in Their Career: An Evaluation of New York University's Dual Master's and Doctoral Programs in Education and Jewish Studies

This study used a qualitative inquiry methodology to explore the experiences of students, which is a common methodological approach in research on higher education when a study's sample size is small and individuals' narratives are diverse (Anderson & Anderson, 2012; Golde & Dore, 2001; Maki & Borkowski, 2006). The evaluation team conducted initial and follow-up phone interviews with the 24 recipients of the Jim Joseph Foundation fellowships under this grant. The interviews inquired about professional experience and academic background, career goals, academic courses and other professional development, professional networking, current employment, and leadership experiences. In addition, the evaluation team conducted interviews with academic advisors and reviewed program materials. To validate the formation of a framework and quality indicators for the review of the programs, the team conducted comprehensive literature review and interviews with employers of the fellows. The evaluation team synthesized the data collected to determine the level of programs' capacity to prepare students for leadership roles in Jewish education and the impact of the programs on students to date

Frame me if you must: PrEP framing and the impact on adherence to HIV Pre-exposure Prophylaxis

Abstract Background “PrEP whore” has been used both as a pejorative by PrEP opponents in the gay community and, reactively, by PrEP advocates as a method to reclaim the label from stigmatization and “slut-shaming.” The actual prevalence and impact of such PrEP-directed stigma on adherence have been insufficiently studied. Methods CCTG 595 was a randomized controlled PrEP demonstration project in 398 HIV-uninfected MSM and transwomen. Intracellular tenofovir-diphosphate (TFV-DP) levels at weeks 12 and 48 were used as a continuous measure of adherence. At study visits, participants were asked to describe how they perceived others’ reactions to them being on PrEP. These perceptions were categorized a priori as either “positively framed,” “negatively framed,” or both. We used Wilcoxon rank-sum to determine the association between positive and negative framing and TFV-DP levels at weeks 12 and 48. Results By week 4, 29% of participants reported perceiving positive reactions from members of their social groups, 5% negative, and 6% both. Reporting decreased over 48 weeks, but positive reactions were consistently reported more than negative. At week 12, no differences in mean TFV-DP levels were observed in participants with positively-framed reactions compared with those reporting no outcome or only negatively-framed (1338 [IQR, 1036-1609] vs. 1281 [946-1489] fmol/punch, P = 0.17). Additionally, no differences were observed in those with negative reactions vs. those without (1209 [977–1427] vs. 1303 [964–1545], P = 0.58). At week 48, mean TFV-DP levels trended toward being higher among those that report any reaction, regardless if positive (1335 [909–1665] vs. 1179 [841–1455], P = 0.09) or negative (1377 [1054–1603] vs. 1192 [838–1486], P = 0.10) than those reporting no reaction. At week 48, 46% of participants reported experiencing some form of PrEP-directed judgment, 23% reported being called “PrEP whore,” and 21% avoiding disclosing PrEP use. Conclusion Over 48 weeks, nearly half of participants reported some form of judgment or stigmatization as a consequence of PrEP use. However, individuals more frequently perceived positively framed reactions to being on PrEP than negative. Importantly, long-term PrEP adherence does not appear to suffer as a result of negative PrEP framing. Disclosures All authors: No reported disclosures

Characteristics of a cohort of high-risk men who have sex with men on pre-exposure prophylaxis reporting transgender sexual partners.

Transgender people continue to be at high-risk for HIV acquisition, but little is known about the characteristics of their sexual partners. To address this gap, we examined sociodemographic and sexual characteristics of cisgender men who have sex with men (MSM) on pre-exposure prophylaxis (PrEP) reporting transgender sexual partners.A cohort of 392 MSM in southern California in a randomized clinical trial for PrEP adherence were followed from 2013 to 2016. Multivariable generalized estimating equation and logistic models identified characteristics of MSM reporting transgender sexual partners and PrEP adherence.Only 14 (4%) MSM reported having transgender sexual partners. MSM were more likely to report transgender partners if they were African American, had incident chlamydia, reported injection drug-using sexual partners, or received items for sex. Most associations remained significant in the multivariable model: African American (adjusted odds ratio [AOR] 11.20, P = .01), incident chlamydia (AOR 3.71, P = .04), and receiving items for sex (AOR 5.29, P = .04). There were no significant differences in PrEP adherence between MSM reporting transgender partners and their counterpart.MSM who report transgender sexual partners share characteristics associated with individuals with high HIV prevalence. Identifying this group distinct from larger cohorts of MSM could offer new HIV prevention opportunities for this group of MSM and the transgender community