Mar 5-9, 2018 Las Vegas NV
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The Trump administration shut down a key clinical guidelines website on Monday, and industry experts have decried the move.
The Department of Health and Human Services revealed on May 14 that it intended to close to the National Guideline Clearinghouse, a part of the Agency for Healthcare Research and Quality (AHRQ), and posted a second notice last week to reiterate the decision.
Budget concerns at AHRQ were cited as the main reason for shutting down the site, which offers clinical guidelines about countless conditions and sees more than 200,000 visitors per month.
“The difficult decision to shutter the NGC was made by AHRQ’s leadership in response to our current budget, and the expiration of funding that supported the NGC,” Alison Hunt, AHRQ spokesperson, told FierceHealthcare.
Hunt said AHRQ will keep a backup of the data previously housed in the NGC, and is “exploring options” to sustain the clearinghouse.
AHRQ has been a target for cost-cutting efforts in the Trump White House, which proposed shuttering the agency entirely.
Leading figures in the industry have slammed the decision on social media since the second notice was posted last week.
Atul Gawande, M.D., a famed surgeon and author who has been tapped to head Amazon, JPMorgan Chase and Berkshire Hathaway’s healthcare venture, said closing the clearinghouse is an “astonishing and unconscionable blow for access to scientific information.”
Valerie King, M.D., director of research at the Center for Evidence Based Policy at Oregon Health and Science University, said in a tweet that eliminating the NGC is “saving pennies to cost millions.”
“There’s a whole lotta scrambling to save/recreate something that would have taken pennies to maintain,” King said in a second tweet.
In response to the NGC shutdown, the medical community has launched petitions to reinstate it and has been teaming with volunteers to clone the site.
In addition, ECRI Institute, an independent nonprofit that built and maintained the clearinghouse, announced Tuesday that it would continue to provide clinical guidelines.
The institute said it will launch a guidance resource that houses “current, properly vetted evidence-based clinical practice guideline summaries and other information.” The first version of the resource site will allow clinicians to search ECRI summaries of available guidance and will be updated to be more user-friendly and offer decision-making support.
“Not all guidelines are created equal. Clinicians want to know what stands behind a particular recommendation, and whether they can trust that recommendation,” Jane Jue, M.D., ECRI’s medical director, said in the announcement. “Trustworthy guidance is the real value we will be providing.”
The Department of Veterans Affairs includes the largest health system in the United States and the second largest agency in the federal government. The system, which accounts for close to $200 billion in federal spending and has more than 350,000 employees, covers the health-care needs of 9 million veterans.
The idea of doing away with the entire system and turning it over to the private sector is not only frightening, it’s morally reprehensible. And yet, if some high-level VA officials in the Trump administration get their way , that’s what would happen.
I spent a year leading a bipartisan commission designed to examine the VHA. And as someone who has spent 35 years leading large, private-sector health systems in urban markets, I fully appreciate the complexity of our nation’s health-care system for veterans. No doubt the system has many problems, in large part created by constant turnover in leadership.
But the VHA also has many great strengths. The system has developed programs that address the service-connected injuries and illnesses of veterans, including for advanced rehabilitation, prosthetics and mental-health services. The system’s organizational model is also critical for the care of men and women who often have multiple injuries and illnesses requiring daily coordination of services.
For decades, the VHA has also partnered with major academic health systems across the country to have access to the best doctors, to teach young doctors about caring for veterans and to conduct research specifically focused on veterans’ needs, resulting in significant innovations in medicine and health-care delivery.
The private sector today is simply incapable of delivering such organized care for veterans, and it does not have the capacity or the sophistication in rehabilitation or mental-health services to meet their complex health-care needs.
I can understand why people may think closing the VHA makes sense — given high-profile cases of dysfunction at the agency, including the wait-time scandal in Phoenix. But it is important to listen to the veterans who are receiving care within the system and to appreciate the scale and complexity of what it delivers every day. At the same time, we should note that private-sector hospitals and health systems have their own quality and service problems, and they escape the scrutiny of the politically charged national spotlight that the VHA deals with every day.