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AHCPR releases CONQUEST 1.0 database

The Agency for Health Care Policy and Research has released a landmark computer tool that will make it easier for health plans, providers, and purchasers to choose and use clinical performance measures to assess the quality of the services they provide and purchase. CONQUEST 1.0, the COmputerized Needs-Oriented QUality Measurement Evaluation SysTem, summarizes information on approximately 1,200 clinical performance measures developed by public and private sector organizations to examine the quality of clinical care.

Because measures are described using a common language, CONQUEST 1.0 will enable users to identify existing measures, compare them directly, and select measures most appropriate to their needs. According to AHCPR's Administrator Clifton R. Gaus, Sc.D., CONQUEST 1.0 will provide clinicians, purchasers, and health plans with one-stop shopping for the most appropriate and cost-effective clinical performance measures to meet their needs. CONQUEST 1.0 is the only tool of its kind that is available publicly. It links clinical conditions to measures through two interlocking databases—a Condition Database and a Measure Database—allowing users to target specific conditions or measures.

CONQUEST 1.0 includes preprogrammed reports on measures and conditions and also allows users to perform tailored searches and create customized reports. Users can enter additional measures and conditions of interest to them if these are not already in the databases. CONQUEST 1.0 will help identify where new measures are needed.

The Condition Database currently contains information on 52 clinical conditions, representing those identified as prevalent by major health surveys and the most costly diagnoses for Medicare and Medicaid. In addition, CONQUEST 1.0 summarizes recommendations from AHCPR-sponsored clinical practice guidelines, findings from AHCPR's Patient Outcomes Research Team (PORT) projects, and other key research.

To date, the Measure Database contains 53 measure sets developed by AHCPR, the Health Care Financing Administration (HCFA), the Department of Veterans Affairs, and other Federal organizations; accrediting organizations such as the National Committee for Quality Assurance, and the Joint Commission on the Accreditation of Healthcare Organizations; associations such as the Maryland Hospital Association and the American Group Practice Association; private sector organizations such as United Health Care and the Pacific Area Business Group on Health; and research organizations such as Harvard University and RAND Corporation.

In addition to information on the performance measures themselves, CONQUEST 1.0 gives the user the ability to examine the clinical rationale behind a given performance measure and the methodological assumptions, data source requirements, sampling requirements, the clinical setting for which the measure was designed, and methods for "scoring" or analyzing a given measure, as well as information on how to obtain measure specifications.

CONQUEST 1.0 also is a tool for learning about performance measures, how to evaluate and select measures for a given purpose, and how to identify and link performance measures that are clinically related.

CONQUEST 1.0 was developed with AHCPR funding under a contract with Mikalix and Company of Waltham, MA, and its subcontractor, the Center for Quality of Care Research and Education at the Harvard University School of Public Health. Methodological guidance and leadership for the development of CONQUEST 1.0 were provided by R. Heather Palmer, M.B., B.Ch., S.M., Director, Center for Quality of Care Research and Education, Harvard University School of Public Health, and Ann G. Lawthers, Sc.D.

CONQUEST 1.0 builds on AHCPR's Measurement Typology project to collect, review, and analyze performance measures used by the public and private sectors to examine quality of care. Phase I of this project, released in March 1995, resulted in the two-volume AHCPR report Understanding and Choosing Clinical Performance Measures for Quality Improvement: Development of a Typology (AHCPR Publication Nos. 95-N001 and 95-N002).

The system, which AHCPR is making available for widespread testing and use, has been designed in Microsoft® Access®. AHCPR has begun a preliminary project to user test CONQUEST 1.0. The project, which is being jointly funded by AHCPR and the Robert Wood Johnson Foundation, will bring together a geographically, professionally, and clinically diverse group of about 30 participants to evaluate the user-friendliness of the tool and identify clinical performance measurement needs and the potential of CONQUEST to meet those needs.

The CONQUEST 1.0 databases and the user's guide are available as FTP files on AHCPR's site on the World Wide Web. The databases have been created in Microsoft® Access® but may be usable with other database software. The user's guide and final report are in WordPerfect® versions 6.0 and greater. The appendixes are in WordPerfect® 6.1.

A limited supply of CONQUEST 1.0 materials including a diskette containing the databases, overview of the final report, and user's guide are available from AHCPR (AHCPR Publication No. 96-N009).

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