How to measure

Most health care organizations have some understanding of “why” we should measure outcomes. They see the value in aligning all processes toward the one common goal that really matters: the outcomes of care that patients experience.

What isn’t immediately clear, however, is exactly “how” we should measure and report patient-centered outcomes. ICHOM is spearheading efforts in this burgeoning field to enable health care institutions around the world to undertake this journey toward routine outcomes measurement. Indeed, many around the world are already measuring outcomes, and we have taken it upon ourselves to disseminate key learnings from these institutions to others who wish to do the same.

The Journey

Any health care institution wishing to measure outcomes will go through a series of steps. The exact terrain of this journey will depend on the starting point and the goals (e.g.. organize a multi-sites comparisons through automatic data capture with the Electronic Medical Records, vs. measuring in a single department with paper to track individual patient disease progression). However, we have found that the journey can be summarized in the following four stages:

1. Engage & Prepare: Identify key evangelists and engage the senior management and workforce. Set up a multi-disciplinary project team, assess your starting point and identify your goals, then map out your project plan. This “diagnostic” process is key to ensuring the efforts will translate into results farther down the line.

2. Set Up Data Collection: Develop a data-capture model (when are data points captured?) and identify the tools that you wish to use (how the data points will be captured). With this, select the most appropriate data-storage solution. The data collection will begin. The data-capture model will require regular review and iterations, to ensure data accuracy and quality.

3. Measure & Analyze: Verify the accuracy of your data to ensure it is of high quality. Review your goals to ensure that you analyze and risk-adjust data appropriately. Then, report your data in the most meaningful way, depending on the goal the organization wants to achieve.

4. Learn & Drive Change: Learn from your outcomes data to identify best practices and opportunities for improvement. Establish an “outcomes culture” and drive change through the organization to improve health care for patients.

This journey will require numerous iterations at every level. However, once you have your vision and infrastructure in place, outcomes measurement can very much become a routine part of your daily practice.

The Implementation Journey

ImplementationJourney-High-Quality

What’s the Right Solution for Me?

There is no one-size-fits-all solution to implementing outcomes measurement; every organization will have a unique journey to undertake.

For instance, while the empirical approach to engaging and preparing the organization will be relatively similar, the key challenges may differ. Are the clinicians on board? Will the organization dedicate the right amount of resources? Similarly, the data-collection and storage solution to select will depend very much on the pre-existing IT infrastructure and the scale of the project the organization wishes to undertake.

A key learning is that it is not necessary to aim for the most sophisticated solution in the first instance. The implementation of outcomes measurement is an iterative learning process that will likely involve evolution through several stages. The best approach is to be willing to learn and improve on the outcomes measurement model as the organization progresses through the journey!

A Great Example