One of my perennial thoughts, aside from my perennials, is health care measurement. I appreciate reading how others approach this as in the recent Cancer Journal: What is health? – a piece by a contributor to the Incidental Economist who happens to also be undergoing treatment for cancer. He talks about three factors – longevity, feeling good, and function (doing what you want to do) – that impact the various decisions he makes around types of treatment and how that impacts his life.
These are key facets of life that have impacted much of how we think about the work that we do at the Foundation for Health Care Quality. Measuring how long we live is probably the easiest, function somewhere in the middle, and feeling good the hardest of all.
This past quarter I have had a series of conversations about the future of measurement. How are we going to build a system capable of truly measuring how a person feels, how healthy they are, the health of an entire population? How is our system going to be able to send information between the spaces providing us care? I have been lucky to participate in the Performance Measures Coordinating Committee’s workgroup on the future of health care measurement. This future-thinking space is where I like to operate – and where ideas can be born and grow.
These measurement conversations are so intertwined with our partnership with the Washington Health Alliance to move our system to pay for value. We need to define value before we can pay for value – and yes this is difficult. There is a balance between not letting the perfect be the enemy of the good and being fair to our hard-working providers.
An article in the NEJM Catalyst says, “With the dominance of compliance and process metrics, payers and regulators hold health care professionals accountable only to surrogate metrics rather than to the results that a properly functioning health care system should deliver: better outcomes for patients achieved at lower total cost.” I think we can do better than this. As a person who uses our health care system, I want my encounters with the health care system to be respectful and useful to me. We all want to feel good. As a member of our Washington State quality community, I want to help our delivery sites course correct when needed, to be able to look at themselves honestly, and to help their patients.
We have much more to do to right-size our measurement efforts and welcome everyone to our FHCQ table as we build this future state.