Committee on Core Metrics for Better Health at Lower Cost

Consensus

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Thousands of measures are in use today to assess health and health care in the United States. Although many of these measures provide useful information, their usefulness in either gauging or guiding performance improvement in health and health care is seriously limited by their sheer number, as well as their lack of consistency, compatibility, reliability, focus, and organization. To achieve better health at lower cost, all stakeholders - including health professionals, payers, policy makers, and members of the public - must be alert to what matters most. What are the core measures that will yield the clearest understanding and focus on better health and well-being for Americans?

Vital Signs explores the most important issues - healthier people, better quality care, affordable care, and engaged individuals and communities - and specifies a streamlined set of 15 core measures. These measures, if standardized and applied at national, state, local, and institutional levels across the country, will transform the effectiveness, efficiency, and burden of health measurement and help accelerate focus and progress on our highest health priorities. Vital Signs also describes the leadership and activities necessary to refine, apply, maintain, and revise the measures over time, as well as how they can improve the focus and utility of measures outside the core set.

If health care is to become more effective and more efficient, sharper attention is required on the elements most important to health and health care. Vital Signs lays the groundwork for the adoption of core measures that, if systematically applied, will yield better health at a lower cost for all Americans.

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Publication information

308 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-32493-9
ISBN Ebook: 0-309-32494-7
DOI: https://doi.org/10.17226/19402

Suggested citation

Institute of Medicine. 2015. Vital Signs: Core Metrics for Health and Health Care Progress. Washington, DC: The National Academies Press.

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David Blumenthal

David Blumenthal, MD, MPP, became President and CEO of the Commonwealth Fund, a national health care philanthropy based in New York City, in January, 2013. Previously, he served as Chief Health Information and Innovation Officer at Partners Health System in Boston, MA, and was Samuel O. Thier Professor of Medicine and Professor of Health Care Policy at Massachusetts General Hospital/ Harvard Medical School. From 2009 to 2011, Dr. Blumenthal was the National Coordinator for Health Information Technology under President Barack Obama. In this role he was charged with building an interoperable, private and secure nationwide health information system and supporting the widespread, meaningful use of health IT. Prior to that, Dr. Blumenthal was a practicing primary care physician, director of the Institute for Health Policy, and professor of medicine and health policy at Massachusetts General Hospital/Partners Healthcare System and Harvard Medical School. As a renowned health services researcher and national authority on health IT adoption, Dr. Blumenthal has authored over 250 scholarly publications, including the seminal studies on the adoption and use of health information technology in the United States. Dr. Blumenthal received his undergraduate, medical, and public policy degrees from Harvard University and completed his residency in internal medicine at Massachusetts General Hospital.

Julie Bynum

Julie P.W. Bynum, MD, MPH, is Associate Professor of Medicine at the Geisel School of Medicine at Dartmouth and The Dartmouth Institute for Health Policy and Clinical Practice, where she is also the Associate Director of the Center for Health Policy Research. Dr. Bynum’s work is focused on assessment of health system performance for the elderly using national U.S. Medicare administrative data. Dr. Bynum has received funding from the American Geriatric Society Foundation for Health in Aging Program for Research on Health Outcomes and has been a Robert Wood Johnson Physician Faculty Scholar. She was a National Institute of Aging Beeson Scholar (K23) studying the quality and efficiency of healthcare delivery to high-risk elderly. One of Dr. Bynum’s contributions to the field has been to develop a method of creating “virtual” physician-hospital networks that allows the measurement of care delivered and its outcomes for a population served by a specific group of providers. These networks were used in the conceptual development of the Accountable Care Organization legislation. She has continued her policy-relevant efforts as a 2011-2013 Health & Aging Policy Fellow funded by the Atlantic Philanthropies. Currently she leads two NIH funded studies: Efficiency of Care for High Cost High Need Beneficiaries and Optimizing Fracture Care Outcomes: A Comparative Effectiveness Approach.

