Measuring patient health outcomes. What's in your database?

There are certain topics I want to stick a pin in for more in-depth discussions. I often begin with FAQs and either address them in a blog or more recently in short e-books for a fraction of my consulting fees. Hear me out on this one but there is a major drawback to consultancy--scalability. If this last year of frantic travel taught me anything it was I can't be in 3 places at one time. Two places? Easy. If you have a smart phone you can attend meetings while you attend meetings.

The image above reminds me of networks. Today was a warm but wet and overcast morning for a run. When I looked up through the trees I was reminded of how our connections inspire and challenge us to do a little better, deliver a better product, or tell a more compelling narrative. As a follow up to a year of meaningful engagement (hey 100,000+ of you can't be wrong) I wanted to put a pin in identifying and measuring outcomes. The theme of 2015 was "value". The new year will tug on the thread and hopefully introduce a way forward in value-based health care. Are you ready?

I wrote a brief introductory book on designing learning objectives but you can also find a few insights here and here.

I wrote in the book, "Big data has forced many a hand into the analytic sphere with limited guidance and direction. Quality metrics are often selected
based on ease of measurement at the expense of evidence or utility."

The data we collect can either inform or distort. Many clients don't realize that learning objectives aren't trivial. They focus your content and link directly to the quality of educational outcomes or if designed thoughtfully--actual patient outcomes.

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A pivotal discussion about Value-Based Health Care describes an important distinction and how we define outcomes. I work with teams that often substitute process and compliance measures for outcomes at the patient level. The figure below provides a framwork developed by Michael E. Porter for measuring health status, the patient experience, and long term health status.

The International Consortium for Health Outcomes Measurement (ICOHM) has developed a consistent global, core data-set across multiple disease states. Click the link for more information about how the standard set measures were developed.

​The graphic below is also from Value-Based Health Care. Briefly, a radar chart is presented to allow you to view performance of 3 different surgeons against multiple outcome measures in two different procedures. Radar charts (or spider charts as I recall them being called)--are an often maligned graphic display. If created correctly they can display multivariate data in two dimensions for identifying performance gaps--limited to 5 to 7 variables. A score of 100 is an optimal performance. For example there would be a higher rate of readmission rates for gastric bypass procedures for surgeon B--not so great.

I begin research on the ICHOM website when writing about unmet needs, creating learning objectives, or validating core outcomes measures. If you are working with EHR/EMR data the categories are helpful for identifying data fields of interest in a relational database and how you will ultimately query the data.

Thoughtful discussions about content development and outcomes analytics that apply the principles and frameworks of health policy and economics to persistent and perplexing health and health care problems...
 
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