The 1,492 page report showed what data could do for health management–such as develop treatment norms for different diagnoses, the logic that came to underpin most health care payments in the United States. One result was that Blue Cross became independent of the American Hospital Association in 1961 and McNerney became president of the Blue Cross Association that year. Others in the Department of Medical Care Organization took it up and continued with the Medical Care Chart Book, published 1962-1991. Gradually, federal and state governments had begun to publish the kind of systematic data it contained.

The book sold about 10K copies in its first edition (an academic bestseller), and led to a series of authorized additional editions. More to the point, it was a monument in the development of more precise, informed, quantitative provider management. Griffith followed in 1987 with The Well-Managed Community Hospital, now in its 7th edition, and titled The Well-Managed Healthcare Organizatio. It is a recommended reference for American College of Healthcare Executives’ Fellowship Examination.

DOPPS, developed by investigators at Arbor Research Collaborative for Health, and joined by co-investigators from U-M, has produced hundreds of peer-reviewed studies examining global dialysis practices and their impact on patient outcomes ranging from anemia management in end-stage renal disease to bone and mineral metabolism in dialysis patients.  Variability in practice at the dialysis facility level and at the country level and a novel cohort study design incorporating randomly selected facilities and randomly selected incident dialysis patients, enabled DOPPS researchers to document the critical importance of native arteriovenous fistula over prosthetic graft or temporary catheter-based dialysis.  More recently, the DOPPS Practice Monitor (DPM) has examined the effects of changing reimbursement systems (the so-called ESRD bundle) on dialysis practice, access to care, management of anemia, and a host of other outcomes important to patients, providers, and payers.

This project developed a unique relational database, linking chronic disease clinical information from the electronic medical records (EMR) of the U-M Health System to multi-payer claims data. The database is dynamic, with most information available for between 2 and 5 years, and has strong potential for sustainability. The database can be used to evaluate the quality of clinical care as well as models of care delivery that are particularly important for complex patients, such as the patient-centered medical home, transitional care, and complex care coordination. This project concerned AHRQ priority populations, including low-income and uninsured patients, older adult patients, and patients with diabetes. The population of patients used consisted of those patients who were attributed to the UMHS as continuing care patients, who were also in adjudicated and validated chronic disease registries. These registries organize EMR diagnostic and management information for patients with physician adjudicated chronic disease diagnoses. Complete claims are available for most of the relevant patient population.