Lori Coyner

Lori Coyner recently joined the Oregon Health Authority as Director of Accountability and Quality where she oversees the quality and incentive metrics for Oregon’s Coordinated Care Organizations (CCOs). CCOs are the basis for Oregon’s health care transformation effort for Medicaid enrollees. Prior, she served as the Director of Measurement and Reporting at the Oregon Health Care Quality Corp. Ms Coyner is an accomplished biostatistician and was responsible for the development of Quality Corp’s quality and utilization reporting system and measure development. Additionally, she has many years of experience working in academic settings at Oregon Health & Sciences University and the University of New Mexico, School of Medicine. She maintains her faculty appointment in the OSHU Department of Public Health and Preventive Medicine where she teaches Introduction to Biostatistics.

Diana S. Dooley

Diana Dooley, Secretary, California Health and Human Services Agency, appointed December 2010 by Governor Jerry Brown, leads 13 state departments within the Agency, chairs Covered California (the Health Benefit Exchange) and serves as chair or member of numerous other boards and commissions. Previously, Dooley was President and CEO of the California Children’s Hospital Association. Dooley began her career as an analyst for the State and in 1975, she was appointed to the staff of Governor Jerry Brown for whom she served as Legislative Director and Special Assistant until the end of his term in 1983. Before becoming an attorney in 1995, she owned a public relations and advertising agency. Dooley moved into health care in 2000 when she left her private law practice to serve as General Counsel and Vice President at Children’s Hospital Central California. Dooley is active in civic and community affairs, having served on the Boards of Directors of the UC Merced Foundation, Blood Source of Northern California and The Maddy Institute at California State University, Fresno. She is also a past president of Planned Parenthood, the Visalia Chamber of Commerce and the Central California Futures Institute. Dooley is a native of Hanford, California and graduated from Hanford High School in 1969. She received her bachelor’s degree in Social Sciences from California State University, Fresno in 1972 and her law degree from San Joaquin College of Law in 1995. She is married to Dan Dooley and has two adult daughters.

Timothy G. Ferris

Timothy G. Ferris, MD, MPH, is Vice President for Population health at Partners Healthcare, Medical Director at Massachusetts General Physicians Organization and an Associate Professor of Medicine and Pediatrics at Harvard Medical School. Dr. Ferris is a practicing general internist and a Senior Scientist in the Mongan Institute for Health Policy. He holds degrees from Middlebury College, Oxford University, Harvard Medical School, and the Harvard School of Public Health. His management responsibilities include oversight of ACO contracts, performance improvement initiatives, medical staff affairs, physician integration strategies, and innovation in care delivery. Dr. Ferris has over 90 publications in the areas of health care quality measurement, risk adjustment, population management, and information technology. He has led efforts at Partners Healthcare, a network of hospitals and physicians in Boston, to improve the quality of care and decrease costs of care for all patients served within this system, focusing particularly on the sickest, highest risk patients. He was the principal investigator for a six year Medicare demonstration project examining how best to redesign care to improve quality and decrease costs for Medicare beneficiaries. This demonstration project won the 2011 National Patient Safety Foundation’s Socius Award. Dr. Ferris has received funding from AHRQ, NIH, and the Commonwealth Fund and he has served on research review committees for the Agency for Healthcare Research and Quality (AHRQ), as well as multiple committees for the National Quality Forum (NQF) where he chaired the Consensus Standards Approval Committee. He has served as a consultant to the Institute for Healthcare Improvement, Congressional Research Service, National Governor’s Association, and the World Health Organization.

Sherry Glied

Sherry A. Glied, PhD, will be Dean of New York University’s Robert F. Wagner Graduate School of Public Service beginning in August, 2013. From 1989-2012, she was Professor of Health Policy and Management at Columbia University’s Mailman School of Public Health. She was Chair of the department from 1998-2009. On June 22, 2010, Glied was confirmed by the U.S. Senate as Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services, and served in that capacity from July 2010 through August 2012. She had previously served as Senior Economist for health care and labor market policy on the President’s Council of Economic Advisers in 1992-1993, under Presidents Bush and Clinton, and participated in the Clinton Health Care Task Force. She has been elected to the Institute of Medicine of the National Academy of Sciences, the National Academy of Social Insurance, and the Board of AcademyHealth, and has been a member of the Congressional Budget Office’s Panel of Health Advisers. Glied’s principal areas of research are in health policy reform and mental health care policy. Her book on health care reform, Chronic Condition, was published by Harvard University Press in January 1998. Her book with Richard Frank, Better But Not Well: Mental Health Policy in the U.S. since 1950, was published by The Johns Hopkins University Press in 2006. She is co-editor, with Peter C. Smith, of The Oxford Handbook of Health Economics, which was published by the Oxford University Press in 2011. Glied holds a B.A. in economics from Yale University, an M.A. in economics from the University of Toronto, and a Ph.D. in economics from Harvard University.

