In its latest report, Vital Signs: Core Metrics for Health and Health Care Progress, the Institute of Medicine (IOM) Committee on Core Metrics for Better Health at Lower Cost proposes a set of core measures intended to promote understanding and improvement of health outcomes at the national, state, and local levels.
The report finds that – although a tremendous amount of effort has been put into the development of a number of health quality metrics – the resulting “imperfect, too numerous, and uncoordinated” measures in use today have led to burdensome data collection, unclear prioritization of measures with the most potential to improve health, and an inability to compare performance across systems, states, and individuals. Additionally, the report suggests that health improvement measurement should focus not only on the health care system, but also on socioeconomic determinants of health (e.g. housing, education, and environment).
In compiling the list of 15 core categories of metrics, the IOM committee hopes that greater standardization can improve efficiency and also have a more significant impact on health outcomes. The core measurement areas would include:
- Life expectancy and wellbeing
- Socioeconomic determinants of health (i.e. obesity, addictive behavior, unintended pregnancy, healthy communities)
- Health delivery measures (i.e. preventive services, care access, patient safety, evidence-based care, and care being matched with patient goals)
- Cost burdens (both personal and population spending)
- Engagement (of individuals as well as communities)
In its release of the report, the IOM encourages multi-stakeholder engagement across clinicians, payers, governments, employers, and public health leaders in order to develop more specific measures within these categories and implement them in a standardized way.
“The core measurements proposed in the report would harmonize the large number of existing metrics, reduce the redundancies, and decrease the excessive burden on providers and health systems. This opportunity to align and widely adopt these measures could help the nation progress toward better health at lower cost.”
– Victor Dzua, Institute of Medicine
The standardization of health metrics, the report suggests, will depend in part on the continued adoption of electronic health records and other emerging technologies that allow efficient, real-time access to data.