Program Performance Targets Exceeded or Not Met

The performance target for the following measure was set at an approximate level target, and the deviation from that level is slight. There was no effect on overall program or activity. The average number of antibiotic prescriptions for U.S. children ages 1-14 in Fiscal Year (FY) 2007 was 0.52. The data does not represent a statistically significant decline from the FY 2004 estimate of 0.56. Results from FY 2004 through FY 2007 show that the average number of antibiotic prescriptions for U.S. children ages 1-14 has not increased, or decreased, but has remained the same statistically.

Measure	FY	Target	Result
By 2014 antibiotic inappropriate use in children between the ages of one and fourteen should be such that use is reduced from 0.56 prescriptions per year to 0.42 per child (25%) (4.4.1)	2009	1.8% drop	Available Dec-09
	2008	1.8% drop	Available Dec-08
	2007	1.8% drop	0.52
	2006	1.8% drop	0.60
	2005	1.8% drop	0.59
	2004	Baseline	0.56

The performance target for the following measure was set at an approximate level target, and the deviation from that level is slight. There was no effect on overall program or activity. The difference between the target result (35%) and the actual result (36.51%) is slight (1.51%). 

Measure	FY	Target	Result
By 2014 reduce congestive heart failure readmission rates during the first six months from 38% to 20% in those between 65 and 85 years of age. (4.4.2)	2009	Drop to 34.5%	Available Dec-09
	2008	Drop to 34%	Available Dec-08
	2007	Drop to 35%	36.51%
	2006	Drop to 36%	36.74%
	2005	Drop to 37%	36.99%
	2004	Baseline	38.0%

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Discussion of AHRQ Strategic Plan and Goals

The table below highlights the links between AHRQ's four strategic plan goals and the specific objectives of the new HHS Strategic Plan.

HHS Strategic Goals	Safety/Quality—Reduce the risk of harm from health care services by promoting the delivery of appropriate care that achieves the best quality outcome.	Efficiency—Achieve wider access to effective health care service and reduce health care costs.	Effectiveness—Assure that providers and consumers/patients use beneficial and timely health care information to make informed decisions/choices.	Organizational Excellence—Develop efficient and responsive business practices.
1: Health Care  Improve the safety, quality, affordability and accessibility of health care, including behavioral health care and long-term care.
1.1  Broaden health insurance and long-term care coverage.
1.2  Increase health care service availability and accessibility.	X
1.3  Improve health care quality, safety, cost, and value.	X	X	X
1.4   Recruit, develop, and retain a competent health care workforce.	X		X
2: Public Health Promotion and Protection, Disease Prevention, and Emergency Preparedness  Prevent and control disease, injury, illness, and disability across the lifespan, and protect the public from infectious, occupational, environmental, and terrorist threats.
2.1  Prevent the spread of infectious diseases.
2.2  Protect the public against injuries, and environmental threats.
2.3  Promote and encourage preventive health care, including mental health, lifelong healthy behaviors, and recovery.	X
2.4  Prepare for and respond to natural and man-made disasters.
3: Human Services  Promote the economic and social well-being of individuals, families, and communities.
3.1  Promote the economic independence and social well-being of individuals and families across the lifespan.
3.2  Protect the safety and foster the well-being of children and youth.
3.3  Encourage the development of strong, healthy, and supportive communities.
3.4  Address the needs, strengths, and abilities of vulnerable populations.
4: Scientific Research and Development  Advance scientific and biomedical research and development related to health and human services.
4.1  Strengthen the pool of qualified health and behavioral science researchers.			X
4.2  Increase basic scientific knowledge to improve human health and development.
4.3  Conduct and oversee applied research to improve health and well-being.	X		X
4.4   Communicate and transfer research results into clinical, public health, and human service practice.	X	X

AHRQ research supports improving health care quality, safety, cost, and value. Also, the work performed by the Agency, directly supports the Secretary's Priorities. AHRQ continues to support the cornerstones of Value-Driven Health Care by coordinating processes for recognizing Community Leaders and Value Exchanges; developing a Learning Network for Value Exchanges; and developing a curriculum for Community Leaders to help them improve and eventually reach the status of Value Exchange.

AHRQ's research supports the Secretary's priority for Personalized Health Care (PHC), specifically as it relates to linking clinical and genomic information. The Agency's research efforts in PHC and Comparative Effectiveness Initiatives are driven by the ideal of providing the right care to the right person at the right time. Such efforts will build strong correlations between genomics and targeted personalized health care. As a result, the infrastructure needed for AHRQ's research in Personalized Health Care and Comparative Effectiveness share a common platform along a continuum as both are targeted toward developing information and findings to allow clinical care to provide the right intervention, to the right individual at the right time.

Investments in PHC and Comparative Effectiveness research will result in a Distributed Network Infrastructure—data sets and collaboration research tools across sites; Priority Setting and Research Gap—target funding to the most critical research issues; Generation of New Research and Evidence—fund actual studies in PHC and clinical effectiveness; and, Translation of Findings from Personalized Health Care—the development of translation materials that will make the initiatives findings actionable.

The President's call for most Americans to have access to electronic health records (EHR) is the major long-term goal of AHRQ's Health Information Technology (Health IT) portfolio and the health IT initiative.  This initiative includes support for planning, implementing, and measuring the value of health IT; developing statewide and regional networks; and, encouraging the adoption of health IT by sharing knowledge. Previous and ongoing research has developed data tools and languages for use in the healthcare setting, and continues to point to the need for health IT.

AHRQ continues to support research, demonstration, and implementation projects that address the specific challenges facing stakeholders either actively utilizing or contemplating HIT activities. Major projects include Computerized Physician Order Entry (CPOE) Utilization and Impact, the Electronic Health Record (EHR), and the Personal Health Record (PHR). These tools are significant and important tools to improving the quality, safety, and efficiency of care.

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