HOW HEALTHY ARE WE?
The call for new measures of population health may result in additional data demands on providers
For years, public health officials have said the U.S. spends more money on healthcare than other countries but lags far behind in global health rankings. But a report from the Institute of Medicine last week delivered even more disturbing news: as a nation, we don’t know how to solve this problem.
That’s because the U.S. doesn’t have a clear strategy or the right measurement tools to evaluate the social and environmental factors that make Americans healthy or sick, according to the report, For the Public’s Health: The Role of Measurement in Action and Accountability, which was sponsored by the Robert Wood Johnson Foundation.
To help the nation change course, the IOM report makes seven primary recommendations, some of which concern collaboration between medical-care organizations and governmental agencies to share information taken from clinical data. The idea is to collect and manage health data more completely and efficiently, and then make that data meaningful to improve the quality of life.
Separately, last week, a presidential committee recommended ways to standardize and protect electronic health information data (See story, p. 12).
Should HHS follow the IOM’s recommendations, this could mean hospitals and physicians might again have to bolster their datacollection efforts for the federal government.
“This is a public good and, therefore, I would not expect that it’s reliant on hospital contributions,” Nancy Foster, vice president of quality and patient safety at the American Hospital Association, said about the financial resources required to achieve the report’s objectives. “It should be resourced through public means.”
For hospitals, the fifth recommendation is likely to be the most important, Foster said. That recommendation calls for state and local public health agencies to collaborate with clinical-care delivery systems so the public has greater awareness of the appropriateness, quality, safety and efficiency of clinical-care services in their states and communities. It also suggests that performance reports on overuse, underuse and misuse—on things such as preventive and diagnostic tests, procedures and treatments—be made available for certain interventions.
“I think hospitals have to be a part of this, but they’re not the primary group,” Foster said of the report’s findings and suggestions. “Given state budgets and local county budgets, it’s a pretty daunting task unless they start with what they have,” Foster said, adding that existing data could be used as a fulcrum to leverage further activity.
The report is the first of three on public health from the IOM. An 18-member committee—which convened in October 2009—will release the second study, on law, in the first half of 2011. The third and final report, on financing, is expected in the second half of next year.
For this first study, which amounted to 170 pages, the committee was asked to review population-health strategies, related metrics and interventions within the context of a reformed healthcare system. It also was tasked with reviewing the role of score cards and other measures, and summarizing how they could be used to hold government and other stakeholders accountable. The report included a statistic published this fall in the journal Health Affairs that said the U.S. spends more than 17% of its gross domestic product on healthcare, but
Better tools would allow communities to encourage behaviors that improve the overall health of their residents, experts say.