https://immattersacp.org/weekly/archives/2021/05/11/5.htm

ACP recommends caution in the use of patient-reported outcome-based performance measures

Data are needed to demonstrate that patient-reported outcome-based performance measures improve quality of care and are an effective tool to accurately compare physician performance, a new paper said.


A new paper from ACP acknowledges the potential for patient-reported outcome-based performance measures to assess and improve patient-centered care but recommends they be used with caution.

Data are needed demonstrating that patient-reported outcome-based performance measures improve quality of care and are an effective tool to accurately compare physician performance and, as a result, can be used for accountability purposes, the paper said. In addition, patient-reported outcome-based performance measures should be based on the same rigor of evidence as any other performance measure.

Challenges in developing and applying measures include the following, the paper said:

  • There are many physician-, system-, and patient-related factors tied to the successful management of multiple chronic conditions, as is done in both ambulatory and hospital-based internal medicine;
  • Some patient-reported, outcome-based performance measures are highly dependent on patient factors (e.g., access to care, family and community support);
  • Studies have demonstrated limited correlation between some patient-reported outcome-based performance measures scores and individual physician performance, citing factors that are not under the influence of the individual physician.

Because of these challenges, patient-reported outcome-based performance measures should not be used to measure individual physician performance unless there is evidence to show an association between the patient-reported outcome measure and the care provided by the physician, the paper stated. Such measures should not be widely adopted into ambulatory and hospital-based internal medicine until they are rigorously developed and physicians can seamlessly integrate patient-reported data collection into practice. In their current state, the measures are not optimal for improving patient outcomes.

The paper, by the ACP Performance Measurement Committee, was published May 11 by Annals of Internal Medicine.