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Healthcare Quality Metrics 'Abysmal,' Senate Panel Hears

Cheryl Clark, for HealthLeaders Media, July 2, 2013

Another issue confounding measure developers is that today, unlike in years past, patients are much more likely to have multiple comorbidities.  

Quality measurement science, Cassel said, "has understandably focused initially on high prevalence, high yield conditions like diabetes, hypertension and heart disease," looking at one disease across time, "and have not put as much investment into composite measures" that aggregate a patient's outcomes overall.  

As a result, an individual quality measure may "kind of backfire because what you might want for someone with diabetes, who doesn't have any other problems, could be very different for a patient with Alzheimer's disease, and is suffering from two or three malignancies and other kinds of issues, perhaps in a nursing home."

Cassel appeared to make the panel uncomfortable when she pointed out the danger of "overpromising" of what a good measure set can actually do because misdiagnosis "is probably 15% to 20%" of what is considered a medical error.

"A big part is making sure patients get the right diagnosis," she said. "We have no measures that tell you. All the measures we have assume that the patient comes in the door with the diagnosis on their forehead."

That prompted Sen. Patrick Toomey, (R-PA), to remark, "It strikes me that we could have a real problem measuring the final outcome of a patient's care if we don't know how well we got the diagnosis straight in the first place."


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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2 comments on "Healthcare Quality Metrics 'Abysmal,' Senate Panel Hears"


Peter (7/4/2013 at 9:06 AM)
Sadly, we're an industry ecosystem that is still largely disconnected and pointing fingers at each other. Without de-humanizing care or de-valuing healthcare professionals, we need to accept that "healthcare" is a supply chain that is, for the first time, getting wired for optimization. Consumers need to be accountable for their health (and costs). Doctors need to care about outcomes and health not visits and billing. Everyone will make EMRs and their affiliate systems (PACS, VNA... Etc.). become more useful and effective when they understand the supply chain of health and how to improve. Then again, I don't even know my blood pressure... So I'll start with me.

Harvey (7/2/2013 at 10:48 AM)
Patients are not always compliant, are they taking the correct meds, are they staying on their restricted diet, have they really stopped smoking, are they keeping their specialist appointments etc.Quality is not a one way street. Congress also decided to let free enterprise have free reign over EMR's and now millions of dollars and an enormous amount of resources are being wasted trying to get EMR's to communicate with each other. Physicians are wasting valuable resources and money chasing after specialist trying to get their patients consults. EMR is a wonderful tool unfortunately American business tainted it and it will take years and years to deliver the product that it should and can be.