Mostashari: Clinical quality measurement system needs to evolve

To meet the industry's goals of providing high quality, safe and affordable healthcare, quality measures need to transition from "setting specific narrow snapshots" to a more broad based, meaningful and patient center based assessments "centered in the continuum of time in which care is delivered," according to an article published in the Journal of the American Medical Association this week by National Coordinator for Health IT Farzad Mostashari and other U.S. Department of Health & Human Services officials.

The article stresses the need to identify important clinical measures, discontinue the use of those of little value and "create a portfolio that meets the needs of payers, policy makers and the public." 

To transition to the quality measures of the future, the authors recommend that the measures be more population based. They also should be reoriented and realigned around patient-centered outcomes that span settings, and realigned vertically--individually, group/practice and population--with feedback at each level. The authors point out that HHS already is working on such a realignment. 

Future quality measurements also need to be a collaborative effort, according to the authors.

"As measures are increasingly implemented in payment programs based on value, the public and private sectors must collectively work to ensure the implementation of patient-centered measures that matter, minimize clinician burden, focus on improvement, and develop an agile learning measurement enterprise," they say. 

The authors also state that health IT will make these goals easier to meet. 

Quality improvement is a major tenet of the Affordable Care Act. However, both measuring and improving quality is a challenging task. 

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