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Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
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Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
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THE NATIONAL ACADEMIES PRESS      500 Fifth Street, NW      Washington, DC 20001

NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

This activity was supported by Contract/Grant No. 6485813 between the National Academy of Sciences and the Blue Shield of California Foundation. The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.

International Standard Book Number-13: 978-0-309-28522-3
International Standard Book Number-10: 0-309-28522-4

Additional copies of this workshop summary are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu.

Copyright 2013 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Suggested citation: IOM (Institute of Medicine). 2013. Core measurement needs for better care, better health, and lower costs: Counting what counts: Workshop summary. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
×

“Knowing is not enough; we must apply.
Willing is not enough; we must do.”

                                                 —Goethe

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Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
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THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.

www.national-academies.org

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
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PLANNING COMMITTEE ON CORE METRICS FOR BETTER CARE, BETTER HEALTH, AND LOWER COSTS1

CRAIG JONES (Chair), Director, Vermont Blueprint for Health

DAVID ATKINS, Director of the Quality Enhancement Research Initiative, Veterans Health Administration

MAUREEN BISOGNANO, President and Chief Executive Officer, Institute for Healthcare Improvement

MICHAEL E. CHERNEW, Professor of Health Care Policy, Harvard Medical School

DIANA S. DOOLEY, Secretary, California Health and Human Services

JULIE GERBERDING, President of Merck Vaccines, Merck and Co, Inc.

MARJORIE GINSBURG, Executive Director, Center for Healthcare Decisions

KATE GOODRICH, Senior Technical Advisor to the Director of the Office of Clinical Standards and Quality and Chief Medical Officer, Centers for Medicare & Medicaid Services

GEORGE J. ISHAM, Senior Advisor and Senior Fellow, HealthPartners, Inc.

PETER MARGOLIS, Professor of Pediatrics and Director of Research at the James M. Anderson Center for Health System Excellence, Cincinnati Children’s Hospital Medical Center

LEO S. MORALES, Associate Professor, Health Services and Medicine, University of California, Los Angeles

JUDY MURPHY, Deputy National Coordinator for Programs and Policy, Office of the National Coordinator for HIT

SAMUEL R. NUSSBAUM, Executive Vice President, Clinical Health Policy, and Chief Medical Officer, WellPoint, Inc.

PATRICK REMINGTON, Associate Dean for Public Health and Professor of Population Health Sciences, University of Wisconsin School of Medicine and Public Health

EDWARD J. SONDIK, Director, National Center for Health Statistics

DAVID M. STEVENS, Director of the Quality Center and Associate Medical Director, National Association of Community Health Centers

THOMAS B. VALUCK, Senior Vice President, Strategic Partnerships, National Quality Forum

__________________

1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
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ANNE F. WEISS, Senior Program Officer and Director of Quality/ Equality Health Care, Robert Wood Johnson Foundation

NANCY WILSON, Senior Advisor to the Director, Agency for Healthcare Research and Quality

IOM Staff

KATE BURNS, Program Assistant

CLAUDIA GROSSMANN, Senior Program Officer

DIEDTRA HENDERSON, Program Officer

ELIZABETH JOHNSTON, Program Assistant

ELIZABETH ROBINSON, Research Associate

VALERIE ROHRBACH, Senior Program Assistant

JULIA C. SANDERS, Senior Program Assistant

ROBERT SAUNDERS, Senior Program Officer

ISABELLE VON KOHORN, Program Officer (through August 2012)

BARRET ZIMMERMANN, Program Assistant

J. MICHAEL MCGINNIS, Senior Scholar, Executive Director, Roundtable on Value & Science-Driven Health Care

Consultant

JOE ALPER, Consulting Writer

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
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ROUNDTABLE ON VALUE & SCIENCE-DRIVEN HEALTH CARE1

MARK B. McCLELLAN (Chair), Director, Engelberg Center, The Brookings Institution

DAVID BLUMENTHAL, President, Commonwealth Fund

BRUCE G. BODAKEN, Chairman, President, and Chief Executive Officer, Blue Shield of California

PAUL CHEW, Chief Science Officer and Chief Medical Officer, Sanofi U.S.

CAROLYN M. CLANCY, Director, Agency for Healthcare Research and Quality (ex officio)

FRANCIS COLLINS, Director, National Institutes of Health (ex officio) (designee: Susan Shurin)

HELEN DARLING, President, National Business Group on Health

SUSAN D. DEVORE, Chief Executive Officer, Premier, Inc.

