“Mr. President, I am pleased that we are witnessing today the passage of legislation that is critical to improving the quality of health care in this country.” These words are those I used on November 3, 1999 on the floor of the United States Senate when the Healthcare Research and Quality Act passed unanimously.
December 6 marks twenty years since the Act was signed into a law—a bipartisan bill that I authored with Senator Ted Kennedy. With broad support across both parties, we established the Agency for Healthcare Research and Quality (AHRQ) as the lead federal agency responsible for improving the safety and quality of American healthcare. It was the first federal legislation mandating research on healthcare errors (controversial at that time and obviously useful today) and continuous quality improvement in patient care.
Quality, outcomes, and patient safety—these have become the essential cornerstones of today’s value-based care, a concept not yet specifically defined at that time.
Then, I shared in my Senate remarks that, “I believe the Agency can truly make a difference in improving health care quality in this country. The work of the Agency fills a crucial need by translating advances in medicine into what works for me, as a physician, in my daily practice… I also believe the work of the Agency is essential for improving the long-term stability of the Medicare program and improving the health care system in general by providing the tools we need to assess and improve health care quality.”
Two decades later, I’m proud to say what I believed of the agency in 1999 has been proven true today.
This little-known organization plays an outsized role in our health, and much has been achieved. The agency, for example successfully led a collaborative that reduced hospital-acquired conditions by 21%, resulting in 125,000 fewer patient deaths and $28 billion in savings since 2010. Furthering their commitment to patient safety, AHRQ backed the deployment of a proven safety program to 1,100+ intensive care units that achieved a 41% decline in central line bloodstream infections (a leading mortality risk), with further investments leading to a 91% decline nationwide from 2010 – 2015. AHRQ also supported providers in creating the world’s largest registry for pediatric inflammatory bowel disease, with registry data leading to dramatic improvements for children with inflammatory bowel disease, including higher rates of remission, and improved growth and nutrition. The agency’s research showed antipsychotics for children were still lacking in effectiveness, demonstrated that certain sensory-focused interventions improved autism behaviors, and raised a red flag on rising opioid use in the United States, among many other vital findings.
We have heard too many times that our health care system is broken. The staff of AHRQ are the men and women who are committed to fixing it.
This anniversary also gives me pause to remember my physician colleague and personal friend Dr. John Eisenberg. AHRQ would not be what it is today without the visionary leadership of its former director, who worked closely with me and my Senate colleagues in writing the 1999 Act that shaped the future of the agency. His dreams have been realized. John sadly passed away from a brain tumor in 2002 while leading AHRQ, but I know he’d be impressed with how much good has been accomplished since his years of service. He was wholeheartedly committed to its mission “to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and… to make sure that the evidence is understood and used.” Too often great research is published then put on a shelf to collect dust—whereas the AHRQ supports putting pivotal findings into action.
Fast-forward to today, and AHRQ Director Gopal Khanna has an exciting vision for the agency’s future. He smartly explains that, “While science and research for cures is needed, science, research and implementation for improving delivery of care is imperative.” After listening to those in the healthcare trenches—the patients, clinicians, researchers and others—AHRQ has committed to creating long-term strategies to address the most pressing of our nation’s challenges:
- Improving care for Americans living with multiple chronic conditions or MCCs. More than 25% of Americans live with MCCs, including 80% of Medicare beneficiaries.
- Providing data and analytics to policymakers to empower informed decision making. Many policymakers still make decisions based largely on expert opinion rather than tapping into the explosive potential of new data resources and analytic strategies.
- Reducing diagnostic errors. An estimated 12 million people per year are affected by diagnostic errors, including 4 million suffering serious harm.
Applying the scientific minds at AHRQ to these healthcare issues that affect all Americans undoubtedly saves lives. They may not make the flashy headlines doing it, but the impact of their quiet, consistent efforts cannot be understated.
Two decades ago, we all came together with a shared goal of better-quality health for all Americans through scientific, evidence-based research put into action. At times, as leadership changes in Washington, not all are as familiar with the unparalleled efforts of this agency and its funding can come into question. But with the growing complexity of the healthcare system and as the country continues to move toward value-based care, its mission and mandates will be more important than ever. I will always stand to defend the brilliant, life-saving work of the AHRQ, and I’m excited to see what the next twenty years will bring.