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AHRQ Performance Plans for FY 2002 and 2003 and Performance Report for FY 2001

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Budget Line 1—Research on Health Care Costs, Quality, and Outcomes

Funding Levels

Fiscal Year 2001: $226,385,000 (Actual - Current Law)
Fiscal Year 2001: $227,897,000 (Actual - Proposed Law)
Fiscal Year 2002: $247,645,000 (Appropriation)
Fiscal Year 2002: $249,171,000 (Current Estimate)
Fiscal Year 2003: $194,000,000 (Request - Current Law)
Fiscal Year 2003: $195,611,000 (Request - Proposed Law)

This budget line represents the bulk of the Agency's research (extramural and intramural) portfolio. Dissemination and evaluation activities are also included. The first five of the annual performance plan's six goals are used to track Agency performance in these areas.

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GPRA Goal 1: Establish Future Research Needs Based on User's Needs. (HCQO)

Strategy: Cycle of Research Phase 1: Needs Assessment

In the field of health services research, the user of the information plays a critical role. If health services research is to improve the quality of health care, it must provide answers to the questions and issues that represent the barriers to improvement. AHRQ emphasizes open communication with users of its research to ensure that it is addressing important questions. Through continued emphasis on the first phase of the cycle of research, needs assessment, AHRQ will continue to assure that the Agency's research begins and ends with the user.

Types of Indicators: Output

Use of Results by AHRQ:

Input received on specific topic areas and health care issues are used in the Agency's program and budget development activities. The result is research agendas and program initiatives that are informed by the real needs of the user community.

Data Issues:

To provide context for reviewing the advice received from users, AHRQ reviews major articles in the research literature pertaining to a particular subject area. This allows the Agency to assess where the user input fits into the current body of research and how best to proceed. Through a 1999 study conducted by the Lewin Group, we learned that user input loses much of its critical meaning when aggregated. The Agency has, therefore, created a data management system that will, in its final stage, electronically store the source document and have word search capability so that staff can identify relevant documents and access them efficiently from their desk top computers when performing program and budget development activities. Additionally, to ensure that the input from users is incorporated into Agency activities, a number of check points have been integrated into the planning processes where user input is explicitly identified and assessed in relation to the proposed activities.

GPRA Goal 1—Fiscal Year 2001 Results

Objective 1.1: Define direction of Fiscal Year project funding priorities, in large part, by needs assessment activities.

1st Indicator: Agency research agenda covering strategic goal areas for Fiscal Year 2001 priorities (patient safety and informatics) is documented based on consultations with various groups.

Results: A Patient Safety Reporting Summit with relevant public and private sector stakeholders was held on April 23-24, 2001 in Restin, VA. Secretary Thompson opened the summit, with over 300 attendees.

AHRQ sponsored IT expert meetings at the spring and fall American Medical Informatics Association (AMIA) conferences on electronic medical records and a expert meeting on child health and information technology. AHRQ participated in IT meetings at Ambulatory Pediatrics Association and American Medical Association (e-health) annual meetings. In addition the agency contracted Health Strategies Consultancy for an assessment of AHRQ's role in IT within HHS.

GPRA Goal 1—Fiscal Year 2002 Indicators

Goal 1 Objectives
Objective 1.1: Define direction of Fiscal Year project funding priorities, in large part, by needs assessment activities.

Fiscal Year 2002 Indicator
Agency research agenda covering strategic goal areas for Fiscal Year 2002 priorities (investigator-initiated research, national quality report, national disparities report) is documented by July 2002 based on consultations with various groups.

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GPRA Goal 2: Make significant contributions to the effective Functioning of the U.S. health care system through the creation of new knowledge. (HCQO)

Strategy: Cycle of Research Phase 2: Knowledge

There are many gaps in knowledge in all areas of health care. New questions emerge as new technologies are developed, the population's demographics change, areas of inquiry previously under-emphasized take on greater importance, and research previously undertaken identifies further areas that need attention. Therefore, AHRQ will continue to focus on creating new knowledge through its peer reviewed extramural and intramural research and assessing the findings that result from completed projects.

Type of Indicators: Process and Output

Use of Results by AHRQ: AHRQ uses three approaches to illustrate how it addresses its core activity of creating new knowledge. First, the Agency documents science advances that have resulted from its investment of funds, staff, and other resources. This enables the Agency to do the following:

  • Identify and highlight significant research findings from research funded or sponsored by AHRQ;
  • Focus its translation and dissemination activities to maximize the potential use of critical findings in the health care system;
  • Annually assess progress toward filling the gap between what we know and what we need to know about health care.