JUDITH FAULKNER, Founder and Chief Executive Officer, Epic Health Systems

THOMAS R. FRIEDEN, Director, Centers for Disease Control and Prevention (ex officio) (designee: Gail Janes)

PATRICIA A. GABOW, Former Chief Executive Officer, Denver Health

ATUL GAWANDE, General and Endocrine Surgeon, Brigham and Women’s Hospital

GARY L. GOTTLIEB, President and Chief Executive Officer, Partners HealthCare System

JAMES A. GUEST, President and Chief Executive Officer, Consumers Union

GEORGE C. HALVORSON, Chairman and Chief Executive Officer, Kaiser Permanente

MARGARET A. HAMBURG, Commissioner, Food and Drug Administration (ex officio) (designee: Peter Lurie)

JAMES HEYWOOD, Co-Founder and Chairman, PatientsLikeMe

RALPH I. HORWITZ, Senior Vice President, Clinical Evaluation Sciences, GlaxoSmithKline

PAUL HUDSON, EVP North America, AstraZeneca

BRENT C. JAMES, Chief Quality Officer and Executive Director, Institute for Health Care Delivery Research, Intermountain Healthcare

MICHAEL M. E. JOHNS, Executive Vice President for Health Affairs, Emeritus, Emory University

CRAIG JONES, Director, Vermont Blueprint for Health

__________________

1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.

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Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
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GARY KAPLAN, Chairman and Chief Executive Officer, Virginia Mason Health System

RICHARD C. LARSON, Mitsui Professor, Massachusetts Institute of Technology

JAMES L. MADARA, Chief Executive Officer, American Medical Association

FARZAD MOSTASHARI, National Coordinator, Office of the National Coordinator for Health IT (ex officio)

MARY D. NAYLOR, Professor and Director, NewCourtland Center for Transitions and Health, University of Pennsylvania

WILLIAM D. NOVELLI, Former Chief Executive Officer, AARP; Professor, Georgetown University

SAM NUSSBAUM, Executive Vice President, Clinical Health Policy, and Chief Medical Officer, WellPoint, Inc.

JONATHAN B. PERLIN, Chief Medical Officer and President, Clinical and Physician Services, HCA, Inc.

ROBERT A. PETZEL, Under Secretary for Health, Department of Veterans Affairs (ex officio)

RICHARD PLATT, Professor and Chair, Population Medicine, Harvard Medical School

JOHN W. ROWE, Professor, Mailman School of Public Health, Columbia University

JOE SELBY, Executive Director, PCORI

MARK D. SMITH, President and Chief Executive Officer, California HealthCare Foundation

GLENN D. STEELE, President and Chief Executive Officer, Geisinger Health System

MARILYN TAVENNER, Administrator, Centers for Medicare & Medicaid Services (ex officio) (designee: Patrick Conway)

REED D. TUCKSON, Executive Vice President and Chief of Medical Affairs, UnitedHealth Group

MARY WAKEFIELD, Administrator, Health Resources and Services Administration (ex officio)

DEBRA B. WHITMAN, Executive Vice President, Policy and International, AARP

JONATHAN WOODSON, Assistant Secretary for Health, Department of Defense (ex officio)

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
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Institute of Medicine
Roundtable on Value & Science-Driven Health Care
Charter and Vision Statement

The Institute of Medicine’s (IOM’s) Roundtable on Value & Science-Driven Health Care has been convened to help transform the way evidence on clinical effectiveness is generated and used to improve health and health care. Participants have set a goal that, by the year 2020, 90 percent of clinical decisions will be supported by accurate, timely, and up-to-date clinical information, and will reflect the best available evidence. Roundtable members will work with their colleagues to identify the issues not being adequately addressed, the nature of the barriers and possible solutions, and the priorities for action, and will marshal the resources of the sectors represented on the Roundtable to work for sustained public– private cooperation for change.

******************************************

Vision: Our vision is for the development of a continuously learning health system in which science, informatics, incentives, and culture are aligned for continuous improvement and innovation—with best practices seamlessly embedded in the care process and new knowledge captured as an integral by-product of the care experience.

Goal: By the year 2020, 90 percent of clinical decisions will be supported by accurate, timely, and up-to-date clinical information, and will reflect the best available evidence. We feel that this presents a tangible focus for progress toward our vision, that Americans ought to expect at least this level of performance, that it should be feasible with existing resources and emerging tools, and that measures can be developed to track and stimulate progress.

