Ask Dr. Parker: Making Measures Better

Rich Parker, MD answers a question about improving measures to make them more meaningful to providers.

Ask Dr. Parker

“Current value measures are either very narrow (what happens in a single hospital department) or very broad (infection rates for the whole hospital).  What are the top changes that make the measures more meaningful to providers and patients?”

The whole process of giving meaningful feedback to providers is incredibly difficult.  The most meaningful measures are usually the clearest, such as decreasing line infections or wound infections by well-trained providers following good agreed upon guidelines.

This question focuses on hospital-based measures.  These usually revolve around specific things such as central line infections, or more patient-centered attitudes about care as captured in patient surveys.  For any given patient, how she or he was treated both from a technical perspective and interpersonal perspective adds up to their “whole experience”.  It is impossible to break out how much of each of those categories meant more to any individual patient.

For doctors, some with very technical jobs such as surgery can kind of be rated by their outcomes, but this is made difficult by the challenges with risk adjusting their patients.  Doctors with more cognitive skill sets, such as internal medicine, can barely be measured at all, except by patient surveys and the doctors’ performance on the discrete and limited quality measures used by their organization.

But that said, the measures – and there are so many of them now – have evolved to a fairly reasonable set for clinical use.  I would suggest that from a process perspective, a better mechanism should exist for physician leaders to offer input into improving existing measures, deleting less useful measures, and creating new measures.

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Dr. Richard Parker

Dr. Parker serves as chief medical officer for Arcadia with overall responsibility for the design and implementation of clinical strategies, input into the roadmap and development of Arcadia’s technology and service programs, thought leadership in support of providers transitioning to value-based care, and strategic advisory work for physician leaders at Arcadia’s clients.

Previously, Dr. Parker was an internist with a 30-year history at Beth Israel Deaconess Medical Center. From 2001 until 2015, Dr. Parker served as the medical director and chief medical officer for the 2,200 doctor Beth Israel Deaconess Care Organization. He oversaw the physician network evolve from a fee-for-service payment system to a nationally recognized global payment pioneer Accountable Care Organization. Dr. Parker’s other areas of expertise include end of life care, medical malpractice, care of the mentally ill, electronic medical records, and population health management. Dr. Parker served as assistant professor of medicine at Harvard Medical School. Dr. Parker graduated from Harvard College in 1978, and the Dartmouth-Brown Program in Medicine in 1985.

Dr. Parker is an in-demand speaker to associations, companies, and academic institutions on the topics of population health management, electronic health records, value-based care, and evolutionary, medical and business impacts of stress.

February 14, 2017

http://www.arcadiasolutions.com/ask-dr-parker-value-patients/

In the previous Ask Dr. Parker column, Dr. Parker answered a question about measuring and managing provider collaboration across the full cycle of care to drive value for the patient.

Read the article