Accountability for clinical preventive services

Clinical preventive services are important in both the civilian and military health care systems. In the civilian sector, preventive services have been included in the movement for more accountability for health care services. Four civilian accountability models have at least some preventive services evaluation. DEMPAQ is a program developed for Medicare, and collects data both from claims records and from office medical records. PROSPER is an example of another type of model, and uses patient questionnaires to collect information. A third model, HEDIS, produces the popularly-called "report cards." HEDIS relies on administrative data generally available in managed care organizations. "Passports" is yet another model that offers the potential for perhaps the most efficient way to evaluate preventive services, but it is still developmental. None of these civilian models is directly applicable to today's military care system. However, the Composite Health Care System, a computer system widely used in military treatment facilities, offers a possible mechanism to provide local accountability for clinical preventive services that should be easy and efficient.