Harkness Project Title: Integrating the Quality Tools: Barriers and Opportunities for Co-developing Guidelines and Performance Measures
Mentors: Elizabeth A. McGlynn, Ph.D. and Paul G. Shekelle, M.D., Ph.D.
Placement: RAND Corporation
Biography at time of Harkness Fellowship: Rubin Minhas, M.B.Ch.B., a 2008–09 Commonwealth Fund Harkness Fellow in Health Care Policy and Practice, is a general practitioner and Honorary Senior Lecturer within the Faculty of Science, Technology and Medical Studies at the University of Kent. He serves as current chair of the National Institute of Health and Clinical Excellence (NICE) Familial Hypercholestorlamia Guideline, and has co-authored NICE guidelines for both the primary and secondary prevention of cardiovascular disease. He is an independent member of the NICE Technology Appraisals Committee, which he formally represents in the NICE Topic Selection process. Minhas is also an active member of several organizations and committees, including chair of the Cardiovascular Working Group of the South Asian Health Foundation, and technical advisor to the National Prescribing Centre. His interests include cardiovascular disease, evidence-based decision making and its translation into clinical policy. He has co-authored two cardiology textbooks and submissions to the House of Commons Health Select Committee, in addition to publications in the Journal of the Royal Society of Medicine, Heart, International Journal of Clinical Practice, British Medical Journal, Lancet, and the Journal of Clinical Pathology. Minhas holds a medical degree from the University of Leeds.
Project: Minhas’ project sought to: (1) assess the quality of a selection of U.S. clinical guidelines; and (2) explore the feasibility of developing clinical guidelines and performance measures through a single process. For the first part, he assessed the technical quality of guidelines on three different topics (e.g., diabetes, coronary heart disease, etc.), drawn from the U.S. National Guidelines Clearinghouse. For the second part of his project, he developed a theoretical model of the strengths and weaknesses of guidelines and performance measures for quality improvement, and conducted a search of the National Quality Measures Clearinghouse to identify existing examples of co-development of guidelines and indicators.
Career Activity Since Fellowship
- Clinical Director, Editor-in-Chief, BMJ Evidence Centre, 2009-2013
Current Position: Group Scientific & Medical Director. Nuffield Health. (Updated April 2013)
Sharma V, Minhas R. “Explanatory models are needed to integrate RCT and observational data with the patient's unique biology.” J R Soc Med. 2012 Jan;105(1):11-24.
Gauld R, Burgers J, Dobrow M, Luxford K, Minhas R, Wendt C, Cohen AB. “Quality improvement, information technology and primary care can improve healthcare system performance. But are policy makers promoting them?” Int J Clin Pract. 2012 Sep;66(9):827-33.
Bedford M, Pettersen K, Minhas R. “Strength of evidence and handling uncertainty: practical considerations and general observations.” J Clin Epidemiol. 2011 Dec;64(12):1272-4.
Minhas R. “Mugged by reality.” Int J Clin Pract. 2011 Oct;65(10):1020-2.
Wendt C, Minhas R. “The power of ideas – can Obama’s healthcare reforms change the U.S. health system?” Int. J Clin Prac March 2010; 64(4): 423-425.
R. Minhas, "Towards a Better Value Health System—The Role of NICE in the U.K. Health Care System," National Guideline Clearinghouse, Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. Accessed May 7, 2009, at http://www.guideline.gov/resources/commentary.aspx?file=NICE.inc.
Minhas, R. and Wendt, C. (2009): Letter from America: The Political Economics of US Healthcare Reform. Journal of the Royal Society of Medicine, 102(4): 129—133. Minhas, R.; Wendt, C.; and Wierzibicki, A. (2008): Is healthcare in the United States too big to fail? International Journal of Clinical Practice, 62, 12, 1827-1830
Minhas R, Patel KCR, Wierzbicki AS. “Personal View: The UK needs and Institute of Medicine.” BMJ 2008;337:a1623.