Dr Helen Burstin Discusses Gaps in Quality Measurement

Helen Burstin, MD, MPH, FACP, chief scientific officer of The National Quality Forum, explained that the 2 gaps that exist in quality measurement currently include data infrastructure and patient engagement.

Transcript (slightly modified)

Where is one of the biggest gaps in quality measurement right now?

For example, care coordination measurement. We all know it’s important. We’ve all identified it as something that is kind of a lynch pin in our efforts to move the system forward. It is very, very difficult currently to get at good care coordination measures. We don’t have the data infrastructure currently with interoperable systems to allow us to look across systems.

We are beginning to rely on the voice of the patient, which is wonderful in terms of 1, input into asking patients and their families for example about how well coordinated care was. But, as you think about trying to get towards value, things like care coordination and other key areas like end-of-life care, adverse medical events, so many of the big issues that we know drive both adverse patient effects but also higher costs are some of the issues we’re trying to get our arms around.

How do gaps in quality measurements occur?

There are a couple of different reasons. I think first, certainly, not having available data is a pretty significant piece of it. I think that’s what’s driven some of the gaps around care coordination, for example.

I do think secondly, and one of the things we’ve learned as part of this new work we’re doing around this measure incubator and our desire to launch this measure’s collaborative is that a rate limiting step for many measure developers, even if they come up with a great, new innovative measures, are the test beds aren’t there to test the measure. So again, we’re trying to think about how we can do that.

I think the third thing for some of these measures that are specially patient-centered, we don’t have enough patient engagement through the measure development process. So we’re trying to think about ways to ensure that from the start of measure development, you’ve got significant patient representation and their voices heard all the way through the process and secondly, you’ve got data all the way through the process. So you can really be much more agile and create a better measure.