Second, AHRQ documents coverage in major journals and/or evidence of use of research findings. Coverage by popular and professional media is highly competitive. AHRQ's receiving coverage is an initial indication that its investment in research has the potential for significant impact when disseminated and implemented widely. The actual use of the findings by purchasers, professional associations, managed care organizations, and/or insurers also signals that the new knowledge has the potential to make a difference. The ultimate outcome or impact will be evaluated after the finding has been implemented over a period of time.

Third, the statistics on the number of grants funded and dollars invested in particular areas are used to determine whether the AHRQ portfolio has a significant body of work underway to begin to inform the field. They are also used in gauging the investment in these areas vs. other programs as AHRQ allocates its resources.

Data Issues:

Project officers in consultation with grantees largely do collecting data and/or anecdotes on the use of research results or tools through searches of the literature, media outlets, and Internet listings and tracking. The information is captured through regular communications with partners, researchers, associations, and Federal, State, and local governments. Anecdotal information is used only when it can be verified with the actual user. Documentation of the use is sought whenever possible. AHRQ continues to look for ways to introduce efficiencies in this labor-intensive effort.

GPRA Goal 2—Fiscal Year 2001 Results

Objective 2.1: Determine annually the salient findings from research in each of the three areas (outcomes; quality; and cost, access, and use) and develop plan for next steps translation and dissemination.

1st Indicator: Produce an annual report that describes at least 12 science advances covering the three research goal areas (outcomes; quality; cost, access, and use). For each finding, specific steps in translation and dissemination are identified and initiated.

Results: AHRQ has identified at least 12 science advances. These findings are highlighted in the AHRQ Accountability Report which is being submitted to Congress under separate cover. The following list exemplifies the types of findings contained in this report as well as how the findings were disseminated:

  • Routine medical testing prior to cataract surgery (Effectiveness): Cataract PORT II

    Finding: Routine medical testing prior to cataract surgery doesn't improve outcomes and in most cases is unnecessary.

  • Educational program for nursing home physicians and staff to reduce use of non-steroidal anti-inflammatory drugs among nursing home residents: a controlled trial

    Finding: The educational program and algorithm described in this study could help reduce the overuse of NSAIDs in elderly nursing home patients. May 2001 Medical Care

  • A qualitative study of increasing beta-blocker use after myocardial infarction (Quality)

    Finding: A newly tested classification system may help hospitals to identify areas of improvement and then to make successful quality care improvements. May 23, 2001 Journal of the American Medical Association

  • A randomized clinical trial of outpatient geriatric evaluation and management

    Finding: Targeting outpatient geriatric evaluation and management (GEM) slows a patient's functional decline in his or her daily activities. April 2001 Journal of the Am. Geriatrics Society

  • Management of dental patients who are HIV positive

    Finding: The antifungal medication, fluconazole, may help prevent the development of thrush in the mouths of HIV-infected patients. August 2001 Oral Surgery, Oral Medicine, Oral Pathology

2nd Indicator: Generate 2 - 3 synthesis reports on research findings and practical applications on Agency priority topics.

Results: AHRQ has, to date, completed two synthesis reports highlighting research findings related to Patient Safety and End of Life Care for patients. In addition a Fact Sheet on Diabetes was developed for use by clinicians and their patients. The research synthesis entitled "Reducing and Preventing Adverse Drug Events To Decrease Hospital Costs" can be found at the following URL http://www.ahrq.gov/qual/aderia/aderia.htm.

Objective 2.2: Achieve significant findings from AHRQ sponsored and conducted research.

1st Indicator: Findings from at least 40 AHRQ sponsored or conducted research are used by public and private partners to improve health care.

Results: Numerous examples of AHRQ sponsored and conducted research that has either been published in the peer review literature or that illustrates how findings are used by public and private partners to improve health care can be found in AHRQ's electronic publication "Research Activities".

