Health care quality measures have raised concern among doctors – but technology could change that

As recently as a decade ago, many doctors didn’t think the quality of their care could be measured. “Any attempt to do so was ‘bean counting’ folly at best or destructive and dangerous at worst,” wrote internist and Harvard professor and health policy researcher Ashish Jha on his blog. Since then, however, we have seen a “sea change,” he noted.

Hundreds of quality measures have been developed, and patient engagement and patient satisfaction are now measured and factored into Meaningful Use requirements and value-based care reimbursements. Doctors are “grumblingly accepting that quality measurement is here to stay,” according to Dr. Jha. Yet uneasiness about measuring the quality of health care remains. Why?

What health care measures and why

Some aspects of health care can be measured more easily than others. For instance, the effective use of beta-blockers for heart disease or good management of diabetes care have been measured as part of the Physician Quality Reporting System (PQRS) since Centers for Medicare and Medicaid Services (CMS) established it in 2006 (with financial penalties for non-participation beginning in 2015).

Now, as a part of the industry push towards achieving the Triple Aim – improving patient care, improving the health of populations, and lowering health care costs – federal agencies have established patient engagement measures, all with the end goal of improving the patient experience, reports PatientEngagementHIT.com.

Measuring health IT use to meet MACRA and Meaningful Use requirements is not the only way to measure patient engagement – or quality of care.

The trouble is, the use of health IT and patient portals to meet regulatory requirements such as MACRA and Meaningful Use is not the only way to measure patient engagement – a term that health care professionals are still trying to define.

For more on this topic, see MACRA: What Is It, and Will It Help or Hurt Your Practice?

Can the number-one quality of a good doctor be measured?

We all know that evidence-based quality measures don’t give the whole picture of what makes a good doctor. Dr. Jha conducted an unofficial poll on Twitter: “In one word, what makes a good doctor?” he asked his 14,000+ followers. The number-one response? Empathy. These responses were followed by: being a good listener, being compassionate/kind, and being humble.

Patients say the top qualities for good doctors are empathy and being a good listener – ‘soft skills’ that are hard to measure.

Yet these “soft skills” like empathy and being a good listener are hard to measure. These skills are crucial, however, since they affect everything from referrals and reimbursements to the risk of being sued for malpractice.

We’ve talked before about how patient satisfaction surveys can help doctors improve. It’s not an exact science, but getting feedback from the patient’s perspective can be extremely valuable. How else will you know whether your patient education is building empathy or whether spending too much time on your EHR or mobile devices is hurting your relationship with patients?

For more on this, see Do You Know Your Patient Satisfaction Score? How Surveys Can Help

Measuring the quality of the doctor – or the system?

In his post, Dr. Jha makes the distinction between measuring the quality of the doctor and measuring the quality of the system in which the physician practices – and why we must keep these two sets of metrics separate and not confuse one for the other.

Current metrics such as the PQRS are fine for measuring good systems, he wrote. And we can focus on measuring doctor quality by “soft” skills like empathy through patient satisfaction surveys. “But we also have to focus on intellectual skills, such as ability to make difficult diagnoses and emotional intelligence, such as the ability to collaborate and effectively lead teams,” he added.

What makes a ‘good doctor’? An internist’s ability to listen may affect patient outcomes, but surgeons’ technical skills are arguably more critical.

Dr. Jha also points out that what makes a “good doctor” may vary by specialty. For instance, internal physicians’ ability to listen and be empathetic may affect their patients’ outcomes more than surgeons, for whom technical skills could be seen as more critical.

Why patient education may be the answer

When used effectively, technology may be the answer to “measuring the unmeasurable.” Video-based patient education programs, for instance, have been shown in studies not only to positively affect patient outcomes, but to improve patient satisfaction, as well.

The quality of your patient education may just be the answer to the increasing pressure doctors face in this new health care climate to improve quality of care while simultaneously lowering costs.


For a hands-on look at how our cutting-edge patient education software can help you and your patients, start your free trial of Rendia today!


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