2.       Data availability/access to health systems data for performance measures

a.       Need strategies for obtaining data 

b.      Inability to build relationships with private sector to access data

3.       Need methods for combining disparate data sources

4.       Need strategies for using population data for subpopulation prioritization

5.       On health systems performance measures:

·         Defining “health systems” and “health care systems”

·         Challenges with coding/analysis of medication adherence

6.       Epi and Surveillance is not prioritized by non-epidemiologists (because it is not a grant deliverable)

7.       Proportion of patients with a self-management plan

8.       Proportion of systems with policies encouraging multidisciplinary team-based care (we're using NCQA PCMH accreditation but it's a very clunky system?)

Discussion questions:

1.       What are strategies used by other states to access data sources that are needed to determine the various 1305/11422 performance measures?  

2.       In what ways have states incorporated domain 1 into the work plan (besides reporting of performance measures)?

3.       What is the level of reporting states have used for health systems performance measures?

4.       How can we determine confidence intervals for the age-adjusted discharge rate with any mention of diabetes as diagnosis among adult persons with diabetes?