Enthusiasm for performance measurement in both the public and private health care sectors has helped to create a serious problem: a massive proliferation of measures. Health care organizations involved in care improvement initiatives may be asked to report and collect hundreds of measures aimed at dozens of medical conditions, leading to confusion and inefficiency. In response, the Institute of Medicine (IOM) has identified a set of standardized measures, along with steps for implementing and refining them.
What the Study Found
In a JAMA “Viewpoint,” Commonwealth Fund President David Blumenthal, M.D., a member of the IOM Committee on Core Metrics for Better Health at Lower Cost, and coauthor J. Michael McGinnis, M.D., highlight the 15 measures identified by the IOM: life expectancy, wellbeing, overweight and obesity, addictive behavior, unintended pregnancy, healthy communities, preventive services, care access, patient safety, evidence-based care, care match with patient goals, personal spending burden, population spending burden, individual engagement, and community engagement.
The committee reached a number of important conclusions in developing these measures, including:
- Measurement is not an end “but rather is a means to accomplishing health goals.”
- Composite measures are needed in certain areas, like healthy communities and patient safety.
- Although core measure sets may differ depending on the setting—for instance, a state agency versus a group of cardiologists—all sets should be aligned toward common goals.
Across regions, organizations, and partisan lines, there is increasing agreement that we cannot commit more resources to health care without accounting for value, the authors say. Measuring and monitoring performance will be critical to this endeavor.