NEJM Perspective Piece Recommends Ways to Enhance Healthcare Measurement 

Washington, DC— The December 4, 2014, edition of the New England Journal of Medicine includes a Perspective piece authored by National Quality Forum President and CEO Christine Cassel, MD, and other quality leaders about increasing the likelihood of success for performance measurement. The article, “Getting More Performance from Performance Measurement,” makes several recommendations for strategies that healthcare stakeholders can use to spur advances in measurement.

Co-authors include Patrick Conway, MD, Deputy Administrator for Innovation and Quality and Chief Medical Officer of the Centers for Medicare & Medicaid Services; Suzanne Delbanco, PhD, Executive Director of the Catalyst for Payment Reform; Ashish Jha, MD, MPH, Director of the Harvard Global Health Institute; Robert Saunders, PhD, Senior Director, Quality Measurement, of the National Quality Forum; and Thomas Lee, MD, Chief Medical Officer of Press Ganey.

The authors highlight the critical role of measurement in reducing preventable readmissions and early elective deliveries. They also cite the lessons learned from “unintended consequences” of the CMS quality measure for community-acquired pneumonia, which led to inappropriate antibiotic use in some patients.

According to the authors, strategies for spurring dramatic advances in performance measurement include continuing to improve available measures with a focus on patient health outcomes and improving value; enhancing the use of electronic clinical information, clinical registries, and “big data” sources; aligning reporting requirements among federal, state, and private payers; and consolidating requirements from accrediting and certifying bodies.

The authors make recommendations that specific healthcare stakeholder groups can use to improve healthcare measurement. For example, they suggest that clinicians develop and implement measures relevant to their practice and build the necessary data-collection infrastructure to mine data for opportunities to improve care. The authors also suggest that payers align with other payers “on a smaller set of high-impact and outcome-oriented measures,” and that patients and consumers “call for transparent quality measurement and reporting, and participate in efforts to collect patient-reported outcome information.”

“Although we’ve come a long way, there’s much more that the healthcare community can do to employ performance measurement so that patients get the high-quality care they deserve,” said Cassel. “Advances in the science and practice of performance measurement, improved transparency in results, and the increased investment that all stakeholder groups have in getting more out of measurement are key to driving continued improvement.”

The National Quality Forum leads national collaboration to improve health and healthcare quality through measurement. Learn more at www.qualityforum.org.