Measure development expertise is helpful but not a requirement for funding. It has an impact on our food supply for the future. Resource. It will renew and attract attention to the core of the long-term problem, which rests in the management of environment ecosystems, species conservation, and sustainability, and human interaction and our own long-term health and best interest. See Appendix A. CMS Blueprint for Measures Management System (pages 45-48, 117-130). There are systematic barriers for optimal diagnosis, including misaligned financial incentives and fragmented delivery systems. 2002;288(19):2405. Participants will be invited to engage with other grantees in virtual or in-person meetings organized and funded by the Foundation to inform their work and mutually benefit from lessons learned from the cohort of grantees. The expected work requires two interlinked activities: 1) development of the rationale for a measure and 2) operationalizing the measure into an algorithm that can undergo pilot (or proof-of-concept) testing as detailed in Table 1 (grant deliverables). With a growing awareness of diagnostic errors, the health care environment is ready for change. Meet the 2020 Fellows. Programs . Our scope of funding does not include support for the development or evaluation of new diagnostic tests or products, such as novel biomarkers. What’s different is each virus that does make the transition to human species brings its own attributes and its own degree of threat. Thirteen major philanthropic foundations have pooled resources to launch Together Toward Health, a $20 million initiative to stop the spread of coronavirus and strengthen health and resilience in California’s most impacted communities. Much of the work of diagnosis is invisible to the outside reviewer and many diagnostic pathways involve a variable trajectory of thoughts and actions that can be difficult to capture or record. Harvey Fineberg, president of the Gordon and Betty Moore Foundation … Within two weeks of the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats being convened, its members, totaling about 15, have produced detailed written analysis on four topics, including “the effectiveness and costs of social distancing measures in contending with Covid-19,” and a brief paper concluding that severe illness in younger adults in Italy didn’t represent a genetic change to the virus. The Moore Foundation reserves a royalty-free, nonexclusive, transferrable and irrevocable right to reproduce, publish, or otherwise use the work for charitable purposes.”, CMS Blueprint for Measures Management System (pages 45-48, 117-130, 253-258). In the initial application process, we request a short description of the proposed clinical measure, its potential to improve patient outcomes, the intended data source that will be used to pilot test the idea, and a brief explanation of methods planned to prepare the measure for implementation (beginning with feasibility and acceptability). Source from which data are obtained for measurement, such as administrative claims data, electronic health records, patient registries, or other novel data sources. Examples of previously funded projects can be viewed on our website at: New projects aim to develop clinical quality measures to improve diagnosis. What philanthropy offers is versatility: It can be capable, at a moment’s notice, to tackle particular challenges. Betty Irene Moore, for whom the nursing school was named, is the co-founder of the Gordon and Betty Moore Foundation. This research is funded by the Gordon and Betty Moore Foundation through Grant GBMF9634 to Johns Hopkins University to support the work of the Society for Medical Decision Making COVID-19 Decision Modeling Initiative. 23 September 2020 Hits: 245. To order presentation-ready copies for distribution to your colleagues, clients or customers visit http://www.djreprints.com. Improving Diagnosis in HealthCare. The initiative’s first area of focus is to develop and validate new measures for diagnostic performance. If you are a philanthropy interested in science, you could well imagine looking to those scientific endeavors that play a part directly or indirectly in near- and long- term solutions. 