A Case for Quantity When Measuring Quality
The quality of a physician’s work is now often evaluated in metrics and data. Seventeen years ago, the Institute of Medicine issued a call to arms to Cross the Quality Chasm that opened the floodgates for thousands of measures, from government rules to hospital guidelines and consumer evaluations.
As healthcare has become more complex, the measures to evaluate a physician’s performance, however, have increasingly faced criticism as inadequate. There is ”limited evidence” that many quality measures, including those tied to incentives and those promoted by health insurers, lead to better health outcomes.
“The problem is that bad quality measures can be harmful,” opined lead researcher Catherine MacLean, MD, PhD, in a statement. “They are a waste of time; they’re frustrating and they’re a waste of money. It’s gotten to the point where it’s almost measures for measurements sake.”
For instance, physicians are evaluated on at least 2,500 performance measures, but less than 40 percent of these metrics are considered valid, according to a study published inThe New England Journal of Medicine. “The problem is that bad quality measures can be harmful,” opined lead researcher Catherine MacLean, MD, PhD, in a statement.
“They are a waste of time; they’re frustrating and they’re a waste of money. It’s gotten to the point where it’s almost measures for measurements sake.”
There are many different kinds of physician measures that are often based on surveys, sometimes with limited scope, and physicians may get incentives or reimbursements based on some of the data results. The measurements can be generated from the government, consumer groups, academic institutions or within the physician community itself. The measures may be used for a wide range of a physician’s work, including determining how many providers are using electronic health records or how often they recommend aspirin for ischemic vascular disease, according to an American Academy of Family Physicians review.
Measuring Depth of Knowledge
But, too many measures fail to tap into the many variables of physician’s practice, such as giving the full scope of a practitioner’s diagnostic attributes, using available technology or a physician’s bedside manner with elderly patients.
Ironically, measuring quality has been lacking in its quantity; the deep-rooted questions not only about specific service lines, but also about the depth of knowledge in an organization, and the progression of learning.
Although physicians are employed by hospitals more than ever, they are mostly on their own as they pivot their educational needs under the pressure of metrics, data and technology in a changing healthcare climate.
TheInsight Dashboard from Knowledge to Practice provides data that gives a wide view of knowledge, such as how engaged an organization is with learning to achieve knowledge mastery and judgment. The K2P solution assesses where knowledge can be improved and provides a personalized plan for which topics a physician should focus their learning.
K2P is where hospital administrators, program leaders, physicians and trainees can stay current on medicine in a way that’s easy, efficient and effective.