Larry A. Green

Larry A. Green, MD, was born and raised in Ardmore, Oklahoma, graduating from the University of Oklahoma with a major in psychology. After graduating from Baylor College of Medicine in Houston, Texas, he did his residency in family medicine in Rochester, New York at Highland Hospital and the University of Rochester. He practiced medicine in Van Buren, Arkansas, in the National Health Service Corps, before joining the faculty at the University of Colorado. He has remained a faculty member here throughout his career, during which he has served in various roles, including practicing physician, residency program director, developer of practice-based research networks, and department chair. In 1999 he became the founding director of the Robert Graham Center, a research policy center sponsored by the American Academy of Family Physicians focused on family medicine and primary care, in Washington, D.C. He served on the Steering Committee of the Future of Family Medicine Project that propelled the patient-centered medical home forward. He directed the Robert Wood Johnson Foundation’s Prescription for Health national program focused on incorporating health behavior change in redesigned primary care practices. He is a founding board member for Partnership 2040, a community based participatory research enterprise in the Denver area. He has received the Curtis Hames Award and the Maurice Wood Award for Lifetime Contribution to Primary Care Research. He is a regular member of the Institute of Medicine.

George J. Isham

George J. Isham, MD, MS, is Senior Advisor to HealthPartners, responsible for working with the board of directors and the senior management team on health and quality of care improvement for patients, members and the community. Dr. Isham is also Senior Fellow, HealthPartners Institute for Education and Research and facilitates progress at the intersection of population health, research and public policy. Dr. Isham currently co-chairs the National Quality Forum convened Measurement Application Partnership, chairs the National Committee for Quality Assurances’ clinical program committee and a is member of NCQA’s committee on performance measurement. Dr. Isham is currently chair of a technical expert panel on the National Assessment of the Impact of CMS Quality Measures. Dr. Isham is co-char of the Institute of Medicine's Roundtable on Population Health Improvement and is also chair of the Institute of Medicine’s Roundtable on Health Literacy. He has chaired three studies in addition to serving on a number of IOM studies related to health and quality of care. In 2003 Isham was appointed as a lifetime National Associate of the National Academies of Science in recognition of his contributions to the work of the Institute of Medicine. He is a former member of the Center for Disease Control and Prevention’s Task Force on Community Preventive Services and the Agency for Health Care Quality’s United States Preventive Services Task Force and currently serves on the advisory committee to the director of Centers for Disease Control and Prevention. His practice experience as a general internist was with the United States Navy, at the Freeport Clinic in Freeport, Illinois, and as a clinical assistant professor of medicine at the University of Wisconsin Hospitals and Clinics in Madison, Wisconsin.

