April 20, 2016
Quality Measurement: Focus on the Measures that Matter
New Report Calls for Reforming Healthcare Measurement to Improve Patient Care
ALBANY, N.Y.—In a comprehensive report detailing the chaos of the current healthcare measurement environment, the Healthcare Association of New York State (HANYS) calls for reforming quality measurement to ensure that the focus is on the measurements that matter most for patient care. The report, Moving from Measure Madness to Measures that Matter, urges the healthcare field to collaborate in creating a new, balanced system of quality and safety measurement that will be helpful to patients, payers, and providers.
Currently, healthcare providers report hundreds of measures required by government, commercial payers, accreditation agencies, professional societies, registries, and other organizations. These measures are not coordinated or aligned, and require significant resources focused on data collection, analysis, and reporting.
"While quality measurement and reporting are essential to improving patient outcomes and experience, the deluge reporting requirements is unsustainable and distracting from the measures that matter," said HANYS President Dennis Whalen. "This report showcases the measures currently underway and offers ways for all stakeholders to evaluate which metrics are most useful to improve patient care, outcomes, and experience."
The collection and reporting of each measure requires a complex system of specifications, definitions, data abstraction, and analysis, and may require clinical assessment on an ongoing basis.
For example, stroke care providers must report three separate sets of data that can be interpreted three different ways. These providers must report measures to the New York State Department of Health to be a designated as a New York State Stroke Center, different measures to the federal Centers for Medicare and Medicaid Services (CMS) Inpatient Quality Reporting program, and will soon be required to report measures for electronic health record "meaningful use" and e-measures to CMS.
A more ideal approach is underway for healthcare-associated infection data: providers report information once to the U.S. Centers for Disease Control and Prevention, which then shares with other organizations including New York State and CMS—one measure set for multiple stakeholders.
"What we have right now is a labyrinth of confusing metrics, specifications, and reporting rules that serves no one," said HANYS Quality Institute Executive Director Kathleen Ciccone, Dr.PH., R.N. "We need to get to a common set of measures that matter for improving patient care."
As the healthcare system is transforming care delivery, even more measures are under development, and the current electronic health record technology is too limited to help providers in collection and reporting.
"We need measures that are motivating and provide actionable information to improve care in the future," said Robert J. Panzer, M.D., Associate Vice President for Patient Care Quality and Safety and Chief Quality Officer, Strong Memorial Hospital, University of Rochester Medical Center. "The current state of measurement is just too chaotic to encourage this kind of robust process improvement and ongoing learning."
"Meaningful, easy-to-understand quality measures help everyone—patients and families, clinicians, regulators and payers—assure the safest, highest quality care possible," said Martha J. Radford, M.D., Chief Quality Officer, NYU Langone Medical Center. "Measures that matter are essential for all stakeholders to collaborate to achieve this vision."
"We are in the era of over-measurement in healthcare," said Patrick O'Shaughnessy, D.O., Executive Vice President of Medical Affairs and Chief Medical Officer, Catholic Health Services of Long Island. "We need to unify around a focused and universal set of evidence-based outcome indicators across all payers. Then we can dedicate resources to track and monitor progress and make investments to do the actual work of improving care."
As highlighted in HANYS' previous Report on Report Cards publication—which focused on understanding publicly reported hospital quality measures—HANYS continues to advocate for streamlined quality measurement and strong, evidence-based data that better reflect the hospital environment and can be used to improve hospital quality efforts. Moving from Measure Madness to Measures That Matter continues HANYS' push for good measurements, while assisting providers in creating strategies for managing their internal measurement system.
Associate Director, Public and Media Relations
The Healthcare Association of New York State (HANYS) is the only statewide hospital and continuing care association in New York State, representing 550 non-profit and public hospitals, nursing homes, home care agencies, and other healthcare organizations.