    [Public Papers of the Presidents of the United States: William J. Clinton (1998, Book I)]
    [March 13, 1998]
    [Pages 374-375]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Memorandum on Establishment of the Quality Interagency Coordination Task
    Force
    March 13, 1998

    Memorandum for the Secretary of Defense, the Secretary of Labor, the
    Secretary of Health and Human Services, the Secretary of Veterans
    Affairs, the Director of the Office of Personnel Management

    Subject: Establishment of the Quality Interagency Coordination Task
    Force

        Last November, I endorsed the ``Patient Bill of Rights'' recommended
    by the Advisory Commission on Consumer Protection and Quality in the
    Health Care Industry (the ``Quality Commission''). On February 20, 1998,
    after receiving your encouraging reports from the Vice President about
    the degree to which your agencies are in compliance with these rights, I
    directed you to take all administrative actions under your authority to
    come into compliance.
        As a result of my February 20 memorandum and your commitment to
    implement the Patient Bill of Rights, the Federal Government will be
    taking the lead in ensuring patient protections. By holding the Federal
    Government accountable, we are strengthening our call on the Congress to
    pass patient rights legislation that exceeds these protections to all
    Americans.
        Yesterday, in their report to me through the Vice President, the
    Quality Commission took the next logical step. Building on the Patient
    Bill of Rights, which is explicitly designed to ensure quality, the
    Commission's final report includes

    [[Page 375]]

    recommendations that I am confident will actually improve quality care.
    Specifically, the Commission called for the development of national
    health care quality improvement goals and the use of measurement
    standards that will empower consumers and businesses to make informed
    purchasing decisions based on health plans' quality performance records.
        The Quality Commission recommends establishing ``two complementary
    entities, one public and one private, to provide ongoing national
    leadership in health care quality improvement.'' The Commission
    recommends the creation of a broadly represented, publicly administered
    ``Advisory Council for Health Care Quality'' and a privately
    administered ``Forum for Health Care Quality Measurement and
    Reporting.'' The Commission's approach represents a creative balance to
    achieve constructive involvement from all the parties that have
    important expertise and experience in this area.
        It is my strong belief that we must ensure that all relevant
    agencies within the Federal Government build on their leadership role in
    health care quality. As the Quality Commission report makes clear, the
    lack of coordination and uniform quality standards in both the public
    and private sectors has created conditions that fall ``short of fully
    meeting users' needs, and often are duplicative and unduly burdensome on
    health care providers, plans, and others.'' To that end, the Federal
    Government must use improved standards and goals to better inform and
    empower health care consumers and purchasers under Federal jurisdiction.
    Moreover, we must do a better job of collaborating within and across the
    Federal Government to most efficiently and effectively ensure we achieve
    the national goal of improving quality and health outcomes.
        Therefore, I am directing the Secretary of Health and Human Services
    to immediately establish a ``Quality Interagency Coordination'' (QuIC)
    task force to ensure better coordination among the executive agencies
    with jurisdiction over health programs. I hereby direct you to take the
    following actions consistent with your authority and the mission of your
    agency to meet or exceed the recommendations of the Quality Commission.
        First, I direct that all participating agencies shall have equal
    standing on the QuIC task force.
        Second, I direct the task force to, wherever feasible, collaborate
    on goals, models, and timetables that are consistent with the Quality
    Commission's six ``National Aims for Improvement'': reducing the
    underlying causes of illness, injury, and disability; reducing health
    care errors; ensuring the appropriate use of health care services;
    expanding research on effectiveness of treatments; addressing oversupply
    and undersupply of health care resources; and increasing patient
    participation in their care.
        Third, I direct the Secretary of Health and Human Services to serve
    as the convener of the QuIC task force and to schedule the first task
    force meeting to order by no later than March 27, 1998.
        Fourth, I direct the task force to improve cooperation by the
    participating agencies on the development and utilization of quality
    measurement mechanisms for public sector programs; these efforts should
    be flexible enough to respond to changing needs, technology, and
    information, while being sufficiently standardized to be comparably
    measured.
        Fifth, I direct the task force to work to increase the development
    and dissemination of evidence-based health care information to help
    guide practitioners' actions in ways that will improve quality and
    potentially constrain costs.
        Sixth, I direct the task force to consult with health care workers
    and their representatives, as well as other affected parties, in
    developing models for quality improvement.
        Seventh, I direct the task force to enhance efforts to develop user-
    friendly information for both consumer and business purchasers that
    facilitates meaningful comparisons of quality performances of plans,
    facilities, and practitioners.
        Eighth, I direct all participating agencies, where feasible and
    appropriate, to seek to avoid inefficient duplication of ongoing quality
    improvement efforts and resources.
        Finally, I direct the task force, to every extent possible, to
    endeavor to coordinate the Federal programs' quality reporting and
    compliance requirements to reduce administrative burdens on private
    entities who administer, oversee, or participate in the Nation's Federal
    health programs.

                                                          William J. Clinton