Context: As unprecedented developments in the diagnosis, treatment, and long-term management of disease bring Americans closer than ever to the promise of personalized health care, we are faced with similarly unprecedented challenges to identify and deliver the care most appropriate for individual needs and conditions. Care that is important is often not delivered. Care that is delivered is often not important. In part, this is due to our failure to apply the evidence we have about the medical care that is most effective—a failure related to shortfalls in provider knowledge and accountability, inadequate care coordination and support, lack of insurance, poorly aligned payment incentives, and misplaced patient expectations. Increasingly, it is also a result of our limited capacity for timely generation of evidence on the relative effectiveness, efficiency, and safety of available and emerging interventions. Improving the value of the return on our health care investment is a vital imperative that will require much

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
×

greater capacity to evaluate high priority clinical interventions, stronger links between clinical research and practice, and reorientation of the incentives to apply new insights. We must quicken our efforts to position evidence development and application as natural outgrowths of clinical care—to foster health care that learns.

Approach: The IOM Roundtable on Value & Science-Driven Health Care serves as a forum to facilitate the collaborative assessment and action around issues central to achieving the vision and goal stated. The challenges are myriad and include issues that must be addressed to improve evidence development, evidence application, and the capacity to advance progress on both dimensions. To address these challenges, as leaders in their fields, Roundtable members work with their colleagues to identify the issues not being adequately addressed, the nature of the barriers and possible solutions, and the priorities for action, and marshal the resources of the sectors represented on the Roundtable to work for sustained public-private cooperation for change. Activities include collaborative exploration of new and expedited approaches to assessing the effectiveness of diagnostic and treatment interventions, better use of the patient care experience to generate evidence on effectiveness and efficiency of care, identification of assessment priorities, and communication strategies to enhance provider and patient understanding and support for interventions proven to work best and deliver value in health care.

Core concepts and principles: For the purpose of the Roundtable activities, we define science-driven health care broadly to mean that, to the greatest extent possible, the decisions that shape the health and health care of Americans—by patients, providers, payers and policymakers alike—will be grounded on a reliable evidence base, will account appropriately for individual variation in patient needs, and will support the generation of new insights on clinical effectiveness. Evidence is generally considered to be information from clinical experience that has met some established test of validity, and the appropriate standard is determined according to the requirements of the intervention and clinical circumstance. Processes that involve the development and use of evidence should be accessible and transparent to all stakeholders.

A common commitment to certain principles and priorities guides the activities of the Roundtable and its members, including the commitment to: the right health care for each person; putting the best evidence into practice; establishing the effectiveness, efficiency and safety of medical care delivered; building constant measurement into our health care investments; the establishment of health care data as a public good; shared responsibility distributed equitably across stakeholders, both public and private; collaborative stakeholder involvement in priority setting; transparency in the execution of activities and reporting of results; and subjugation of individual political or stakeholder perspectives in favor of the common good.

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
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Reviewers

This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:

John Auerbach, Northeastern University

Maureen Bisognano, Institute for Healthcare Improvement

Kevin Larsen, Office of the National Coordinator for Health Information Technology

Sam Nussbaum, WellPoint, Inc.

David Stevens, National Association of Community Health Centers

Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by Gerry Shea, National Quality Forum. Appointed by the Insti-

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
×

tute of Medicine, he was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteurs and the institution.

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Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
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Preface

Achieving progress in each aspect of health and health care requires strong measurement capabilities to guide improvement efforts, support decisions on what works best, and promote the development of a learning health system. To understand the challenges and opportunities associated with developing these measurement capabilities, the Institute of Medicine convened a workshop, with the support of the Blue Shield of California Foundation, on core metrics for measuring progress toward the health system’s three-part aim of better care, better health, and lower costs. Individuals with a wide range of perspectives—including clinicians; patients and consumers; economists; researchers; leaders from health care organizations, payers, and industry; and experts from the fields of public health, health information technology, and others—met to consider the core measurement needs for assessing progress, understanding lessons learned from existing data and measurement systems, and assessing the opportunities and challenges for widespread implementation. This publication summarizes the meeting’s discussions on the issues, options, and successful strategies for advancing measurement and enhancing collaborative efforts around measurement of the three-part aim.

The Roundtable’s vision is of a health system that continuously learns and improves, generates new knowledge through each interaction with patients and people, and seamlessly applies new knowledge to improve health and health care. Since its inception in 2006, the Roundtable has advanced this vision by involving stakeholders, including senior leaders, across the

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
×

health and health care system. In engaging these stakeholders in workshops and collaborative activities, Roundtable members and participants have provided guidance on the issues most important to advancing knowledge and promoting continuous improvement of the nation’s health system.

Building on this groundwork, the objectives of the workshop were to discuss the vision for the nature, use, and impact of core health metrics; to identify the important principles, targets, infrastructure, processes, strategies, and policies; and to describe lessons from efforts at national, state, community, and organization levels. Through intensive discussions among breakout groups and among all workshop attendees, the workshop sought to explore the core measurement needs and requirements; to describe a range of priority metric categories; to consider specific metric options that will most reliably measure care outcomes, care costs, and health improvement; and to identify opportunities to accelerate the development of the digital infrastructure, including data capture, interoperability, and consistent measurement across systems. Finally, the sessions highlighted those implementation challenges and potentially successful strategies at the national, state, community, and organizational levels that are important to engage if the nation is to successfully target and track the efforts most important to the efficiency and effectiveness of health and health care.

