Measuring Quality in Cancer Care

Identifying high-quality, cancer care is a laudable goal.  However, a recent article by Alvarnas (2016) says the way many are trying to measure quality of cancer care currently is inadequate.  Specifically:

  1. Quality and value are multidimensional, but the narrow focus of many quality measures undermines their effectiveness and meaningfulness. (Porter 2010)
  2. Quality and value measures are all too often based upon isolated care transactions, rather than based upon the continuum-of-care model that is an essential part of effective cancer care.(Porter 2010)
  3. Few quality/cost/value measures include risk as part of their formulation or expression. (Spinks 2011, CIBMR 2016)
  4. Electronic Health Records do not facilitate capture or assessment of key outcomes data.(Klumpp 2013)
  5. Few quality measures are linked to care strategy, healthcare facility/provider strategic planning, or the development of more effective care systems.(Porter and Lee 2015)
  6. Our measures for assessing patient-reported outcomes are weak, and rarely measure those things which matter most to patients.(Johnson 2016, de Boer et al. 2008)

So what’s the alternative to administrative quality measurement?  Porter and Lee 2015 recommend the following:

The failure to prioritize value improvement in health care delivery and to measure value has slowed innovation, led to ill-advised cost containment, and encouraged micromanagement of physicians’ practices, which imposes substantial costs of its own. Aligning reimbursement with value in this way rewards providers for efficiency in achieving good outcomes while creating accountability for substandard care.

That sounds like a better vision to me.



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