Value-based health care is fundamentally about improving outcomes for patients; thus, a commitment to measurement of patient health outcomes is a necessary component.
Currently, the vast majority of quality indicators used in health care are process measures. Actual outcomes comprised only 7% of the more than 1,950 quality indicators in the National Quality Measures Clearinghouse in 2016, and less than 2% were patient-reported outcomes.1
We should measure outcomes for many reasons, including:
True outcome measurement that effectively drives high-value care requires transparency, integrated care, and interoperability to share data between departments within an integrated system. As Dr. Porter explains above, it is absolutely necessary to value improvement.
However, we should not assume all outcome measurement must be complex. Much of health care is actually routine and predictable. As Schupback, Chandra, and Huckman wrote in Harvard Business Review in 2016:
“Our suggestion for a starting point to measure outcomes is simple, easy, and inexpensive: Ask the patient… For many types of care – especially care that is routine, highly standardized, and completed over a short duration – one may thus get significant mileage out of asking patients very simple question such as, “At this point, how satisfied are you with the outcome of your care?”… The use of measures that we typically see in other consumer products and services may be relevant and helpful in measuring, and thus improving, value. In short, the fact that simple patient ratings of care may not be applicable in all types of care should not cause us to dismiss their use for any type of care.”2
Recall from Module 2 that process measures and outcome measures are both needed to drive improvement. Outcome measures are needed to know what works. Process measures are needed to know what inputs and activities achieved the result. Below, let’s review the different types of measures.
