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The Impact of Public Reporting

Publicly-reported measures are increasingly used as indicators of healthcare quality and performance by government agencies, payers, and consumers. For physicians, navigating publicly-reported data can be confusing and time consuming, but can also be used to improve care and educate patients.

In this series, learn what public reporting means for you and your practice, who is measuring you and how, and what the future holds. Join the discussion as a panel of experts discusses the impact of public reporting in healthcare.

Kenneth Sands, MD MPH
Chief Quality Officer, Beth Israel Deaconess Medical Center, Associate Professor, Harvard Medical School
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Expert Practice Series Presentations
Kenneth Sands, MD, MPH
Chief Quality Officer, Beth Israel Deaconess Medical Center, Associate Professor, Harvard Medical School
(2,151)
269 Comments, last 11 days ago
Susan Abookire, MD, MPH
Chief of Quality and Patient Safety, Mount Auburn Hospital
(377)
57 Comments, last 11 days ago
Robert Klugman MD, FACP
Associate Professor of Medicine and Quantitative Health Sciences, University of Massachusetts Medical School
(652)
390 Comments, last 9 days ago
Richard S. Gitomer, MD, MBA, FACP
President and Chief Quality Officer, Emory Healthcare Network
(835)
377 Comments, last 10 days ago
Evan M. Benjamin, MD, FACP
Sr. Vice President and Chief Quality Officer, Baystate Health, Inc., Professor of Medicine, Tufts University School of Medicine
(2,124)
603 Comments, last 3 days ago
Latest Comments
"You defined quality as desired patient outcome measuring structure, process and outcome. You thoroughly reviewed the value framework defined by the patient through the these three tiers - health status, process of recovery, and sustainability.  Current measurement systems are lacking and need to assess accountable care.  Integration of what matters to patients comprehensively regarding outcome, experiences and costs of care are crucial points which must be evaluated.

The triple aim measures health outcomes, disease burden and risk status, however, health outcomes should account for the underprivileged residing in poverty stricken areas where there may be a lack of access to health care facilities and PCPs.  These individuals are usually lacking in education and may have an inadequate diet etc.  Therefore, when evaluating a PCP due to a poor health outcomes these variables should be taken into account.  If a PCP is graded against their peers considerations for where patients reside should be reflected in the report.  If pts in an affluent locale where pts are making six figures with post graduate degrees, these pts are more likely to adhere to the advice provided by their PCPs and have a better health status.     

In addition, utilizing questionnaires to ascertaining safety, effectiveness, timeliness, efficiency, equitability of the patient centered care process are helpful, but they may be biased regarding drug seeking patients who don’t get what they desire (DRUGS).  I know this all too well having worked as a RN in the ED for numerous years.  Now, as a FNP I see patients in a rural health clinic where non-compliance with scheduled OV, laboratory  F/U, prescription refills is prevalent.  Yes, pts may be assigned to a Primary Centered Medical Home, but why should the PCP be graded poorly on outcomes where pts don’t take some responsibility to comply with their care etc.

Excellent series, I thoroughly enjoyed all of the sections.  Thought provoking questions and interesting informative program.

Thanks,

Valerie"
Valerie Ting, APRN-BC
Nurse Practitioner, Comprehensive Health Center
603 Comments, last 3 days ago
"We all know that time is of the essence when presented with an AMI.  In rural Southern Illinois we have limited hospitals a few as 25 bed critical access beds without OB coverage.  Yes, we have trained experience medical personal from the Paramedics, Trauma Nurse Specialists and Board Certified Emergency Department Physicians and treat patients and transfer them to larger hospitals capable to meet their needed once the patients are stabilized.  We do well with door to drug for TPA, but without a cath lab we have to stabilized the patient until we can complete a transfer after MD acceptance of the pt. to an outlying facility.  Grading hospitals should take other variables ie social, economic and cultural should be take into consideration when compiling their data.

How can small rural hospitals caring for sicker poor under served population of patients be expected to compare to the larger metropolitan hospitals with with a variety socioeconomic patients and of  all of their specialists etc.?

If you are in working in a poor rural area with primarily Medicaid and Medicare patients with only a small critical access hospital without all of the high tech equipment or specialists available you are bound to receive lower scores.  We all know that the elderly and poor present were more co morbidities, limited education and may not have access to a proper diet, as well as, poor life style habits i.e. nicotine abuse, ETOH usage and even illicit drug usage, therefore skewed data. 

The drug seeking or revolving door patients with an agenda can also skew your reports simply because they didn’t get the right fix.  These patients know that patient satisfaction surveys inquire about their pain control at discharge.

What are the credentials of the individuals grading PCPs? 

I have used Metformin off label to assist with weight control in patients who weren't diabetic.  Then, I received a grade from Illinois Health Connect implying I wasn't completing mandatory quarterly HgB A1Cs on all my pts who were receiving Metformin.  Many times data is skewed due to misinformation or understand. 

Excellent information and great graphs.

    

Thanks,

Valerie"
Valerie Ting, APRN-BC
Nurse Practitioner, Comprehensive Health Center
390 Comments, last 9 days ago
 
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