How Are We Doing Measuring Health Care Quality?

1. Since the early 2000s, increasing evidence of mediocre outcomes and unsustainable cost increases have led to multiple efforts to assess the quality of medical care.
2. Unfortunately, the assessments have tended to either center on patient satisfaction (purely subjective) or adherence to defined processes that can be harvested from claims (demonstrably unrelated to actual outcome).
3. There are now so many rating systems that more than 1,600 hospitals in the United States can claim to be “Top 100,” “Grade A,” or a “Best Hospital.”
4. Emergency room physicians typically click a mouse over 4,000 times in a 10-hour shift, often to prove that they have satisfied a process measure.
5. Avedis Donabedian, a professor in the University of Michigan School of Public Health, defined three aspects of measuring quality: (a) how was the work organized?; (b) what were the processes used in the work?; and (c) what was the outcome?

We would argue that the first two are interesting, but the third is essential. We need to find the doctors who get the people as well as possible as quickly and cost efficiently as possible. Then we need to help people get to those doctors. With time and good data collection, we may be able to look back and find out why some people do it better than others, but first let’s get people to the best care.

Reference: Robert Wachter, How Measurement Fails Doctors and Teachers, New York Times (January 16, 2016).

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IntegerHealth uses advanced data analytics to help self-insured employers decrease the costs of their healthcare plans and workers’ comp programs, while improving the care that their employees receive, and getting them back to work faster. If you think that we can help you, please contact our President, Scott Roloff, at (817) 849-9402 or [email protected].