Helen Burstin, MD, MPH, FACP Executive Vice President & CEO Council of Medical Specialty Societies. November 28, 2017 ECRI Annual Conference

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1 Helen Burstin, MD, MPH, FACP Executive Vice President & CEO Council of Medical Specialty Societies November 28, 2017 ECRI Annual Conference

2 I have no disclosures

3 American Academy of Allergy, Asthma & Immunology American Academy of Dermatology American Academy of Family Physicians American Academy of Hospice and Palliative Medicine American Academy of Neurology American Academy of Ophthalmology American Academy of Orthopedic Surgeons American Academy of Otolaryngology Head and Neck Surgery American Academy of Pediatrics American Academy of Physical Medicine and Rehabilitation American Association of Clinical Endocrinologists American College of Cardiology American College of Emergency Physicians American College of Medical Genetics American College of Obstetricians and Gynecologists American College of Occupational and Environmental Medicine American College of Physicians American College of Preventive Medicine American College of Radiology American College of Rheumatology American College of Surgeons American Epilepsy Society American Geriatrics Society American Medical Informatics Association American Psychiatric Association American Society of Anesthesiologists American Society of Clinical Oncology American Society for Clinical Pathology American Society of Colon and Rectal Surgeons American Society of Hematology American Society of Nephrology American Society of Plastic Surgeons American Society for Radiation Oncology American Society for Reproductive Medicine American Urological Association Congress of Neurological Surgeons North American Spine Society Society for Vascular Surgery Society of Critical Care Medicine Society of Gynecologic Oncology Society of Hospital Medicine Society of Interventional Radiology Society of Nuclear Medicine and Molecular Imaging Society of Thoracic Surgeons

4 1. CMSS convenes members around critical issues and serve as their common voice to more effectively accomplish mutual goals. 2. CMSS and its member specialty societies will facilitate a culture of performance improvement in medical practice. 3. CMSS and its member specialty societies will model professionalism as measured by: Altruism (putting the needs of patients first) Self-regulation Transparency (to peers, patients and the public)

5 Effectiveness of Quality Measurement and Monitoring

6 Importance to measure and report What is the level of evidence for the measures? Is there an opportunity for improvement? Scientific acceptability of the measurement properties What is the reliability and validity of the measure? Usability and Use Can audience use the performance results for both accountability and performance improvement? What are the benefits and risks associated with measurement? Feasibility Can the measure be implemented without undue burden, capture with electronic data/ehrs? Assess related and competing measures

7 Measure only when and where it is appropriate Prioritize measures that will drive improvement Build measurement into workflow and clinical practice (e.g., registries) Solicit feedback on burden, benefits, and risks of measurement Remove measures that do not add value

8

9 Need for Prioritization and Alignment Macrosystem State or federal reported measures Mesosystem Plan or health system measures Community measures Microsystem Clinician/Practice/Individu al measures Mary Applegate, MD

10 Prioritizing Measures Outcome-focused: Preference for outcome measures and measures with strong link to improved outcomes and costs Improvable and actionable: Preference for outcome measures and measures with strong link to improved outcomes and costs Meaningful to patients and caregivers: Preference for person-centered measures with meaningful and understandable results for patients and caregivers Support systemic and integrated view of care: Preference for measures that reflect care that spans settings, providers, and time to ensure that care is improving within and across systems of care

11 High medical risk (measured) Higher social risk (measured) Higher social risk (unmeasured) Worse outcomes for beneficiaries with social risk factors Higher medical risk (unmeasured) Quality of care Social support and environment

12

13 University of Rochester VOICE 13

14 Patient Reported Outcomes Clinical Outcomes Rx Prescribed

15 Why we measure? Improve healthcare quality 15

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