Craig A. Jones

Craig A. Jones, MD, is the Director of the Vermont Blueprint for Health, a program established by the State of Vermont, under the leadership of its Governor, Legislature and the bi-partisan Health Care Reform Commission. The Blueprint is intended to guide statewide transformation of the way that health care and health services are delivered in Vermont. The program is dedicated to a high value, high quality health care system for all Vermonters, with a focus on prevention. Currently, Dr. Jones serves on several committees and workgroups including the Institute of Medicine's Consensus Committee on the Learning Healthcare System in America, and the Roundtable on Value and Science Driven Healthcare. Prior to this he was an Assistant Professor in the Department of Pediatrics at the Keck School of Medicine at the University of Southern California, and Director of the Division of Allergy/Immunology and Director of the Allergy/Immunology Residency Training Program in the Department of Pediatrics at the Los Angeles County + University of Southern California (LAC+USC) Medical Center. He was Director, in charge of the design, implementation, and management, of the Breathmobile Program, a program where mobile clinics deliver ongoing care to inner city children in at their schools and at County clinics. This program evolved from community outreach to a more fully integrated Pediatric Disease Management Program for the Los Angeles County Department of Health Services, and has spread to several other communities across the country. He has published papers and abstracts in Pediatric Research, Pediatrics, Journal of Pediatrics, Pediatrics in Review, Journal of Clinical Immunology, Journal of Allergy and Clinical Immunology, Annals of Allergy, Asthma and Immunology, CHEST, and Disease Management. Dr. Jones was an Executive Committee and Board Member for the California Chapter of the Asthma & Allergy Foundation of America, as well the chapter President. He is a past president of the Los Angeles Society of Allergy Asthma & Immunology, and a past President and a member of the Board of Directors for the California Society of Allergy Asthma & Immunology. Dr. Jones received his undergraduate degree at the University of California at San Diego and his M.D. at the University of Texas Health Science Center in San Antonio, Texas. He completed his internship and residency in pediatrics at LAC + USC Medical Center, where he also completed his fellowship in allergy and clinical immunology.

Robert Kocher

Robert Kocher, MD is a Partner at Venrock and focuses on healthcare IT and services investments. He currently serves on the Board of Castlight Health and is a Board Observer at ConsultingMD. He is on the Advisory Boards of Harvard Medical School Health Care Policy Department, USC Leonard D. Schaeffer Center for Health Policy and Economics where he is also a Senior Fellow, National Institute of Healthcare Management, ChildObesity180, and as a Guest Scholar at the Brookings Institution Engleberg Center for Health Reform. He Co-Founded, and has served as Co-Chair for the past four years, the Health Data Initiative, a joint effort of HHS and the Institute of Medicine, to release healthcare data to spur private sector innovation to improve healthcare cost and quality. He is also a member of the Health Affairs Editorial Board. Prior to Venrock, Bob served in the Obama Administration as Special Assistant to the President for Healthcare and Economic Policy on the National Economic Council. In the Obama Administration, Bob was one of the shapers of the Affordable Care Act focusing on cost, quality, and delivery system reform and health IT policy. He was one of the leaders of the First Lady’s “Let’s Move” childhood obesity initiative, led the formation of the Partnership for a Healthier America, and served on the Federal Advisory Panel charged with developing a national obesity strategy. Prior to the White House, he was a Partner at McKinsey & Company where he led McKinsey Global Institute’s healthcare economics work and Center for U.S. Health System Reform. He has worked widely across the US healthcare system to improve regulatory policy, economic performance, labor productivity, clinical outcomes, and patient experience. Bob received undergraduate degrees from the University of Washington and a medical degree from George Washington University. He completed a research fellowship with the Howard Hughes Medical Institute and the National Institutes of Health, and went on to complete his internal medicine residency training at the Beth Israel Deaconess Medical Center and the Harvard Medical School.

Kevin Larsen

Kevin Larsen, MD, is Medical Director of Meaningful Use at the Office of the National Coordinator for Health IT. In that role he is responsible for coordinating the clinical quality measures for Meaningful Use Certification and overseas the development of the Population Health Tool projectpophealth.org. Prior to working for the federal government he was Chief Medical Informatics Officer and Associate Medical Director at Hennepin County Medical Center in Minneapolis, Minnesota. He is also an Associate Professor of Medicine at the University of Minnesota. Dr. Larsen graduated from the University of Minnesota Medical School and was a resident and chief medical resident at Hennepin County Medical Center. He is a general internist and teacher in the medical school and residency programs. His research includes health care financing for people living in poverty, computer systems to support clinical decision making, and health literacy. In Minneapolis he was also the Medical Director for the Center for Urban Health, a hospital, community collaboration to eliminate health disparities. He served on a number of state and national committees in informatics, data standards and health IT.

