Listen to patient goals to flesh out quality care metrics, doctor says


A Salt Lake City physician wants to redefine value in the healthcare system based upon what patients want, rather than solely through arbitrary metrics.

In an article appearing in Stat, Vivian Lee, M.D., CEO of Utah Health Care and dean of the University of Utah School of Medicine, describes a system with the patient’s desires at the center of their care plan as “the holy grail.” She’s gotten to this point through a systematic approach to solving the core problem of value-based care: finding the best way to measure care quality.

Lee started out by pushing the University of Utah to post patient reviews of doctors publicly, despite skepticism from the chief medical officer of the company that administers patient surveys for the system. That raised the degree of transparency and kicked off a national trend, but also generated a wave of anger from physicians who felt such reviews would be detrimental to their reputation. “We are going to need to get thicker skin,” Lee told her colleagues. Since then, the University of Utah’s doctors have seen improvements in their national rankings on patient satisfaction surveys, according to the article.

Lee’s next step required collecting detailed healthcare data to get a clearer view of the cost of care. Specifically, she wanted to compare the differences in expenses across similar patients in order to nail down best practices, improving both outcomes and cost efficiency. The next evolution of this process involves adding patients’ expectations to the mix, alongside quality metrics under development by doctors and payers.

The result will be what Lee calls the “perfect care index,” capturing targets that range from standard outcomes (“Did the patient avoid infections?”) to outcomes more tightly tied with patient satisfaction (“Can she play with her kids?”). Lee sees such a tool as the key to achieving the Triple Aim, driving efficient, high-quality care alongside greater patient satisfaction.