The following is a brief list of articles and projects that can be found in this publication:

  • Ayanian J. (2001) Increased mortality among middle-aged women after myocardial infarction: Searching for mechanisms and solutions. Annals of Internal Medicine. 134:239-241.
  • Basu J. (2001) Access to primary care: The role of race and income. A study of municipal health services clinics. Journal of Health and Social Policy. 13(4):57-73.
  • Burstin H, Lewin, D and Hubbard, H. (2001) Future directions in primary care research: Special issues for nurses Policy, Politics, and Nursing Practice. 103:103-107.
  • Coppola K, Ditto P, Danks J, and Smucker W. (2001) Accuracy of primary care and hospital-based physician's prediction of elderly outpatient's treatment preferences with and without advance directives. Archives of Internal Medicine. 161:431-440.
  • Ditto P, Danks J, Smucker W, and others. (2001) Advance Directives as acts of communication. Archives of Internal Medicine. 161:421-430.
  • Fernandez A, Grumbach K, Vranizan K, and others. (2001) 'Primary care physicians' experience with disease management programs. Journal of General Internal Medicine. 16:163-167.
  • Fink K, Baldwin L, Lawson H and others. (2001) The role of gynecologists in providing primary care to elderly women. Journal of Family Practice. 50(2):153-158.
  • Franks P. (2001) Impact of patient socioeconomic status on physician profiles: A comparison of census-derived and individual measures. Medical Care. 39(1): 8-14.
  • Frazier L, Colditz G, Fuchs C and Kuntz K. (2000-Oct) Cost-effectiveness of screening for colorectal cancer in the general population. Journal of the American Medical Association. 284(15): 1954-1961.
  • Galsgow R and Bull S. (2001) Making a difference with interactive technology: Consideration in using and evaluating computerized aids for diabetes self management education. Diabetes Spectrum. 14(2): 99-106.
  • Kiefe K. (2001). Improving Quality Improvement Using Achievable Benchmarks Of Care Feedback. Journal of the American Medical Association. June 13, 2001
  • Malkin J, Broder M and Keeler E. (2000-Oct) Do longer postpartum stays reduce newborn readmissions? Analysis using instrumental variables. Health Services Research. 35(5 pt 2):1071-91.
  • Murphy J, Chaing H, Montgomery J, Rogers W and Safran D. (2001) The quality of physician-patient relationships. Journal of Family Practice. 50(2): 123-129.
  • Pathman DE. (2000). State Scholarship, Loan Forgiveness, And Related Programs: The Unheralded Safety Net. Journal of the American Medical Association. October 25 2000
  • Rollman B, Gilbert T and others. (2001). The electronic medical record. Archives of Internal Medicine. 161:189-197. (R01 HS09421)
  • Safran D, Montgomery J, Chang H, Murphy J and Rogers W. (2001). Switching doctors: Predictors of voluntary disenrollment from a primary physician's practice. The Journal of Family Practice. 50(2): 130-135
  • Siminoff LA. (2001). Factors Influencing Families Consent To Donation Of Solid Organs For Transplantation. Journal of the American Medical Association. July 4, 2001

In addition, AHRQ has issued press releases describing the findings and conclusions of 45 studies that were funded or sponsored by AHRQ. Media coverage of these studies includes at least 996 newspaper and magazine articles and over 500 online news reports and television and radio stories. Coverage ranged from 225 newspaper articles, 175 television and radio reports and numerous online news stories for a study on ear surgery to 10 key health care trade press reports for a study of declining health insurance enrollment.

Objective 2.3: Initiate Fiscal Year Research Initiatives.

Funding of a minimum of 60 projects in the following areas:

  • Reducing Medical Errors and Enhancing Patient Safety
  • Using Computers and Information Technology to Prevent Medical Errors
  • Working Conditions

Results: AHRQ has invested $50 million to fund 94 new research grants, contracts and other projects to reduce medical errors and improve patient safety. This initiative represents the federal government's largest single investment to address the estimated 44,000 to 98,000 patient deaths related to medical errors each year. The 94 projects will be carried out at state agencies, major universities, hospitals, outpatient clinics, nursing homes, physicians' offices, professional societies and other organizations across the country. These projects will address key unanswered questions about how errors occur and provide science-based information on what patients, clinicians, hospital leaders, policymakers and others can do to make the health system safer. The results of this research will identify improvement strategies that work in hospitals, doctors' offices, nursing homes and other health care settings across the nation.

This $50 million research initiative is the first phase of a multi-year effort. Many institutions will receive additional funds to continue their work in future years. These projects reflect the input of consumers, health care providers and policymakers from a national research summit last year led by AHRQ and its partners on the Quality Interagency Coordination (QuIC) Task Force. These projects fall into the following six major categories of awards:

Supporting Demonstration Projects to Report Medical Errors Data: These activities include 24 projects for $24.7 million to study different methods of collecting data on errors or analyzing data that are already collected to identify factors that put patients at risk of medical errors.