Elizabeth A. McGlynn

Elizabeth McGlynn, PhD, is the Director of the Center for Effectiveness and Safety Research at Kaiser Permanente. McGlynn is an internationally known expert on evaluating health care delivery. Most recently she held the RAND Distinguished Chair in Health Care Quality. Her leadership in developing a comprehensive method for evaluating the technical quality of care delivered to adults and children in the United States produced a seminal national study that demonstrated the magnitude of the quality problem in the United States for everyone. At RAND McGlynn led a team of investigators that developed a comprehensive method for evaluating health policy proposals and a model to estimate the effects of coverage expansion policies on the number of newly insured, the cost to the government, the effects on premiums in the private sector, and the financial impact on households. She has conducted research on efficiency and effectiveness of care measures. Her recently published results inform methodological and policy issues for implementing these measures at the individual physician level for payment and public reporting. Dr. McGlynn is a member of the Institute of Medicine and serves on a variety of national advisory committees. She was a member of the Strategic Framework Board, which provided a blueprint for the National Quality Forum on the development of a national quality measurement and reporting system. She chairs the board of AcademyHealth, serves on the board of the American Board of Internal Medicine Foundation, and has served on the Board of Providence-Little Company of Mary Hospital Service Area in Southern California. She serves on the editorial boards for Health Services Research and The Milbank Quarterly and is a regular reviewer for many leading journals. Dr. McGlynn received her bachelor’s degree in international political economy from Colorado College in Colorado Springs, her master’s degree in public policy from the University of Michigan’s Gerald R. Ford School of Public Policy, and her Ph.D. in public policy from the Pardee RAND Graduate School.

Elizabeth Mitchell

Elizabeth Mitchell serves as President & CEO of the Network for Regional Healthcare Improvement, a national network of multistakeholder Regional Health Improvement Collaboratives with over 30 members across the US. Prior to this, Elizabeth was the CEO of the Maine Health Management Coalition, an employer-led, multi-stakeholder coalition working to improve the value of healthcare services. Elizabeth also served as the CEO of the Maine Health Management Coalition Foundation leading its performance measurement and public reporting program and engaging the public in the use of cost and quality information. While at the Coalition, she led many multistakeholder payment reform and healthcare system redesign efforts, established the MHMC Data and Analytics program with a multipayer claims database and was the nation’s 4th designee in CMS’ Qualified Entity Certification Program. Elizabeth was integral to the development of Maine’s successful State Innovation Model grant in which MHMC was named as the State’s ‘Implementation Partner’. Elizabeth serves on the Board of the National Quality Forum and on the Coordinating Committee of NQF’s Measure Application Partnership. She served for several years on the Board of the National Business Coalition on Health and Chair of its Government Affairs Committee and as Vice-Chair and Chair of the Board of the Network for Regional Healthcare Improvement. Elizabeth is past-chair of Maine’s Chartered Value Exchange, a convener of Maine’s Aligning Forces for Quality Alliance, and served on the Advisory Council of the Maine Quality Forum. Prior to being appointed CEO of the Maine Health Management Coalition, Elizabeth worked for MaineHealth, Maine’s largest integrated health system where she worked with employers and led several transparency and quality improvement efforts. She served two terms representing Portland in the Maine State Legislature, and chaired the Health and Human Services Committee. Elizabeth has held posts at the National Academy for State Health Policy, and London’s Nuffield Trust. Elizabeth was selected for an Atlantic Fellowship in Public Policy by the Commonwealth Fund and the British Council. While in the UK, she completed the International Health Leadership Program at Cambridge University’s Judge School of Management, while pursuing graduate studies at the London School of Economics. Elizabeth lives in Portland, Maine with her husband and four children.

Sally Okun

Sally Okun, RN, MMHS, is the Vice President for Advocacy, Policy and Patient Safety at PatientsLikeMe (PLM) where she oversees patient voice initiatives; participates in health policy discussions at the national and global level; and is the company’s liaison with government and regulatory agencies. Sally joined PLM in 2008 as the manager of Health Data Integrity oversaw the site’s medical ontology, patient vocabulary and the pharmacovigilance and drug safety platform. Prior to joining PLM Sally, a registered nurse, practiced as a palliative and end-of-life care specialist. In addition as an independent consultant she contributed to multiple clinical, research, and educational projects focused on palliative and end-of-life care for numerous clients including Brown University, Harvard Medical School, MA Department of Mental Health, Hospice Education Network and the Robert Wood Johnson Foundation. She received her nursing diploma from the Hospital of St. Raphael School of Nursing; BSN from Southern Connecticut State University; and Master's degree from The Heller School for Social Policy & Management at Brandeis University. She completed study of Palliative Care and Ethics at Memorial Sloan-Kettering Cancer Center and was a fellow at the National Library of Medicine Program in Biomedical Informatics.