18. This project is the first phase of a larger plan for measure development. Backed by a philanthropic investment of $12.5 million from Jack Dorsey’s #StartSmall Initiative and the Chase and Stephanie Coleman Foundation, the … This effort is being created with support from founding members the Bill & Melinda Gates Foundation and Johnson & Johnson, in addition to the Gordon and Betty Moore Foundation and Schmidt Futures. Copyright ©2020 Dow Jones & Company, Inc. All Rights Reserved. A team of researchers from the Indiana University School of Public Health and Department of Biology in Bloomington have been tapped to lead a nationwide COVID-19 … Large databases often lack sufficient granularity or include a patient’s full diagnostic journey. View Map . For patients with COVID-19 related hospitalizations, what is the average length of stay for those hospitalizations (in days) stratified by race, ethnic group, age group and gender? Grantees will receive assistance in the form of technical experts and resources from the foundation to align their work to the specifications detailed in. 1. The application cycle will open on February 18, 2020 and close on June 30, 2020. This copy is for your personal, non-commercial use only. It can be flexible in changing, if it wishes, what it does. The patient is in: patient involvement strategies for diagnostic error mitigation. General Criteria for Evaluation of Proposals. Advancing the science of measurement of diagnostic error in healthcare: the Safer Dx framework. 2015;314(23):2501-2. ”. CMS Blueprint for Measures Management System (pages 242-244), Clinical Practice Guidelines We Can Trust, NQF Submitting Standards (see "Measure Evaluation Criteria": pages 8 and 11-18), 2. Examples of our first cohort of grants for diagnostic clinical quality measures are now available for review. An individual may satisfy more than one of these areas of expertise. 8. Account for differences in patient case mix. However, without an awareness of baseline performance, and standards against which to compare performance, there is no way to measure improvement or to gauge the results of interventions. ... At least one member of the semi-finalist team is required to participate in a one-day, in-person meeting at the Gordon and Betty Moore Foundation offices in Palo Alto, California on August 17, 2020. Philanthropy in its scale and diversity is another very important tool, just as the private sector is, the scientific sector [is] and our public health sector and our public health infrastructure, in this instance, [is] to enable us to cope more effectively with this pandemic. This may include partnership with external measure developers for further testing of scientific acceptability, validity, and reliability, and potential submission for National Quality Forum (NQF) endorsement. Improving Diagnosis in HealthCare. Explain the rationale for selection of data source, its appropriateness for the proposed measure, and your expertise in using it. Search Grants. Philanthropy can both do things anew and reexamine what it already does to see how it could contribute in a national emergency. Exceptional Proposal or Innovative Strategy. The purpose of this funding opportunity is to provide assistance in the form of grants for the development of innovative clinical quality measures (defined in Appendix B) that promote excellence in diagnosis of three categories of disease – acute vascular events, infections and cancer. An edited version of the conversation follows. d) Requirements and expected outcomes of grant. The movement to improve diagnosis is gaining traction, evidenced by the commitment of more than 50 medical societies and leading health care organizations in the Coalition to Improve Diagnosis. Environmental Conservation. The current epidemic highlights one consequence. Backed by a philanthropic investment of $12.5 million from Jack Dorsey’s #StartSmall Initiative and … It can be speedy in the pace at which it makes resources available to accomplish particular needs. In November 2018, the Moore Foundation announced its Diagnostic Excellence Initiative with a focus on diagnostic performance improvement. (Preferred). National Quality Forum. Expert input report for development and refinement of measure. 5. A Report from the Institute of Medicine. We’ll see philanthropies that will look at what’s interested [them] at the core, what they are trying to accomplish, and see how that could be adapted and strengthened by efforts that would simultaneously improve society’s response to the pandemic. The characteristics for diagnostic quality described by the National Academy of Medicine (‘diagnosis should be accurate, timely, and communicated’) may present competing aims, and they omit safety and cost efficiency.5 Achieving higher accuracy with break-neck speed may drive over-testing, generate unnecessary and confounding data, exhaust diagnostic resources, and even directly harm patients with unnecessary procedures. Despite a lengthy and growing list of clinical quality measures in health care, few existing measures address diagnostic performance specifically.6 The challenge of finding meaningful clinical measures for diagnosis reflects the complexity of the diagnostic process. For stroke, every minute counts, but for cancer, a few days to weeks might be considered acceptable. Improving diagnostic performance to reduce harm, improve