National Quality Forum CEO Christine Cassel, MD, outlines a "path forward" for healthcare quality measurement in a commentary published Sept. 1 in the Journal of the American Medical Association. Cassel recommends actions that healthcare stakeholders can take to support timely, accurate and meaningful metrics of healthcare quality.
The article, "Learning From the Past to Measure the Future," which is co-authored with Richard Kronick, the director of the Agency for Healthcare Research and Quality, highlights the findings of a meeting of nearly two dozen leaders in healthcare quality and improvement. Convened by NQF and AHRQ, the leaders looked at existing abilities to measure healthcare, discussed what has and has not worked, and formulated a vision for the future.
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Healthcare is at a "critical inflection point" of multiple policies and initiatives seeking to improve healthcare quality and value, Cassel and Kronick write. At the same time, there are concerns that national improvement is not occurring quickly enough given the resources expended on measurement and reporting.
To support the future of quality measurement, they recommend healthcare stakeholders align to reduce the number of measures in use and place greater emphasis on how measurement can support internal improvement efforts along with payment and accountability applications.
Cassel and Kronick also call for the development of better measures through greater collaboration with measure users and by garnering feedback from clinicians and healthcare organizations using measures at the point of care.
Advances in technology have made it possible for the healthcare field to start leveraging the large amounts of data available from electronic health records, insurance claims, federal and state sources, and communities, they note. Meanwhile, advances in delivery system integration have "created a platform whereby measurement can effectively be used for improvement and reporting with less cost."
[See also: Systems reengineering to improve care.]
"As attention rightly turns to reducing waste and improving the value of dollars spent by consumers, purchasers, and taxpayers, measurement science must keep pace," Cassel and Kronick write, adding that public-private partnerships can best deliver on the real goal of measurement: quality improvement.
The message is timely. The U.S. Department of Health and Human Services announced earlier this year that it will tie 90 percent of Medicare payments to quality or value by 2019.
