Lunch Keynote at NCQA HL7 Digital Quality Summit. The video of this deck is available at https://youtu.be/YV5Ih6mVafk
www.netspective.com© 2017 Netspective. All Rights Reserved.1REIMAGINING QUALITYMEASUREMENTBy Shahid N. Shah, Publisher, Netspective Media
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www.netspective.com© 2017 Netspective. All Rights Reserved.2WACKY IDEASWELCOME FORNEXT HOUR
www.netspective.com© 2017 Netspective. All Rights Reserved.3WHY ARE WEMEASURINGQUALITY?OUTCOMESPROCESSCOMPLIANCECOSTS
www.netspective.com© 2017 Netspective. All Rights Reserved.4WHO ARE WEMEASURINGQUALITY FOR?PATIENTSHEALTHSYSTEMSPAYERS &INSURERSREGULATORSCAREPROFESSIONALSPATIENT’SCAREGIVERS
www.netspective.com© 2017 Netspective. All Rights Reserved.5Meaningful Use (MU)made us take us our eyeoff the ball and we endedup with crappy measures
www.netspective.com© 2017 Netspective. All Rights Reserved.6What would qualitymeasurement look like ifMU silliness didn’t makeus take our eye off theinnovation ball?
www.netspective.com© 2017 Netspective. All Rights Reserved.7We’d focus on qualityimprovement (QI) and continuousquality assurance (CQA) notdata collection and qualitymeasurement.
www.netspective.com© 2017 Netspective. All Rights Reserved.8Let’s reimagine QI andCQA for a patient-first,digital-first qualityexperience (PDQX)
www.netspective.com© 2017 Netspective. All Rights Reserved.9Let’s reimagine QI andCQA with a zero-basedPDQX approach:start from scratch
www.netspective.com© 2017 Netspective. All Rights Reserved.11Seema VermaAdministratorLast week, CMS announced our new initiative “Patients Over Paperwork” toaddress regulatory burden. This is an effort to go through all of our regulations toreduce burden. Because when burdensome regulations no longer advance thegoal of patients first, we must improve or eliminate them.…We’re revising current quality measures across all programs to ensure thatmeasure sets are streamlined, outcomes-based, and meaningful to doctors andpatients. This includes a review of the Hospital Star Rating program. And, we’reannouncing today our new comprehensive initiative, "Meaningful Measures.”…“Meaningful Measures” takes a new approach to quality measures to reduce theburden of reporting on all providers…Meaningful Measures will involve onlyassessing those core issues that are the most vital to providing high-quality careand improving patient outcomes.…It’s better to focus on achieving results, as opposed to having CMS try tomicromanage and measure processes. This will help two things:• Help address high impact measurement areas that safeguard public health.• Help promote more focused quality measure development towards outcomesthat are meaningful to patients, families and their providers.“”SPEECH: Remarks by Administrator Seema Verma at the Health Care Payment Learning and Action Network (LAN) Fall Summit (As prepared for delivery - October 30, 2017)https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-10-30.html
www.netspective.com© 2017 Netspective. All Rights Reserved.12No measure that isn’t understandable by patients ortheir caregivers would be prioritized for inclusion.MUST be UNDERSTANDABLE by PATIENTS and CAREGIVERSCreate a maximum of 10 measures per condition orprocedure and then every time we have a great ideafor another one, eliminate an older one.EVERY NEW MEASURE MUST ELIMINATE an OLDER MEASUREIf a measure isn’t demonstrating outcomes easilyunderstood by patients or loved ones, we’d ignore it.MUST be OUTCOMES FOCUSED, not PROCESS CENTRICPDQX MeasuresReimagine drastically reducing what we measure
www.netspective.com© 2017 Netspective. All Rights Reserved.13Patients don’t really have a voice today in qualitymeasures, how will we setup that feedback loop?HOW DO WE KNOW WHAT MATTERS TO PATIENTS and CAREGIVERS?VALIDATED “PROMS” (PATIENT REPORTED OUTCOMES MEASURES)What kind of telemetry and continuous learning canwe put into place to know which are useful vs. not?HOW DO WE KNOW IF SOMEONE IS USING AN OLD MEASUREWHEN WE WANT TO DEPRECATE OR ELIMINATE IT?Healthcare outcomes are notoriously difficult todetermine, do we not measure process at all?WHO DETERMINES OUTCOMES FOCUSED vs. PROCESS CENTRIC?USE SAME APPROACH AS PROMS DEVELOPERSPDQX ChallengesPatient-centric and outcomes-focused easier said than done
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www.netspective.com© 2017 Netspective. All Rights Reserved.19Opaque Transparent
www.netspective.com© 2017 Netspective. All Rights Reserved.20Reportable ActionableInstant Feedback forImmediate Interventions
www.netspective.com© 2017 Netspective. All Rights Reserved.21Consensus-drivenData-driven
www.netspective.com© 2017 Netspective. All Rights Reserved.22Eminence-drivenEvidence-driven
www.netspective.com© 2017 Netspective. All Rights Reserved.23Compliance ValuePATIENT SAFETY
www.netspective.com© 2017 Netspective. All Rights Reserved.24Analog Digital
www.netspective.com© 2017 Netspective. All Rights Reserved.25Manual System Generatedif you have to hand enter it, it’s a crappy measure
www.netspective.com© 2017 Netspective. All Rights Reserved.26Discrete Continuous
www.netspective.com© 2017 Netspective. All Rights Reserved.27Retrospective reportingInteractive telemetryEVENT DRIVEN SDKs
www.netspective.com© 2017 Netspective. All Rights Reserved.28Institution-framedPatient-framed
www.netspective.com© 2017 Netspective. All Rights Reserved.29Population-basedPersonalized
www.netspective.com© 2017 Netspective. All Rights Reserved.30Sector-specific UnifiedMU, HEDIS, STARS, MIPS, MACRA, 21st Century Cures, etc.
www.netspective.com© 2017 Netspective. All Rights Reserved.31MeasurementProcess ImprovementCare Assurance
www.netspective.com© 2017 Netspective. All Rights Reserved.32BACK TOREALITY
www.netspective.com© 2017 Netspective. All Rights Reserved.33DOES SIMPLE ACTOF MEASUREMENTIMPROVE QUALITY?
www.netspective.com© 2017 Netspective. All Rights Reserved.34DOES INCREASINGMEASUREMENTTRANSPARENCY YIELDHIGHER QUALITY?
www.netspective.com© 2017 Netspective. All Rights Reserved.35How can we helpimplement CMS’s new“Patients Over Paperwork”and “Meaningful Measures”initiatives?
www.netspective.com© 2017 Netspective. All Rights Reserved.36No measure that isn’t understandable by patients ortheir caregivers would be prioritized for inclusion.MUST be UNDERSTANDABLE BY PATIENTS and CAREGIVERSCreate a maximum of 10 measures per condition orprocedure and then every time we have a great ideafor another one, eliminate an older one.EVERY NEW MEASURE MUST ELIMINATE AN OLDER MEASUREIf a measure isn’t demonstrating outcomes easilyunderstood by patients or loved ones, we’d ignore it.MUST be OUTCOMES FOCUSED, not PROCESS CENTRICPDQX MeasuresReimagine drastically reducing what we measure
www.netspective.com© 2017 Netspective. All Rights Reserved.37THANK YOUShahid N. Shah, Publisher, Netspective Media[email protected] @ShahidNShahREIMAGINING QUALITYMEASUREMENT