Multiple individuals contributed valuable time toward the development of the workshop and this publication. We are especially indebted to those who provided their counsel by serving on the workshop planning committee. We would like to acknowledge and offer strong appreciation for the speakers and workshop participants whose rich discussions are summarized in this publication. In addition, a number of Roundtable staff played instrumental roles in coordinating the workshop and translating the workshop proceedings into this summary, including Rob Saunders, Julia Sanders, Valerie Rohrbach, Barret Zimmermann, and Claudia Grossmann. We would like to acknowledge the efforts of Isabelle Von Kohorn, who spearheaded the early stages of this work. We would like to recognize Joe Alper for his assistance in drafting this publication. Finally, we want to thank Daniel Bethea, Marton Cavani, Laura Harbold DeStefano, and Chelsea Frakes for helping to coordinate various aspects of review, production, and publication.

Reliable assessment represents a foundational component of a continuously learning health system. The discussions summarized in this workshop explore the potential and challenges for expanding the measurement infrastructure and outline potential strategies and actions to catalyze progress. We believe Core Measurement Needs for Better Care, Better Health, and

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
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Lower Costs: Counting What Counts will be a valuable resource in efforts to build the needed measurement capabilities for improving health and health care for the nation and that it sets the stage for the deeper focused assessment that can lead to consensus core metrics to guide progress going forward.

Craig Jones, Chair
Planning Committee on Core Metrics for Better Care,
Better Health, and Lower Costs
Director, Vermont Blueprint for Health

J. Michael McGinnis
Senior Scholar
Executive Director, Roundtable on
Value & Science-Driven Health Care
Institute of Medicine

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
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Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
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Acronyms and Abbreviations

ACA

Affordable Care Act

ACO

accountable care organizations

AF4Q

Aligning Forces for Quality

AHA

American Hospital Association

AHRQ

Agency for Healthcare Research and Quality

AMA

American Medical Association

 

CAHPS

Consumer Assessment of Healthcare Providers and Systems

CCO

coordinated care organization

CDC

Centers for Disease Control and Prevention

CMS

Centers for Medicare & Medicaid Services

 

DALY

disability-adjusted life year

 

EHR

electronic health record

 

HALY

health-adjusted life year

HEDIS

Healthcare Effectiveness Data and Information Set

HHS

U.S. Department of Health and Human Services

HIPAA

Health Insurance Portability and Accountability Act

HRSA

Health Resources and Services Administration

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
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IHI

Institute for Healthcare Improvement

IOM

Institute of Medicine

IT

information technology

 

NCQA

National Committee for Quality Assurance

NIH

National Institutes of Health

NQF

National Quality Forum

 

OECD

Organisation for Economic Co-operation and Development

ONC

Office of the National Coordinator for Health Information Technology

OSHA

Occupational Safety and Health Organization

 

QALY

quality-adjusted life year

QASC

Quality Alliance Steering Committee

 

WCHQ

Wisconsin Collaborative for Healthcare

Suggested Citation:"Front Matter." Institute of Medicine. 2013. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18333.
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Health care quality and its affordability have become very pressing issues in the United States. All sectors of the country are attempting to push forward initiatives that will improve the health care system as well as the health of the American population in general. Despite the economical dedication to health care, about 1/5, the system remains uneven and fragmented, patient harm is quite common, care is often uncoordinated, and many more mishaps occur. There exists many obstacles to improve the nation's health care system; these include the capacity to reliably and consistently measure progress. In 2006 the Institute of Medicine (IOM) established the Roundtable on Value & Science-Driven Health Care which has since accelerated the development of a learning health system- one in which science, informatics, incentives, and culture are aligned to create a continuous learning loop. This learning loop would thus help make the health care system better.

In response, the IOM organized a 2-day workshop to explore in depth the core measurement needs for population health, health care quality, and health care costs. The workshop hoped to gain a full understanding of how to improve the nation's measurement capacity to track progress in the health care system. Having this knowledge would help the nation get one step closer to the creation of an efficient learning loop.

The workshop was divided into a series of sessions that focused on different aspects of measurement. Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary includes explanations and key details for these sessions: Vision, Current Measurement Capabilities, Specifying the Shape of a Core Metric Set, and Implementation. The report also features common themes within these areas, the workshop agenda, and information about those involved.

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