Helen Burstin, MD, MPH, FACPExecutive Vice President & CEO

Council of Medical Specialty Societies

November 28, 2017

ECRI Annual Conference

I have no disclosures

American Academy of Allergy, Asthma & Immunology

American Academy of Dermatology

American Academy of Family Physicians

American Academy of Hospice and Palliative Medicine

American Academy of Neurology

American Academy of Ophthalmology

American Academy of Orthopedic Surgeons

American Academy of Otolaryngology—Head and Neck Surgery

American Academy of Pediatrics

American Academy of Physical Medicine and Rehabilitation

American Association of Clinical Endocrinologists

American College of Cardiology

American College of Emergency Physicians

American College of Medical Genetics

American College of Obstetricians and Gynecologists

American College of Occupational and Environmental Medicine

American College of Physicians

American College of Preventive Medicine

American College of Radiology

American College of Rheumatology

American College of Surgeons

American Epilepsy Society

American Geriatrics Society

American Medical Informatics Association

American Psychiatric Association

American Society of Anesthesiologists

American Society of Clinical Oncology

American Society for Clinical Pathology

American Society of Colon and Rectal Surgeons

American Society of Hematology

American Society of Nephrology

American Society of Plastic Surgeons

American Society for Radiation Oncology

American Society for Reproductive Medicine

American Urological Association

Congress of Neurological Surgeons

North American Spine Society

Society for Vascular Surgery

Society of Critical Care Medicine

Society of Gynecologic Oncology

Society of Hospital Medicine

Society of Interventional Radiology

Society of Nuclear Medicine and Molecular Imaging

Society of Thoracic Surgeons

1. CMSS convenes members around critical issues and serve as their common voice to more effectively accomplish mutual goals.

2. CMSS and its member specialty societies will facilitate a culture of performance improvement in medical practice.

3. CMSS and its member specialty societies will model professionalism as measured by:

Altruism (putting the needs of patients first)

Self-regulation

Transparency (to peers, patients and the public)

Effectiveness of Quality Measurement and Monitoring

Importance to measure and report ◦ What is the level of evidence for the measures?

◦ Is there an opportunity for improvement?

Scientific acceptability of the measurement properties ◦ What is the reliability and validity of the measure?

Usability and Use◦ Can audience use the performance results for both

accountability and performance improvement?

◦ What are the benefits and risks associated with measurement?

Feasibility ◦ Can the measure be implemented without undue burden,

capture with electronic data/EHRs?

Assess related and competing measures

• Measure only when and where it is appropriate

• Prioritize measures that will drive improvement

• Build measurement into workflow and clinical practice (e.g., registries)

• Solicit feedback on burden, benefits, and risks of measurement

• Remove measures that do not add value

Mesosystem

Microsystem

Macrosystem

Plan or health system

measures

Community measures

State or federal reported

measures

Clinician/Practice/Individu

al measures

Need for Prioritization and Alignment

Mary Applegate, MD

Outcome-focused: ◦ Preference for outcome measures and measures with strong

link to improved outcomes and costs

Improvable and actionable:◦ Preference for outcome measures and measures with strong

link to improved outcomes and costs

Meaningful to patients and caregivers:◦ Preference for person-centered measures with meaningful

and understandable results for patients and caregivers

Support systemic and integrated view of care:◦ Preference for measures that reflect care that spans

settings, providers, and time to ensure that care is improving within and across systems of care

Prioritizing Measures

Worse

outcomes for

beneficiaries

with social

risk factors

High medical

risk

(measured)

Higher

medical risk

(unmeasured)

Quality of care

Social support

and

environment

Higher social

risk

(unmeasured)

Higher social

risk

(measured)

http://www.partners.org/index.asp

13

University of Rochester

VOICE

2015 2016

RxPrescribed

Patient ReportedOutcomes

ClinicalOutcomes

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Why we measure?Improve healthcare quality