Editor-in-Chief: Norbert Goldfield, MD
ISSN: 0148-9917
Online ISSN: 1550-3267
Frequency: 4 issues / year
About this Issue

Big Data—Hype and Promise

This issue of the journal has, as its focus, Big Data. Paradoxically, I wanted to take on this topic because I believe its value is overhyped. That is, we know what we need to do for health care delivery reform—without Big Data. To have successful health care delivery reform (defined as stabilizing health care costs while improving health care outcomes) payers need to a.pass on a significant (not total) financial risk;
b.deliver meaningful reports to providers; and
c.encourage collaboration between providers and all payers.


Big Data—What Is It and What Use Is It?
Atkinson, Graham DPhil

The first natural question is: What is “Big Data”? This question will have as many answers as the number of people you ask. “Big Data” does not simply mean working with large data sets but rather involves some or all of the following features.


Leveraging Data to Systematically Improve Care: Coronary Artery Disease Management at Geisinger
Graf, Thomas MD; Erskine, Alistair MD; Steele, Glenn D. MD, PhD

CORONARY ARTERY DISEASE (CAD) is a common, complex, and critical chronic disease that necessitates a team approach to optimize the care of patients by comprehensively measuring and improving care and a systematic team approach to care delivery.


Big Data and the Electronic Health Record
Peters, Steve G. MD; Buntrock, James D. MS

Big Data refers to a set of technologies, evolved from the Internet search era, that allow large-scale data management, processing, and indexing. These new technologies allow the processing of large and complex data sets that defy usual search and retrieval.


Secure E-mailing Between Physicians and Patients: Transformational Change in Ambulatory Care
Garrido, Terhilda MPH; Meng, Di PhD; Wang, Jian J. MS; Palen, Ted E. PhD, MD, MSPH; Kanter, Michael H. MD

The use of secure e-mail to provide ambulatory care raises important questions about quality, patient satisfaction, provider workloads, and utilization of other health care services. In this report, we outline what is currently known at Kaiser Permanente about secure e-mail between physicians and patients and describe the focus of our future efforts to assess the impact on value and quality of this important care modality.


Self-Care: The New Principal Care
Nelson, Eugene C. DSc, MPH; Meyer, Gregg MD, MSc; Bohmer, Richard MBChB, MPH

WE OFFER a prediction: Self-care will become the new, acknowledged principal source of care. More people in more places will take more responsibility for being the principal provider of their own health care.


The Medication Minefield: Using Computerized Decision Support Systems to Reduce Preventable Adverse Drug Events and Hospitalizations
Bernstein, Richard MD; Kogan, Polina PharmD; Collins, Arlen MD

This article will use the term adverse drug event similar to one used by the Agency for Health Research and Quality (AHRQ) and its Patient Safety Network (PSNet), namely, an adverse event involving the use of medication, some of which are preventable or ameliorable. In the latter instance, while not preventable, the consequences and complications could be mitigated (PSNet, n.d.).


Critical Reflections on the Role of CBPR Within an RCT Community Health Worker Prevention Intervention
Rosenthal, E. Lee PhD, MS, MPH; Balcazar, Hector G. PhD; De Heer, Hendrik D. PhD, MPH; Wise, Sherrie MPH; Flores, Leticia MPH; Aguirre, Melissa BCH

ADVANCING HEALTH using a combination of science and community-centered approaches requires new evaluation and research paradigms that emphasize integration of participant and stakeholder input at all stages of the process (De Las Nueces et al., 2012). Bridging culturally and community-based research with traditional scientific inquiry is a necessity if science and practice are to coalesce to ultimately allow for translation of that science into health promotion practice.


Identifying Key Patient Demographics and Organizational Factors That Contribute to Health Center Participation in Research
Shin, Peter PhD, MPH; Sharac, Jessica MSc, MPH; Beeson, Tishra MPH; Proser, Michelle MPP; Jester, Michelle MA

Federally Qualified Health Centers are not only an essential source of comprehensive primary care but are also a largely untapped wealth of community-based resources, knowledge, and expertise for public health and health services research. Federally Qualified Health Centers are commonly referred to as Community, Migrant, Homeless, and Public Housing Health Centers.


The Role of Community Health Centers in Assessing the Social Determinants of Health for Planning and Policy: The Example of Frontier New Mexico
Bruna, Sean PhD; Stone, Lisa Cacari PhD; Wilger, Susan BS, MPAff; Cantor, Jeremy MPH; Guzman, Carolina MPH

The empowerment of people to exert control over their own health needs through multisector community development lies at the crux of the approach used successfully by many CHCs to address social determinants of health (Goldfield, 2009; Hunt, 2005).


Conceptual Errors in the CMS Refusal to Make Socioeconomic Adjustments in Readmission and Other Quality Measures
Atkinson, Graham DPhil; Giovanis, Theodore MBA

THE Centers for Medicaid & Medicare Services (CMS) has argued there should not be an adjustment for socioeconomic status (SES) in readmission and quality measures, and its various measures deliberately do not include such adjustments.


Regular Exercise Is Strongly Associated With Anticipated Success for Reducing Health Risks
Wasson, John H. MD

REGULAR exercise is a healthy behavior associated with desirable benefits such as reduced likelihood of dying from known heart disease and many measures of well-being (Garcia et al., 2012; Heran et al., 2011).