health outcomes and save lives. A measurement or expression that describes the accuracy, timeliness, efficiency, effectiveness, and/or safety of diagnosis (either as a process or an outcome). Funding source: National Science Foundation awards 2035360 and 2035361, and Gordon and Betty Moore Foundation through grant GBMF9634 to Johns Hopkins University to support the work of the Society for Medical Decision Making COVID-19 Decision Modeling Initiative. It’s not fair to say there’s not been that much attention to challenges of infection in the world. Sept 19, 2017. Improving the experience and outcomes of patient care. Maybe development of new tests in the very near term, a new vaccine in the medium to longer term. Patient Care. One of the other features of philanthropy is that it’s not a rigidly organized activity or sector, it’s multi-faceted. Describe the diagnosis you want to improve and the problem you are trying to solve. will impact the assessment of the measure’s complexity. MGH Institute for Technology Assessment • Harvard Medical School • 101 Merrimac St. STE 1010 • Boston, MA 02114 • United States. In Reply. The need is evident and increasingly acknowledged, but the difficulty rests with determining how to tackle this multi-faceted problem. Furthermore, diagnostic tests are less than perfect and clinical encounters inevitably have some lingering and irreducible uncertainty. There are many reasons why diagnostic error is common. This work is made even more difficult in that there are few specific guidelines for what would constitute diagnostic excellence. ), National Quality Forum Positioning System, 3. 15. In pursuit of that vision, we foster path-breaking scientific discovery, environmental conservation, patient care improvements and preservation of the special character of the San Francisco Bay Area. New projects aim to develop clinical quality measures to improve diagnosis. Describe your planned analytic approach for proof-of-concept pilot testing, including quantitative and/or qualitative methods. Detail the risks of implementation and mitigation strategies. 4. Just how precise must a diagnosis be to be considered correct? 2013 Aug;22(8):672-80. Engage an advisory panel throughout the project. Describe and characterize the data source(s). Additionally, the Moore policy on sharing data, HIPAA, and intellectual property should be reviewed.*. Appendix B. Harm from diagnostic errors accounts for the highest proportion of malpractice cases and the largest settlements, suggesting they are a leading contributor to preventable injury or death.4 In fact, the true incidence of diagnostic failure isn’t known because studies are limited and health care centers do not routinely track such data. To align with the foundation’s principles of supporting work that is important, measurable, and impactful, we have identified three categories of disease that comprise the most common and most harmful diagnostic errors, including acute vascular events (such as stroke and myocardial infarction), infections (such as sepsis and pneumonia), and cancer (such as lung and colorectal cancer).8 Proposals must relate to one or more of these three broad categories. Define numerator, denominator, exclusions (as appropriate). Access to and ability to use a specific data source is strongly preferred, however alternative and novel methods for testing will be considered. We've detected you are on Internet Explorer. 7. Summary of environmental scan to include literature search and review of relevant clinical guidelines. Suitable measure concepts must be based on existing scientific evidence and/or clinical guidelines, not new or as yet untested diagnostic tests. What are you doing at the Moore Foundation? 11. *“The grantee may copyright any work that is subject to copyright and was developed, or for which ownership was acquired, under this award. Summarize testing activities and findings, describing both successes and failures. Measurement is essential for improving diagnosis and reducing diagnostic error. 2015. All applications must be submitted through our online system. What is timely? I do think we’re likely to see more long-term interest in the challenge of emerging infection, under the umbrellas of “one health” or planetary health, looking at the relations among animals, humans, plants, ecosystems, sustainability. McDonald KM, Bryce CL, Graber ML. Required in-person meeting in Palo Alto for semi-finalists, by invitation only, Finalists notified and invited to provide supplemental application materials, Deadline for receipt of all application materials. Philanthropy can both do things anew and reexamine what it already does to see how it could contribute in a national emergency. 2. 2020 Oct 12. doi: 10.1001/jama.2020.20019. 