Using Computers and Information Technology to Prevent Medical Errors: These activities include 22 projects for $5.3 million to develop and test the use of computers and information technology to reduce medical errors, improve patient safety, and improve quality of care.

Understanding the Impact of Working Conditions on Patient Safety: These activities include eight projects for $3 million to examine how staffing, fatigue, stress, sleep deprivation, and other factors can lead to errors. These issues-which have been studied extensively in aviation, manufacturing and other industries-have not been closely studied in health care settings.

Developing Innovative Approaches to Improving Patient Safety: These activities include 23 projects for $8 million to research and develop innovative approaches to improving patient safety at health care facilities and organizations in geographically diverse locations across the country.

Disseminating Research Results: These activities include seven projects for $2.4 million to help educate clinicians and others about the results of patient safety research. This work will help develop, demonstrate and evaluate new approaches to improving provider education in order to reduce errors, such as applying new knowledge on patient safety to curricula development, continuing education, simulation models, and other provider training strategies.

Additional Patient Safety Research Initiatives: AHRQ will use the remaining $6.4 million for 10 other projects covering other patient safety research activities, including supporting meetings of state and local officials to advance local patient safety initiatives and assessing the feasibility of implementing a patient safety improvement corps.

A brief list of specific projects funded can be found in the appendix of this report.

GPRA Goal 2—Fiscal Year 2002 Indicators

Goal 2 Objectives Fiscal Year 2002 Indicator
Objective 2.1: Determine annually the salient findings from research in each of the three areas (outcomes; quality; and cost, access, and use) and develop plan for next steps translation and dissemination.

Produce an annual report that reports on at least 18 science advances covering the three research goal areas (outcomes; quality; cost, access, and use).

For each finding, specific steps in translation and dissemination are identified and initiated.

Increase by 15% (relative to FY01 baseline) the number of synthesis reports generated on research findings and practical applications on Agency priority topics.

Patient Safety
Establish baseline for number of science advances in patient safety covering the three research goal areas (outcomes; quality; and cost, access, and use) that will be included in future accountability reports to the Congress.

Generate at least one synthesis report on research findings and practical application in the area of patient safety

Objective 2.2: Achieve significant findings from AHRQ sponsored and conducted research. (This objective is combined with Objective 3.1 in Fiscal Year 2002) Discontinued (This measure is combined with 3.1 in Fiscal Year 2002.)
Objective 2.3: Initiate Fiscal Year Research Initiatives.

Fund or conduct a minimum of 50 projects in the following areas:

  • Patient Safety
  • Translating Research into Practice
  • Healthcare Cost and Utilization Project
  • Medical Expenditure Panel

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GPRA Goal 3: Foster translation and dissemination of new knowledge into practice by developing and providing information, products, and tools on outcomes; quality; and access, use, and cost of care. (HCQO)

Strategy: Cycle of Research Phase 3: Translation and Dissemination

AHRQ is committed to ensuring that the knowledge gained through health care research is translated into measurable improvements in the American health system. AHRQ is focusing on closing the gap between what we know and what we do. Under the "Translating Research Into Practice" initiative, the Agency invests in demonstration projects, public (Federal, state, and local government) and private-sector partnerships, and targeted dissemination activities to develop and test implementation strategies in different settings in the health care system and demonstrate their applicability to widespread dissemination in other areas of the system.

Types of Indicators: Output and process.

Use of Results by AHRQ:

The indicators regarding number of partnerships, attendees at User Liaison Program meetings, or hits on the AHRQ Web site help the Agency determine whether what it produces is of use to major audience segments. The Agency evaluates the results of the GPRA plan indicators in combination with other information such as details about what products were released, feedback from attendees at programs, where the hits are on the web site, and feedback from customers to manage and improve its dissemination efforts.

Frequently, the results of research are not readily implemented in the health care system without an interim step such as the creation of a tool that facilitates use. A major focus for the Goal 3 indicators, therefore, is to look at the creation and use of tools. The indicators for the Agency's investment in training helps the Agency track its success in furthering the field of health services research by fostering new talent. The numbers of trainees funded are a reflection of Agency commitment and the success of the training programs in attracting successful candidates. This data can be used in combination with other information about individual trainees, their research projects, professional credentials of professors and mentors, etc. to assess the overall success of the program.

Data Issues:

The AHRQ has implemented several computer-based reporting tools to monitor usage of Agency information systems and websites. Accurate statistics are recorded on the usage of the National Guideline Clearinghouse, Publications Clearinghouse, and various other Agency Web sites and systems using commercially available reliable and accurate tools, e.g., WebTrends. These tools are used by many corporations and government agencies nationwide to monitor usage and have been certified by various information technology testing and review groups. Information on all grants, which can be word searched, is included in the Agency Management Information System.