Lyn Paget

Lyn Paget, MPH, is the Managing Partner of Health Policy Partners, an independent organization dedicated to connecting patient priorities with policy and innovation. For over 25 years, Ms. Paget has worked to enhance the quality of the patient experience in health care. With a focus on information, engagement, and partnership, she has established strategic alliances with government agencies, medical professional societies, consumer advocacy groups, health care quality organizations and policy leaders to create unity around principles for successful innovation and change. She is currently Project Director for the NCQA/Moore Foundation collaborative project to develop an innovative strategy to rapidly advance patient and family engagement by leveraging health information technology. As the previous Director of Policy and Outreach at the Informed Medical Decisions Foundation, she directed efforts in advocacy, communications and policy development to support sustainable models of patient centered care and shared decision-making. In this role, she built awareness and fostered collaboration among key stakeholder groups, advocated for new models of reimbursement, promoted quality standards for patient experience measures, and disseminated research results and knowledge to enhance the understanding of the patient’s role in medical decision-making. Ms. Paget was instrumental in the development and launch of HealthNewsReview.org – a public access web site designed to evaluate the accuracy and balance of health and medical news stories. She has participated in and led national, state and local initiatives to expand policy and legislative opportunity for sustainable models of patient engagement. She helped established and served as Vice President of the Medical Outcomes Trust, an organization created to promote the routine use of patient-based outcome measures including the SF-36 and other instruments designed to systematically assess health-related quality of life. For several years, she focused in HIV/AIDS prevention working at the AIDS Project Los Angeles and in Washington State where she led a combined city county HIV/AIDS department. Her work in Tacoma received national recognition for innovative approaches to street outreach and education programs. Ms. Paget serves on a number of national and state committees and workgroups to advance the patient’s role and involvement in health care. She has a BS in Health Education from the University of Massachusetts and a Masters in Public Health from the University of California, Los Angeles.

Kyu B. Rhee

Kyu Rhee, MD, MPP, FAAP, FACP, is the Chief Health Director for IBM Corporation, where he has direct global responsibilities for all IBM integrated health services and operations. Prior to joining IBM, Dr. Rhee was Chief Public Health Officer at Health and Human Services (HHS). While at HHS, he was very involved with the Patient Protection and Affordable Care Act (PPACA), serving as a co-chair of the Prevention PPACA committee and as a member of the PPACA Quality committee. Dr. Rhee also served as the Director of the Office of Innovation and Program Coordination at the National Institutes of Health, which is the primary federal agency for research. While at NIH, he served on and led numerous initiatives related to eliminating health disparities and promoting health equity. Prior to his federal government service, he worked in community health care settings as the Chief Medical Officer of Baltimore Medical System Inc., the largest network of Federally Qualified Health Centers in Maryland. In addition, Dr. Rhee served five years as a National Health Service Corps Scholar and Medical Director at Upper Cardozo Health Center, the largest community health center in Washington, DC. Dr. Rhee is board-certified in internal medicine and pediatrics. He received his medical degree from the University of Southern California. He did his residency and served as a Chief Resident in internal medicine and pediatrics at Cedars-Sinai Medical Center in Los Angeles. Dr. Rhee also holds a master's degree in public policy from the John F. Kennedy School of Government, Harvard University with a concentration in Health Care Policy. He received his bachelor's degree from Yale University in Molecular Biophysics and Biochemistry, where he also served as President of the study body. In addition to serving on various national committees and boards, including those sponsored by the Institute of Medicine, the National Quality Forum, and the National Business Group on Health, Dr. Rhee has published numerous peer-reviewed journal articles in the American Family Physician, Pediatric Annals, American Journal of Public Health, and the Journal of Health Care for the Poor and Underserved. He speaks frequently at national, regional, and local meetings, seminars, and conferences.

