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Performance Measurement: At the Core of Care Improvement

February 21, 2012
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Progress seen, but plenty of challenges ahead


Listening to the sessions on performance measurement on Monday, I was impressed by the central role that performance measurement plays in care improvement.
Charlene Underwood, chair of the HIMSS Board of directors, who also serves as director of government and industry affairs at Siemens Healthcare, acknowledges that the challenge of applying data to improver care is a difficult one, but she also believes that health providers are up to the task.
As part of an introduction to the session on Performance Measurement and CDS, she noted that Kathleen Sebelius, secretary of the Department of Health and Human Services, has announced that $3.1 billion has been paid out of the meaningful use program this first year. Sebelius also he also said that the number of hospitals using IT has more than doubled in the last two years. Over 41,000 physicians have achieved meaningful use.
Underwood also spoke of the importance of measurement to the process of improving care, and improving delivery systems. She said that performance measurement is an abstract process that can be used in many ways to improve care.
A key goal of the HITECH Act was that, as a result of care delivery, we would be able to capture the information as a byproduct that would allow us to measure care, she said. “As we get smarter, and as we are basing our measurement on evidence, we can pull that evidence right at the front end for clinical decision support. So we can improve care over time,” she said.
That’s a difficult task, she said. “Multiple measures don’t make it easy; having specs that are written to measures that are captured after the fact doesn’t make it easy,” she said. Nonetheless, the coming together of HITECH, meaningful use, around this area, is critical, and she says it offers an energizing factor that is crucial  to the transformation of the delivery system.
Underwood also noted that part of the focus of the Meaningful Use Workgroup has been putting in definitions where there is evidence that care is improved. Sometimes that’s hard, she said. “The driver there is how can we align our meaningful use efforts and definitions with what’s in the Affordable Care Act, and more importantly, with the change that is necessary in care,” she said.
Underwood says there is bipartisan support in Congress for the necessary changes in the delivery system. “The bottom line is that we are, right now, in accountable care and we right now in the era of transforming care,” she said. The topic of performance measurement is critical, “because we cannot improve what we cannot measure,” she said.