Time For Truth in Advertising in Quality Reporting

By  |  October 17, 2007 | 

Just a quick heads up re: an article that Peter Pronovost (the world’s best patient safety researcher, in my judgment), Marlene Miller (both of Johns Hopkins) and I have in today’s JAMA. In it, we argue that there is now suffficient skin in the quality game that the time has come for there to be a…

stronger environment to help protect patients, clinicians, and payers from misinformation regarding quality of care and to help ensure public trust in the health care profession.

We compare the Wild, Wild West of healthcare quality reports (have you ever seen a hospital report poor performance in an ad or on their website?) to financial and pharmaceutical industry reporting. In these industries, there are uniform standards for reporting, certification for those who report, methods for auditing performance data, and strong systems of accountability, all enforced by the SEC and FDA, respectively. None of this is present in today’s healthcare reporting environment.

This article may not make any of us the most popular kids on the street, but we believe that – absent these kinds of structures and standards – the promise of quality measurement and transparency won’t be realized, since the amount of gaming, selective reporting, and outright fibbing will make quality reports in-credible. Getting this right will be hard work, so we might as well get started now.

About the Author:

Robert M. Wachter, MD is Professor and Interim Chairman of the Department of Medicine at the University of California, San Francisco, where he holds the Lynne and Marc Benioff Endowed Chair in Hospital Medicine. He is also Chief of the Division of Hospital Medicine. He has published 250 articles and 6 books in the fields of quality, safety, and health policy. He coined the term hospitalist” in a 1996 New England Journal of Medicine article and is past-president of the Society of Hospital Medicine. He is generally considered the academic leader of the hospitalist movement, the fastest growing specialty in the history of modern medicine. He is also a national leader in the fields of patient safety and healthcare quality. He is editor of AHRQ WebM&M, a case-based patient safety journal on the Web, and AHRQ Patient Safety Network, the leading federal patient safety portal. Together, the sites receive nearly one million unique visits each year. He received one of the 2004 John M. Eisenberg Awards, the nation’s top honor in patient safety and quality. He has been selected as one of the 50 most influential physician-executives in the U.S. by Modern Healthcare magazine for the past eight years, the only academic physician to achieve this distinction; in 2015 he was #1 on the list. He is a former chair of the American Board of Internal Medicine, and has served on the healthcare advisory boards of several companies, including Google. His 2015 book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, was a New York Times science bestseller.


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One Comment

  1. WRS October 20, 2007 at 10:37 pm - Reply

    This is a great article. The quest for transparency and rush to publish individual outcomes is creating a “Tower of Babel” that could erode, not enhance trust. Our patients and our profession have much to gain from industry and/or national standards IF the information is meaningful.

    What characteristics should the measurements have to avoid confusion and chaos? I would suggest they would be: (1) Accurate (2) Comprehensive (3) Concise–avoid too much info (4) Efficient–not costly to extract (5) Evidence based (6) Relevant (7) Reliable–low variability between those performing the measure (8) Standardized (9) Timely (10) Understandable–if it reads like a prospectus and grandma can’t understand, then forget it (11) Valid

    Perhaps there are other characteristics that a meaningful analysis tool should have.
    Any measurement product should be rated against these ideals.

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