Dana G. Safran

Dana G. Safran, ScD, is senior vice president for performance measurement and improvement at Blue Cross Blue Shield of Massachusetts. In this role, she leads the company's initiatives to measure and improve health care quality, safety, and outcomes. Dr. Safran was one of the developers of the company’s Alternative Quality Contract (AQC), which has served as a model nationally and internationally for payment reform and delivery system improvement. Dr. Safran retains an active academic practice and is associate professor of medicine at Tufts University School of Medicine. Prior to joining BCBSMA, she was director of The Health Institute at Tufts–New England Medical Center. Dr. Safran's empirical research has emphasized the assessment of primary care performance under different models of health care delivery, and the identification of linkages between key attributes of the doctor-patient relationship and outcomes of care. Dr. Safran was previously employed as a policy analyst at the U.S. Congress Office of Technology Assessment and the United Hospital Fund. She earned her Sc.M. and Sc.D. in health policy from the Harvard School of Public Health.

Lewis G. Sandy

Lewis G. Sandy, MS, MBA, MD, is executive vice president, clinical advancement, UnitedHealth Group. He is responsible for advancing productive partnerships and collaborations among physicians and medical/specialty societies, along with a wide range of clinical innovation initiatives across UnitedHealth Group and its stakeholders. He also is a principal in the UnitedHealth Center for Health Reform and Modernization, with a focus on payment/delivery innovation and policy. From 2003 to 2007, he was executive vice president and chief medical officer of UnitedHealthcare, UnitedHealth Group’s largest business focusing on the employer/individual health benefits market. From 1997 to 2003, he was executive vice president of The Robert Wood Johnson Foundation, the nation’s largest health-focused private foundation, where he was responsible for program development and management, strategic planning and administrative operations. Prior to this, Dr. Sandy was a program vice president of the The Robert Wood Johnson Foundation, focusing on workforce, health policy, and chronic care initiatives. An internist and former health center medical director at the Harvard Community Health Plan in Boston, Massachusetts, Dr. Sandy received his BS and M.D. degrees from the University of Michigan and an M.B.A. degree from Stanford University A former Robert Wood Johnson Foundation clinical scholar and clinical fellow in medicine at the University of California, San Francisco, he served his internship and residency at the Beth Israel Hospital in Boston. Dr. Sandy is a senior fellow of the University of Minnesota School of Public Health, Department of Health Policy and Management.

David M. Stevens

David M. Stevens, MD, is Director of the Quality Center and Associate Medical Director of the National Association of Community Health Centers (NACHC) and Research Professor in the Department of Health Policy at the George Washington University School of Public Health and Health Services. Before assuming his current positions, Dr. Stevens was senior medical officer for quality improvement in the Agency for Healthcare Research and Quality (AHRQ) and its Center for Quality Improvement and Patient Safety. While at AHRQ he provided major leadership in AHRQ’s mission to translate research into action. Major initiatives include a AHRQ/Robert Wood Foundation sponsored learning collaborative to reduce health disparities with nine major national health plans; a care management improvement project with seventeen state Medicaid agencies; a partnership with the CDC to develop interventions for the prevention of type II Diabetes Mellitus; an improvement collaborative with End Stage Renal Disease providers; and contributor to the National Health Quality Reports. Before coming to AHRQ, Dr Stevens as chief medical officer was responsible for national clinical leadership of the Health Resources and Services Administration (HRSA) Community and Migrant Health Center Program and for leadership of the HRSA/Bureau of Primary Health Care initiative on eliminating health disparities in underserved and minority populations. This landmark program, the Health Disparities Collaboratives, transformed preventive and chronic care and generated major positive clinical outcomes as documented in peer reviewed scientific literature. With the CDC and the Institute of Healthcare Improvement, he initiated a landmark pilot demonstration on translating research from the Diabetes Prevention Program into practice. Dr Stevens also established national quality improvement policies for clinical programs in health centers, including the opportunity for JCAHO accreditation. With the CDC, he also implemented a major immunization quality improvement initiative, increasing immunization rates by 50% in 10 states in over 100 health centers, affecting 150,000 underserved infants and children each year. He was a practicing family physician and medical director for ten years at community health centers in the South Bronx and in Brooklyn, New York. Dr. Stevens was a member of an HHS workgroup which completed the HHS Strategic Plan for Asthma and a member of the HHS Work Group on reducing health disparities for diabetes. As a member of the commissioned corps of the US Public Health Service, he received numerous awards, including the commissioned corps meritorious service medal, the DHHS Award for Distinguished Service and the Arthur S. Fleming Award, a private-sector award for outstanding federal employees who have made extraordinary contributions to government.

