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)
13
University of Rochester
VOICE
2015 2016
RxPrescribed
Patient ReportedOutcomes
ClinicalOutcomes
15
Why we measure?Improve healthcare quality