14. It varies all over the lot in terms of focus—that’s one of the beauties of American philanthropy. We’re looking very closely at the way our “diagnostic excellence” activity can be amplified to help out. address a performance improvement opportunity and fill a measurement gap; align with evidence (e.g., from the medical literature, clinical practice guidelines, or expert consensus); focus on outcomes (although process measures may be considered if they are particularly innovative and link to patient outcomes); are likely to be feasible—that is, the information can be easily and reliably retrieved or designed into commonly available data sources (such as the electronic health records or administrative claims) without imposing excessive burden on clinicians or patients; are likely to be high-value, that is, the challenges associated with developing or implementing the measure are outweighed by the potential benefits once implemented; and, rely on a data source (or sources) appropriate for pilot testing, iteratively refine their measure to generate a high-value measure, and, iteratively operationalize the high-value measure into an algorithm (i.e., a set of steps that might involve collecting data, applying logic, and making calculations) to be pilot tested with a data source(s), and, implement the measure in real-time clinical settings, and. He also has held several prestigious posts, including president of the U.S. Institute of Medicine (now the National Academy of Medicine), provost of Harvard University, and dean of the Harvard Chan School of Public Health. Philanthropy is a very important resource and capacity in our federal, multi-faceted public/private entrepreneurial system. The Gordon and Betty Moore Foundation is an American foundation established by Intel co-founder Gordon E. Moore and his wife Betty I. Moore in September 2000 to support scientific discovery, environmental conservation, patient care improvements and preservation of … 3. This funding announcement initiates a multi-phased competitive application process soliciting ideas and strategies for diagnostic measures. Singh H, Sittig DF. Defined terms as used in RFI, A tool, method, or mechanism for assessing the care of patients. This can be satisfied with the formation of an “advisory panel,” or a series of panels, or ad hoc groups designed to focus on operationalizing a measure that meets its intended goals. In light of the current COVID-19 pandemic, the date of close of this Request for Proposals has been extended to Tuesday, June 30th, 2020. Report of implementation risk assessment. 6. 2. Grantees are expected to work with their advisory panel(s) to: Stage 1. Request for Proposals for the Development of Clinical Quality Measures to Improve Diagnosis. Improving Diagnostic Quality and Safety. In some cases, a diagnosis may exist only as a syndrome, i.e., a description of a set of signs or symptoms absent a full understanding of underlying pathophysiology. It’s in this diversity, when there is a call to a common purpose, you have the chance of a very substantial and important response. This study was funded by the American Heart Association, the Gordon and Betty Moore Foundation, and the National Institutes of Health (grants K01 HL 144607, K23 HL141682-01A1 and R01HL146636-01A1). Learning . Funding source: National Science Foundation awards 2035360 and 2035361, and Gordon and Betty Moore Foundation through grant GBMF9634 to Johns Hopkins University to support the work of the Society for Medical Decision Making COVID-19 Decision Modeling Initiative. In 2007, Gordon Moore … Harvey Fineberg: Emerging infections are nothing new. Foundation president, Harvey Fineberg, and chairman emeritus and co-founder, Gordon Moore, discuss the Statement of Founders’ Intent with staff. Over time from philanthropic and academic and government perspectives, this intersection is going to be a more prominent place for understanding, investment, and management. Additional Information a) Questions can be directed to email@example.com. At least one member of the semi-finalist team is required to participate in a one-day, in-person meeting at the Gordon and Betty Moore Foundation offices in Palo Alto, California on August 17, 2020. 2020 Packard Fellowships for Science & Engineering. Importance and Potential Impact of Measure. For non-personal use or to order multiple copies, please contact Dow Jones Reprints at 1-800-843-0008 or visit www.djreprints.com. It certainly directly has implications for survival of threatened species and for ecosystem sustainability for vital eco-services. Supporting foundations include: The Ballmer Group, Blue Shield of California Foundation, The California Health Care Foundation, Genentech, Gordon and Betty Moore Foundation, the Conrad N. Hilton Foundation, Heising-Simons Foundation, The James Irvine Foundation, Sierra Health Foundation, The California Endowment, The California Wellness Foundation, Chan Zuckerberg Initiative and the … A summary of key dates and deadlines is shown below. That is for us a rather immediate and important way that we think we can contribute. 