Doctors can’t run fast enough to escape the metrics police. We are measured on just about everything we do. Blood pressure, diabetic control, and number of times per week someone does yoga. The list grows. And the list is different depending on who has the measuring stick. Hospitals, medical groups, insurance companies, and regulatory bodies all want different measurements attended to. While many physicians feel overwhelmed by these and can spend more time working on the metrics than with the patient the question arises: does it help? Do patients live better lives because of all the monitoring taking place outside of their field of vision? The answer is clear and strong. No one knows!
So why go through this effort? The cost, the stress, and the time on tracking these are enormous. Healthcare, specifically outcomes and costs, are becoming more transparent. This is good. This is vital if we want to remove ourselves from our current healthcare crisis. Will proving that we are checking cholesterol levels get us there? Definitely not, but it is part of the journey. Setting up infrastructure to track and report these metrics, getting healthcare professionals to view them regularly, and changing behavior to improve results are heavy lifts that take years to realize.
The Center for Medicare and Medicaid Services (CMS) recently shared good news. CMS convened healthcare systems, providers, payers, and consumers to agree on national standardized measures that everyone agreed were meaningful. We’re moving in the right direction! Measures are becoming patient-centered. This means we will focus on the quality of life a patient is experiencing under a provider’s care. We’ll measure whether or not people are educated about their condition. Most importantly, goals of care and shared decision making we be markers of good care. This means that patients should go through healthcare planning. We can’t expect to get the care that we view as the best and most appropriate for us without having discussions about what that care looks like. These are a series of conversations. Ideally these happen early (when a new diagnosis is made), take place when things are calm rather than in a state of crisis, and involve family or friends. These conversations change outcomes. They help people live better and longer. CMS and other stakeholders realize that these conversations should be prioritized in the upcoming years. Iris Plans realize that you should have these conversations today.