Most of the prominent initiatives in health care rely on analyzing and grading how providers are treating their patients and how payers are managing their responsibilities to members. Whether the measures are clinical, administrative or based on patient-experience, they are central to improving the overall performance of our admittedly expensive health system. So it is obviously critical that the measures themselves have a high level of validity. An article in the latest issue of Health Affairs discusses how to ensure and improve upon this validity. (Health Affairs Article)
The authors point out that even in the case of basic outcome measures like mortality, there can be serious problems in collecting accurate data and ascribing it to a particular episode of care or cause. Different vendors and approaches result in widely varying results, undermining the credibility of the process and of the programs that might use the results, particularly for any purposes related to reimbursement. Attempts to improve upon data collection and analysis add to the overall expense of the process, at a time when we all would hope to be lowering the administrative component of total health spending.
The researchers offer five key recommendations to improve the science of performance measurement: analyze and explain the validity of a measure in a transparent manner; develop standardized surveillance systems to routinize the collection of performance data; evaluate performance change over time, paying close attention to relevant potential statistical biases or errors; create a process to prioritize the value of different measures and create and independent agency to evaluate, recommend the use of, and oversee the use of the measures.
