- There must be a national strategy for data collection, measurement, and reporting that supports performance measurement and improvement efforts of public and private sector stakeholders at the national and community level.
- There must be an organizational infrastructure at the community level that assumes responsibility for improvement efforts, often requiring collaboration among healthcare stakeholders and between healthcare and other sectors; all communities will need resources to benchmark and compare performance, and mechanisms to identify, share, and evaluate progress.
- There must be ongoing payment and delivery system reform—emphasizing primary care—that rewards value over volume, promotes patient-centered outcomes, efficiency, and appropriate care, and seeks to improve quality while reducing or eliminating waste from the system.
As for establishing a common platform for measuring and reporting performance in healthcare, Shortliffe says that’s been a fundamental concern and question for years. “How do we combine data from multiple sources both to optimize individual patient care, and also to better understand the healthcare system to ensure we know what we’re doing,” he asks.
Among the recommendations was further support for the necessity of health information exchanges (HIEs) to break down barriers in healthcare when it comes to aggregating and reporting on patient data.
“Another part of this that isn’t as explicit is the whole issue of information technology and role can play in disparities of care, but also as a wedge that could produce increased disparities in care,” says Shortliffe. “If you look at these recommendations I think you’ll see recognition that the infrastructure has to be broadly available and disseminated if we really want to enhance quality for the nation.”
