Measuring quality of care remains the keystone of the healthcare industry’s move toward rewarding value over volume. Leaders from Swedish Medical Group, the Institute for Healthcare Improvement, and Providence St. Joseph Health suggest refining quality measurement so that it better reflects the patient’s perspective.
Healthcare providers have become overwhelmed by the sheer number of quality measures, not all of which reliably correspond to better outcomes, write Amy Compton-Phillips, M.D., of Providence St. Joseph Health, Christopher R. Dale, M.D.,of Swedish Medical Group, and Kedar S. Mate, M.D., of the Institute for Healthcare Improvement, in a blog post for NEJM Catalyst.
The authors suggest narrowing the focus of quality metrics to an individual patient’s primary and secondary clinical health needs, and scoring them as components of what they call a Personalized Perfect Care (PPC) bundle. Patients whose care provides all components get counted as complete, while those with a deficiency in any component get counted as incomplete.
While such an approach produces lower scores than most existing metrics, the authors argue that the shift toward patient-centric metrics ties quality measurement more tightly to outcomes. The PPC bundle, they write, would allow organizations to measure whether each patient receives evidence-based, effective care, at the right time, for his or her conditions. In addition, they say the measure:
- Simplifies reporting. While the approach doesn’t necessarily reduce the number of metrics available for reporting, it provides a framework within which organizations can focus on the metrics that align with improved population health.
- Improves transparency. Because the PPC bundle is an all-or-nothing measurement, it’s easy for patients to assess it alongside other metrics, like price, in an increasingly transparent healthcare marketplace.
- Helps identify and target underserved patient populations. The authors’ data indicates nearly half their identified gaps in care come from under a quarter of their patient population, suggesting increased attention to patients with multiple care gaps could provide an efficient way to improve quality.