AHRQ tracks print media (newspapers, health care-related trade journals and newsletters, and consumer magazines) and on-line news services for stories about or involving the Agency through a contractor, Burrelle's—one of the Nation's largest and oldest news clipping services. The contractor, Video Monitoring Service, monitors TV and radio news reports on selected studies in major markets around the United States.

Agency program staff maintains other statistics during the normal monitoring of contracts and grants. Certain items, such as the release of a CONQUEST product, are documented on the AHRQ web site when ready so that consumers are aware of the availability. Other items such as the statistics on the ULP program are monitored through the management of the support contracts, travel arrangements, and other records kept in administering the program. Anecdotal information is verified with the primary source before being used by the Agency in this report or for any other uses.

GPRA Goal 3—FY 2001 Results

Objective 3.1: Achieve significant findings from AHRQ sponsored and conducted research and maximize dissemination of information, tools, and products developed from research results for use in practice settings.

1st Indicator: At least 5 public-private partnerships are formed to implement research findings for decision makers.

Results: The following examples of public-private partnerships

  • A meeting was held in June 2001 to discuss opportunities for collaboration and to attempt to match up select TRIP-IIs and PROs. Participants included staff from both AHRQ and CMS (HCFA). The focus of the meeting was to explore how AHRQ could be more strategic in working with PROs to implement findings from TRIP-II as well as the broader array of TRIP related projects.

    Three potential areas for closer interaction are: 1) improving our understanding of the effectiveness of implementation interventions; 2) involving PROs in research; and, 3) developing a research agenda for implementation research. Specific plans were made to hold a meeting hosted by AHRQ and CMS to focus on defining what information the PROs and their customers need in their quality improvement activities and setting a research agenda.

  • In cooperation with the Kantor Family Foundation, AHRQ developed a task order to clarify important issues for patients and clinicians relevant to developing a national outcomes database to inform clinical decisions about treatment alternatives based on knowing what happens to "People Like Me".
  • AHRQ worked with Blue Cross and Blue Shield of Minnesota to develop a provider resources kit, based on the Public Health Service (PHS) Guideline, Treating Tobacco Use and Dependence, which is currently being focus tested with several physicians within the plan's network. This resources kit contains a number of smoking cessation materials to aid physicians in treating patients who smoke and will be distributed to the entire network of physicians in Minnesota.
  • Identified and implemented two specific opportunities for promoting research that uses CEA to inform decisions.

2nd Indicator: Formation of a minimum of 10 partnerships to support dissemination of AHRQ products through intermediary organizations, such as health plans and professional organizations. AHRQ has completed seven public-private partnerships. The partners' activities include, but are not limited, to reprinting and disseminating the information to their constituencies, web linking, and the electronic dissemination of AHRQ materials.

Results: AHRQ continues to be successful in forming partnerships with intermediary organizations that support dissemination of AHRQ products. To date, AHRQ has completed seven public-private partnerships. The partners' activities include, but are not limited, to reprinting and disseminating the information to their constituencies, web linking, and the electronic dissemination of AHRQ materials. Examples of these partnerships include:

  • American Academy of Family Physicians
  • American Medical Informatics Association
  • Society of Academic Emergency Medicine
  • American Association of Health Plans
  • Merck's Institute for Aging Research
  • Department of Veterans Affairs Health Services Research and Development QUERI program
  • Centers for Medicare and Medicaid

AHRQ's successful collaboration with these partners resulted in the following activities:

  • AHRQ, through collaborative efforts with the agency's National Advisory Council (NAC), nursing organizations, AHRQ nurses and others, is establishing outreach paths to the nursing research community. The hope is to facilitate dissemination of AHRQ products through all segments of the health care arena, and, at the same time, to enhance nursing research at AHRQ.
  • In March 2001, AHRQ sponsored a meeting that included nurses from AHRQ, NAC, the American Academy of Nurses, and the Council on Advancement of Nursing Sciences. At this meeting two lists were developed for use by the review staff at AHRQ and members of peer review groups. One list was of nursing journals to be used as peer-reviewed journals when referencing nursing research. The other list was of nurses that can be recruited to serve as peer reviewers for AHRQ-sponsored research proposals. In addition, a series of steps were developed to promote research opportunities for nurses. Following the meeting, in May 2001, as further encouragement for nursing research at AHRQ, an article was written by AHRQ staff and published in Policy, Politics, and Nursing Practice entitled, "Future Directions in Primary Care Research: Special Issues for Nurses". A follow-up meeting is planned for FY02.
  • AHRQ partnered with the American Association of Health Plans to convene a conference, "Building Bridges VII: Assessing Policy Decisions and Their Impact on Health Care Delivery," April 25-27, 2001. Other partners included CDC, BlueCross BlueShield Association, and the National Institute on Disability and Rehabilitation Research. AHRQ disseminated information about how health plan decision makers and researchers could use both Healthcare Cost and Utilization Project (HCUP) data and Consumer Assessment of Health Plans (CAHPS) data for comparative analyses, forecasting, and benchmarking within managed care settings.
  • AHRQ worked with the Tobacco-Free Coalition of Oregon to develop a smoking cessation tools kit, based on the PHS Guideline, Treating Tobacco Use and Dependence, which will be distributed in bulk quantities to all health plans in Oregon.
  • AHRQ worked with the National Educational Association (NEA) to place a tobacco ad in their newsletter and promote the entire product line in the March issue of "NEA Today." The NEA also distributed a flier, which lists the entire PHS smoking cessation product line, to NEA staff.
  • AHRQ worked with the American Cancer Society to distribute 550 copies of the You Can Quit Smoking consumer guides to 11 GIANT Food Store Pharmacies on the East Coast in time for the Great American Smokeout.
  • AHRQ collaborated with Smoke Free Families to develop an intervention piece for the pregnant smoker, based on the PHS Guideline Treating Tobacco Use and Dependence. This piece will be distributed to OB/GYNs and will be promoted in talks with other groups interested in addressing pregnant smokers.
  • AHRQ worked with the Kansas State Employees Health Care Commission to distribute the following AHRQ publications: Staying Healthy at 50+, Child Health Guide, Personal Health Guide, and Your Guide to Choosing Quality Health Care to all Kansas state employees.
  • AHRQ worked with the American Association of Health Plans (AAHP) to facilitate dissemination of Staying Healthy at 50+ to the HMO trade group's 1,000 member health plans by supplying them with sample copies of the publication and by announcing the availability of the publication in its member newsletters.
  • AHRQ worked with the Connecticut Department of Social Services, Elderly Services Division, to distribute the following PPIP publications at various seminars and presentations for area care facilities: Staying Healthy at 50+ (English and Spanish), Personal Health Guide (English and Spanish) and the Adult Preventive Care Timeline.
  • AHRQ worked with Health First Health Plans in Florida to distribute the English-language versions of Staying Healthy at 50+, Child Health Guide, and the Personal Health Guide to its members. The publications were distributed via separate mailings to its Medicare, Commercial and Youth populations accompanied by a letter from the plans' Quality Management Director.
  • AHRQ worked with John Deere Health to distribute Staying Healthy at 50+ to John Deere Health's senior Risk enrollees in the post-enrollment packets along with their benefit booklet and member ID card.

3rd, 4th and 5th Indicator:

The number of hits on the Web site, the number of documents uploaded and the number of inquiries handled on the web site.

Results:

AHRQ has invested significant resources in developing a user friendly web site that allows real time access to a variety of products produced by AHRQ. Use of AHRQ's web site continued to increase in FY 2001 with more than 22.6 million hits compared with 18.8 million hits the previous year. User sessions also rose by almost a million visits—2.4 million up form 1.5 million in FY 2000. Page views increased substantially for FY 2001 at 8.9 million compared with 5.4 million the previous year. Overall workload increased with 5,068 files and documents uploaded to the Web site, compared with 4,400 for FY 2000.

In addition, AHRQ handled 4,006 electronic inquiries during FY 2001 through its Web site Mailbox, up from 3,500 the previous year. These inquiries included requests for Agency information products, funded research, consumer health issues and concerns, technical assistance, referrals to other resources, and requests to use AHRQ electronic content on other Web sites or in electronic or print products.

6th Indicator:

Number of State and local governments trained in the understanding and use of health services research findings through ULP Workshops.

Results:

In FY 2001, ULP sponsored 23 different activities, including 12 National workshops, 7 state-based workshops, one telephone conference and one Web-assisted audio-conference. These activities provided over 2300 health care policy makers from all 50 states, the District of Columbia, American Samoa, the Virgin Islands and Guam with access to research findings they could use to make evidence-based decisions about health care.

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