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* Context.--Quality measures are a cornerstone in measuring physicians' performance within the Centers for Medicare & Medicaid Services' Quality Payment Program (QPP). Clinicians' performance on quality measures and other categories within the QPP determines Medicare part B payment adjustments. Driven by evidence-based clinical practice guidelines, quality measures should focus on high-priority facets of health care, support a desired patient outcome, and address an area with evidence of a gap or variation in provider performance. Objective.--To meet the goals of the QPP, a broad array of quality measures must be developed that allows pathologists the flexibility to choose activities and measures most meaningful to their practice and patient population while also trying to mitigate the challenges of implementation and data collection. Design.--In this second manuscript of the series, we present the development of additional College of American Pathologists-developed quality payment measures for use in the QPP. We also discuss the relationship of quality measure reporting with reimbursement and the challenges with capturing data for quality reporting. Results.--The College of American Pathologists identified 23 new measures for quality performance reporting that reflect rigorous clinical evidence and address areas in need of performance improvement. Conclusions.--Development of quality measures is a necessary and ongoing effort within the College of American Pathologists. Increased awareness about pathology-specific issues in measure development and reporting is essential to ensuring pathology's ability to demonstrate value and meaningfully participate in the QPP. (Arch Pathol Lab Med. 2020;144:697-705; doi: 10.5858/arpa.2019-0378-OA), The Medicare Access and CHIP Reauthorization Act of 2015 led to the creation of a new Quality Payment Program for the Centers for Medicare & Medicaid Services (CMS), which has [...]

* Context.--Quality measures assess health care processes, outcomes, and patient perceptions associated with high-quality health care, which is commonly defined as care that is effective, safe, efficient, patient centered, equitable, and timely. Such measures are now being used in order to incentivize provision of high-quality health care. Objective.--To meet the goals of the Quality Payment Program, quality measures will be developed from clinical practice guidelines and relevant, peer-reviewed research identifying evidence that the measure addresses 3 areas: a high-priority aspect of health care or a specific national health goal or priority; a meaningful focus, such as leading to a desired health outcome; and a gap or variation in care. Design.--Within the College of American Pathologists (CAP), the Measures and Performance Assessment Subcommittee is tasked with developing useful performance measures. Participating practitioners can then select measures that are meaningful to their respective patients and practices, and reflect the quality of the services they provide. Results.--The CAP developed 23 quality measures for reporting to the Centers for Medicare & Medicaid Services that reflect rigorous clinical evidence and address areas in need of performance improvement. Conclusions.--Because the implications of reporting on these pathology-specific metrics are significant, these measures and the process by which they were designed are presented here in peer-reviewed fashion. The measures described in this article (part 1) represent recent efforts by the CAP to develop meaningful measures that reflect rigorous clinical evidence and highlight areas with opportunities for performance improvement. (Arch Pathol Lab Med. 2020;144:686-696; doi: 10.5858/arpa.2019-0377-OA), The Medicare Access and CHIP Reauthorization Act of 2015, which replaced the Sustainable Growth Rate, had broad bipartisan support and established the Quality Payment Program (QPP), which has 2 payment [...]

INTRODUCTION The Missouri River Basin is comprised of more than 100 million acres of cropland across nine states, including Missouri.* 1 It produces nearly half of U.S. wheat, nearly a [...]

Background: The field of health information management (HIM) focuses on the protection and management of health information from a variety of sources. The American Health Information Management Association (AHIMA) Council for Excellence in Education (CEE) determines the needed skills and competencies for this field. AHIMA's HIM curricula competencies are divided into several domains among the associate, undergraduate, and graduate levels. Moreover, AHIMA's career map displays career paths for HIM professionals. What is not known is whether these competencies and the career map align with industry demands. Objective: The primary aim of this study is to analyze HIM job postings on a US national job recruiting website to determine whether the job postings align with recognized HIM domains, while the secondary aim is to evaluate the AHIMA career map to determine whether it aligns with the job postings. Methods: A national job recruitment website was mined electronically (web scraping) using the search term "health information management." This cross-sectional inquiry evaluated job advertisements during a 2-week period in 2021. After the exclusion criteria, 691 job postings were analyzed. Data were evaluated with descriptive statistics and natural language processing (NLP). Soft cosine measures (SCM) were used to determine correlations between job postings and the AHIMA career map, curricular competencies, and curricular considerations. ANOVA was used to determine statistical significance. Results: Of all the job postings, 29% (140/691) were in the Southeast, followed by the Midwest (140/691, 20%), West (131/691,19%), Northeast (94/691, 14%), and Southwest (73/691, 11%). The educational levels requested were evenly distributed between high school diploma (219/691, 31.7%), associate degree (269/691, 38.6%), or bachelor's degree (225/691, 32.5%). A master's degree was requested in only 8% (52/691) of the postings, with 72% (42/58) preferring one and 28% (16/58) requiring one. A Registered Health Information Technologist (RHIT) credential was the most commonly requested (207/691, 29.9%) in job postings, followed by Registered Health Information Administrator (RHIA; 180/691, 26%) credential. SCM scores were significantly higher in the informatics category compared to the coding and revenue cycle (P=.006) and data analytics categories (P<.001) but not significantly different from the information governance category (P=.85). The coding and revenue cycle category had a significantly higher SCM score compared to the data analytics category (P<.001). Additionally, the information governance category was significantly higher than the data analytics category (P<.001). SCM scores were significantly different between each competency category, except there were no differences in the average SCM score between the information protection and revenue cycle management categories (P=.96) and the information protection and data structure, content, and information governance categories (P=.31). Conclusions: Industry job postings primarily sought degrees, with a master's degree a distant fourth. NLP analysis of job postings suggested that the correlation between the informatics category and job postings was higher than that of the coding, revenue cycle, and data analytics categories. [ABSTRACT FROM AUTHOR]

Whilst encounters in psychology are typically experienced relationally, qualitative dyadic research in psychology is relatively rare. This study used qualitative dyadic research to understand psychological therapy assessments, exploring how experiences are actively created through situated, relational encounters. Seven dyads participated in qualitative semi-structured interviews, predominantly from services for trauma survivors. Thematic dyadic analysis explored a third space, distinct from the experiential knowledge of individuals. We found that clients and assessors balance closeness and distance through enacting aspects of their identities impacting on connection, safety, trust and disclosures. Whilst assessors and clients come together as strangers, human beings, experts, collaborators and, at times, survivors, the key determining factor shaping the encounter is how successfully assessors communicate their humanity. We conclude that dyadic qualitative inquiry is a feasible and rich method for understanding the relational in psychological healthcare encounters. [ABSTRACT FROM AUTHOR]

A study was performed to analyze the mechanisms of nontransferred strand cleavage during Tn10 transposition. DNA transposition is a type of genetic recombination wherein genetic elements such as transposons transfer from site to site within and between genomes. It was hypothesized that excision of the double transferred strand occurred through a three-step mechanism involving the generation of a hairpin intermediate by transesterification. Results revealed the formation of the DNA hairpin intermediate at Tn10 ends during the transposition excision reaction.