Paul C. Tang

Paul C. Tang, MD, MS, is Vice President and Chief Innovation and Technology Officer at the Palo Alto Medical Foundation (PAMF), and is Consulting Associate Professor of Medicine at Stanford University. Dr. Tang directs the David Druker Center for Health Systems Innovation and also oversees PAMF's electronic health record (EHR) system and its integrated personal health record system. He has dedicated his professional career to improving the quality of health care in America, innovative uses of health information technology (HIT), empowering patients through HIT, and shaping public policy to enhance health and health care in the US. Dr. Tang is an elected member of the Institute of Medicine (IOM) and chaired an IOM patient safety committee which published two reports: Patient Safety: A New Standard for Care, and Key Capabilities of an Electronic Health Record System. He has served as board chair for several health informatics professional associations, including the American Medical Informatics Association (AMIA). He is Vice Chair of the federal Health Information Technology Policy committee (HITPC), and Chair of its Meaningful Use workgroup. He is also a member of the National Committee on Vital and Health Statistics (NCVHS), and chairs the NCVHS Quality Subcommittee. Dr. Tang chairs the National Quality Forum's (NQF) Health Information Technology Advisory Committee and previously served on the NQF Consensus Standards Approval Committee. He co-chairs the Quality Alliance Steering Committee's Measurement Implementation Strategy subcommittee. Dr. Tang is a recipient of the AMIA Don E. Detmer Award for Health Policy Contributions in Informatics. Dr. Tang received his B.S. and M.S. in Electrical Engineering from Stanford University and his M.D. from the University of California, San Francisco. He completed his residency in Internal Medicine at Stanford University and is a Board-certified practicing Internist.

Steven M. Teutsch

Steven Teutsch, MD, MPH, is Chief Science Officer of the Los Angeles County Department Of Public Health Department, and an Adjunct Professor at UCLA and senior scholar at the University Of Southern California. Until November 2008, he was the Executive Director of Outcomes Research at Merck & Company. Prior to joining Merck, Dr. Teutsch was Director of the Division of Prevention Research and Analytic Methods at Centers for Disease Control and Prevention (CDC) where he was responsible for assessing the effectiveness, safety, and the cost-effectiveness of disease and injury prevention strategies. He has served on multiple IOM and other national committees concerned with measurement of population health. He received his master degree in epidemiology from the UNC School of Public Health, and his medical degree from Duke University School of Medicine.

Robert Saunders

Robert Saunders, PhD, received a BS in Physics from the College of William and Mary in 2000 and a PhD in physics from Duke University in 2006. His graduate research focused on quality measures of medical imaging systems, specifically evaluating breast imaging systems for their performance in breast cancer detection. After his graduate work, he continued his research as a postdoctoral fellow in the Duke University Medical Center Department of Radiology where he also taught public speaking courses in the Medical Physics department. In 2008, he was selected as the Guenther Congressional Science Fellow, where he served in the office of Rep. Rush Holt (New Jersey). At the completion of his fellowship, he was hired as a legislative assistant for Rep. Holt, handling health reform, Medicare and Medicaid, small business, the Congressional Biomedical Research Caucus, and budget policy areas. In addition to these activities, he has served on the Duke University Board of Trustees and is a current member of the William and Mary Graduate Studies Advisory Board.

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Committee on Core Metrics for Better Health at Lower Cost

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