Our expert answers 3 Questions
My research focuses on ways to assess and improve quality of care provided to patients, especially those with chronic conditions. The research brings together experts in measurement and statistics, decision science, information technology, and implementation science, as well as clinical experts and system leaders to design performance measurement and quality improvement tools. These tools are used to assist clinicians in delivering high-quality care by maximizing the delivery of high-value testing, screening and treatments and minimizing provision of low value or harmful care. Our challenge is not only to develop and test the efficacy of such tools but also to implement them in ways that integrate with clinical workflow and improve the patient experience.
We've found that performance measurement is one of the most powerful ways to motivate practice change. Yet, when the measures aren't structured correctly, unintended consequences -- overtreatment and polypharmacy, discounting patient preferences, and frustrating providers -- can result. Our research focuses on developing and testing measures that are clinically meaningful and patient-centered. These measures incorporate individualized data from an electronic health record and patient report that can estimate risk and benefit of treatment, and integrate patient goals and preferences. It's especially exciting to conduct this research in the VA Healthcare System, the largest integrated system in the nation, because of its advanced information systems and data capabilities, ability to test tools across the nation, and commitment to continually enhance quality of care for veterans.
By restructuring performance measurement to focus on patient-centered performance management, we can take advantage of advances in information technology, comparative effectiveness research, and decision science to change the way we deliver care. I believe this is critical to redesigning health care to be not only patient-centered care but also efficient and of high value. Given the mounting evidence that American healthcare does not always deliver the highest quality, despite highest costs, this research should play an important role in health care transformation.