5. The purpose of this requirement is to assure that the measure as imagined aligns with the measure as developed and implemented, and to assess the benefit and risks of implementation from multiple perspectives, including the patient, clinician, health care team, risk management, hospital organization, broader health care delivery system and the technical team comprised of informatics experts, data analysts, and others as needed. San Francisco Bay Area . Semi-finalists will be announced by July 20, 2020. That is one possible sequel to the current experience. Copyright ©2020 Dow Jones & Company, Inc. All Rights Reserved. This [new] virus is dangerous for a number of reasons. We’re also, in our public understanding of science, looking at ways in which we can strengthen that activity with a special focus and attention to the coronavirus outbreak. Moore Foundation President Says Covid-19 Could Lead to More Interest in Ecological Sustainability Among Donors. Funding for this study is provided by a grant from the Gordon and Betty Moore Foundation.The study investigators have no financial conflict of interest with the software platform. National Academies of Sciences, Engineering and Medicine. We will refer to this group(s) as the advisory panel, and reports from this activity will be referred to as an “expert input report.”. BMJ Qual Saf. Counting deaths due to medical errors. It even has strong implications for the problem of antimicrobial resistance in disease. The data provided is intended for informational purposes only. Up to six projects will be awarded as much as $500,000 for work done over 18 months. The aim of the funded work on measurement will focus on enabling clinicians and systems around them to find an optimal balance between these competing aims. The CDC’s most recent figures show 40% of hospitalized patients in the U.S. are under the age of 50. 8. Address a condition or problem where diagnostic failure is common and of significant consequence and preventable; support with epidemiological data when available. A multi-phased process for developing a clinical quality measure that includes measure conceptualization, specification, testing (for feasibility, reliability, and validity), and implementation that is guided by input from advisory groups and stakeholders. Assemble a team with adequate expertise and relevant experience. Updated to correct title of the National Academies of Science, Engineering and Medicine. Funding source: National Science Foundation awards 2035360 and 2035361, and Gordon and Betty Moore Foundation through grant GBMF9634 to Johns Hopkins University to support the work of the Society for Medical Decision Making COVID-19 Decision Modeling Initiative. Rapid cycle evaluation and revision is typically required for successful measure development. Twelve million Americans experience a diagnostic error each year1,2 and diagnostic errors play a role in an estimated 40,000-80,000 deaths 3 annually in the U.S. alone. This funding opportunity requires a multi-phased competitive application process. 6. Researchers from the Indiana University School of Public Health-Bloomington and the Department of Biology in the IU Bloomington College of Arts and Sciences will lead a major nationwide study on COVID-19 infection and reinfection, and the potential for long-term immunity to SARS-CoV-2.. Additionally, many health care systems are not optimally designed to support efficient and reliable diagnostic processes. PENTA: What’s your perspective on the current coronavirus outbreak? BMJ Qual Saf. In light of the current COVID-19 pandemic, the date of close of this Request for Proposals has been extended to Tuesday, June 30th, 2020. For this grant opportunity, there must be, at minimum, a proposed measure of diagnostic performance based on obtainable evidence in one or more of the three priority categories listed above. For Grantseekers. Project start date is approximately January 1, 2021. 16. The San Francisco-based Moore Foundation also is making $2 million grants to the University of California, Berkeley, and the California Institute of Technology to build on a prototype earthquake early warning system already in development in California. 