Metrics That Matter: 2 Proven Ways to Measure Value

Healthcare providers should always strive for quality metrics. Quality measures are vital tools that can identify many aspects of care ranging from safety, effectiveness, timeliness, equity, and opportunities for improvement.

While these check-the-box practices provide critical insights and quantifiable impacts that can help streamline healthcare processes, improve patient outcomes, and adjust organizational structures, growing concerns abound that the heavy focus on metrics is a distraction from patient care – in many ways defeating the purpose of quality metrics in the first place.

Are you working diligently to keep your patients healthy, help them live longer, and achieve quality of life? And how can these benchmarks for true health be measured effectively while minimizing unintended consequences?

Family physician Dr. Lars Peterson shares that although quality care is essential to him and why he became a doctor in the first place, he missed the mark on a value-based metric centered on discussing the risks of obesity with patients. 

The Vice President of Research for the American Board of Family Medicine recounts having critical conversations about lifestyle, diet, and exercise with just about every patient, but a detrimental administrative oversight – not electronically documenting every conversation about obesity with every patient – caused him to fall short, demonstrating that the existing model for measuring value is not infallible.

"We know that lifestyle, exercise, and diet are interventions that can have the greatest impact with any kind of modifiable health outcome – it goes without saying," says Dr. Faisel Syed, ChenMed's National Director of Primary Care. "But if we don't "click" that we talked about these things, we don't get the credit. It's almost like you should have to opt-out and click "I did NOT talk about diet and exercise." To assume we are not talking about lifestyle interventions and getting dinged for that is a little ridiculous."

Metrics That Matter

In a perfect world, performance assessment would lean less on how often providers "check the box" for a commonplace discussion with a patient and rely more heavily on metrics that actually matter. Here are a few underrated KPIs that could be leveraged to gauge the quality of care patients receive today.

The Voice of the Patient

Fostering a trust-based relationship with patients means listening to their feedback. There is an ever-expanding use of quantitative and qualitative methods to capture patients' perspectives, with new survey mechanisms to capture patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs). These could play an integral part in more effectively assessing value at both individual and community levels. Just the implementation of sending a patient satisfaction survey demonstrates that a practice is focused on quality and dedicated to improvement. This alone speaks volumes to value.

Further, patients' experiences can be used to support decision-making, process refinement and optimization, relationship management, and ultimately showcase a clear understanding that experience can influence outcomes and cost-effectiveness.

Whether using written or phone surveys, the key to a successful patient satisfaction survey is to keep it clear, concise, and consistent, and make sure to include the million-dollar question, "Overall, how satisfied are you with your physician?"

Comprehensiveness

One of the four C's of primary care, the true measure of quality reflects positive patient outcomes that occur largely because of the physician's comprehensiveness. Nothing makes a patient feel more valued than a doctor taking their time to thoroughly and patiently address the patient's concerns that brought them in for a visit.

Gauging value can be as simple as asking the following questions: Has the provider taken the necessary steps to deliver the caliber of care that improves the quality and longevity of the patient's life? Did the patient feel seen, heard, and comfortable engaging about their health concerns and prescriptive measures? Did preventive care remediate any issues that could have resulted in readmission, or an emergency room visit?

The current fee-for-service model is a bit antithetical to doctors willing to put in the time and effort required to provide all-encompassing patient care. Time-driven, process-heavy measurements that emphasize quantity over quality impede a provider's ability to go the extra mile for their patients – for after-hours follow-up calls or contacting a patient to offer condolences for a lost loved one, for example – which tends to provide more value to a patient than keying in a documented conversation around BMI. 

It's the Little Things

Metrics in healthcare should be oriented toward rewarding providers for favorable health outcomes and positive patient satisfaction. It's the little things that make the most significant impact.

Healthcare has become too transactional in nature. But language matters. You are not a provider – you are a doctor. They are not a client – they are your patient. They are not encounters – they are visits.

Providers and office staff responding graciously to an unscheduled patient visit matters. Maintaining composure when faced with unexpected scheduling challenges, calling them "patients in need" over aloof "walk-ins," and providing dedicated care that makes a patient feel welcomed instead of a burden despite the unplanned visit can turn an unpleasant experience into a memorable one. Small, effortless measures can drive consistency of future preventive care, reducing emergency department overwhelm and ever-surging healthcare costs, ultimately raising the bar and reflecting true value-based care.

To learn more about metrics that matter, listen to the full episode of Faisel & Friends with Dr. Lars Peterson. Faisel and Friends is a primary care podcast that discusses the state of healthcare in America. Subscribe now to receive the latest episodes.