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Karen Adams, Ann C. Greiner, and Janet M. Corrigan, Editors, Committee on the Crossing the Quality ... - page 8 / 29





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1st Annual Crossing the Quality Chasm Summit: A Focus on Communities http://books.nap.edu/catalog/11085.html


Box ES-3. Measurement: Key Strategies

  • Integrating measurement into the delivery of care to benefit patient care

  • Improving information and communications technology infrastructure to reduce the burden of data collection

  • Focusing on longitudinal change in performance and patient- centered outcomes in addition to point-in-time measures

  • Improving public reporting by effectively disseminating results to diverse audiences


Summit participants called for national organizations, accrediting agencies, and appropriate subspecialty providers to agree on a defined, well-validated set of performance measures for the 5 chronic conditions featured at the summit, subsequently to be expanded to the other 15 priority areas. At present, clinicians collect different data for multiple parties, making the process not only overwhelming, but often infeasible in a climate of limited resources. A parsimonious set of measures would:

  • Reduce redundancy and ease the load of data collection.

  • Permit benchmarking and meaningful comparisons within organizations, across communities, and nationally.

  • Allow for longitudinal patient-focused measures that appraise changes in health status and function over time.

  • Capture community-based measures derived from actionable community-wide aims.

To create relevant measurement sets, participants advanced the idea of a matrix, with the six Quality Chasm aims on one axis and the priority areas on the other, whose cells would be populated with appropriate measures. They also supported public reporting of quality outcomes, including patient-centered measures of experience. Dissemination of this information must be done in a way that is meaningful and useful to different audiences.

Box ES-4. Information and Communications Technology: Key Strategies

  • Using standardized systems

  • Leveraging federal leadership to accelerate the adoption of electronic health records

  • Creating a public utility that holds data at the local level

Information and Communications Technology

The importance of patients’ access to and control of their health records was reiterated during many of the sessions at the summit. Ideally, patient health information would be stored in a transportable electronic format, easily retrieved from any computer regardless of software or system requirements. A companion goal would be for all providers’ offices to have electronic health records. Both of these visions highlight the urgent need for national data standards, as transmitting health information across organizational and regional boundaries is severely stymied today by the inability of different computer systems to “talk” to each other in a common language—referred to as lack of interoperability. Accelerating the uptake of information and communications technology would involve a dual strategy of new financial incentives for clinicians from the private sector to invest in the necessary infrastructure, such as the Bridges to Excellence program (Bridges to Excellence, 2004), and federal leadership in

Copyright © 2004 National Academy of Sciences. All rights reserved. This executive summary plus thousands more available at http://www.nap.edu


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