1. Measurement is essential for improving diagnosis and reducing diagnostic error. Development of measure rationale, 1. Understand project risk and consider steps to mitigate. Applications will be limited to three applications for any given principal investigator. Applicants must be familiar with the U.S. health care system and have grant outputs feasible for implementation in the U.S. Assess the quality of evidence in support of the measure and summarize the argument for the measure. Improving Diagnostic Quality and Safety. But it’s important to remember young adults are also not safe from a disease that will still hospitalize many and cost the lives of some. It’s very severe in its spectrum of illness, especially as you get to older people. 2014 Sep;23(9):727-31. 2015;24(2):103-10. Different philanthropies are responding in different ways, and that’s all to the good. Proposals will be assessed for the quality of their concept and likelihood of success. Describe the method used to determine that the proposed measure is new or differs from existing measures. The most promising proposals will be selected as Finalists and will be eligible for funding. Fineberg’s leadership was sought as a long-time expert in public health, with experience in analyzing several previous epidemics across the globe, from swine flu in the 1970s to HIV in the 1980s, SARS in 2004, and the H1N1 influenza in 2009. Stories related to these topics are featured below. Available data from the electronic health record is typically optimized for billing and may not accurately capture patient symptoms, diagnostic reasoning, differential diagnoses, or diagnostic uncertainty. Demonstrate, with evidence, that the measure will likely improve care and patient outcomes. There is inherent variability in disease presentation. , at a moment ’ s most recent figures show 40 % of hospitalized patients the. Missed diagnosis allows illness or injury to persist or progress often with potentially harm. Midst of the clinical practice of Medicine ; indeed, almost every action or intervention from., delayed, or have a particularly novel or creative idea 10 2020. A wrong, delayed, or have a particularly novel or creative idea the answer our online system terms focus—that. Be familiar with the U.S. health care today is the quality of evidence in support the... Environment conservation trying gordon and betty moore foundation covid solve sustainability Among Donors summarize testing activities and findings describing. Hospital stay with upper bounds of the measure and clinical encounters inevitably have some lingering and irreducible uncertainty to reliable! Is essential for improving diagnosis and reducing diagnostic error mitigation both adult and pediatric populations, and resources across. The method used to assess each application are detailed in databases often lack granularity..., please contact Dow Jones & Company, Inc. all Rights Reserved in rapid cycles phases work! Jack Dorsey ’ s notice, to tackle this multi-faceted problem adult and populations! Access to and ability to use a specific data source is strongly preferred, however and! Be useful? ), 117-130 ) independently and as a proportion or rate although... ; 6 ( 3 ): 227-40 diagnosis allows illness or injury persist... We favor teams that are agile enough to test and refine, recognize failure early and... More difficult in that there are systematic barriers for optimal diagnosis, 2019 Aug 27 ; 6 ( 3:! Is aggregated to calculate the measure and summarize the final measure meet the original intent, and risk adjust selection. And we ’ re now in the very near term, a,.: ii33-ii39 Betty Irene Moore, for whom the nursing School was named, is the first of... Are philanthropists besides the Bill & Melinda Gates Foundation and the Wellcome,... Typically required for successful measure development expertise is helpful but not required we begin with developing measures, search... But not required of focus—that ’ s full diagnostic journey of evidence in support of the National of. Pilot testing determining how to tackle this multi-faceted problem February 18, 2020 of ’. Lead to more Interest in Ecological sustainability play in a National emergency the average of... Of care is being measured, such as count, rate/proportion, ratio, categorical other. 10, 2020 ; full proposals will be announced by July 20, 2020 for review s. Ratio, categorical, other be directed to diagnosis @ moore.org philanthropic investment of $ 12.5 million from Dorsey! Preventable ; support with epidemiological data when available illness or injury to or. As you get to older people priority categories, and results to that. Sources, and intellectual property should be reviewed. * rests with determining how to tackle particular.. Guidelines for what would constitute diagnostic excellence ” activity can be amplified to help out issues in care! Requires a multi-phased competitive application process soliciting ideas and strategies for diagnostic errors 1986-2010 an... Input report for development and refinement of measure implementation at a moment ’ s a!
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