Tag Archives: quality improvement

Change Focus from Cost to Value via Patient Outcomes!


I’m a TED fan, if you are not aware of TED.com you need to be! To whet your appetite invest under 13 minutes to watch this lecture, here.  Stefan Larsson, (not to be confused with Stieg although, some parallels may exist with the Millennium Series!), describes the reasoning behind the ICHOM initiative, (ichom.org), who according to it’s site:
“The International Consortium for Health Outcomes Measurement (ICHOM) is a non-profit organization founded by three esteemed institutions with the purpose to transform health care systems worldwide by measuring and reporting patient outcomes in a standardized way.”

Here is the simple concept:

The problem is that we have been measuring the cost and using that as the metric how do you gain a measurement of the ‘outcomes’? That is the role of ICHOM, to measure the outcomes and create the benchmarks as well as find best practices. (If you didn’t watch the lecture he gives examples in hip replacement and prostate surgery.)

The key message is that wherever there has been a focus on improving patient outcomes the costs have dramatically dropped, not too much of a surprise there! I’m guessing that your immediate reaction is, ‘That is all good but who is going to do all this data collection work?’ Interesting is their answer is to use the data that should already exist in patient records as well as involve the patient themselves, reuse and distribution of workloads.

I only have one question, if we have been benchmarking in enterprises for decades, how come this is a new concept in healthcare?  There are numerous benchmarking organisations in various sectors who study a multitude of issues and collect data and publish the benchmarks for these aspect.

I think the answer is simple, in healthcare it’s not that easy!  In commercial organisations there are a relatively small set of quantitative ‘variables’, and in the most they revolve around PROFIT! This may include derivative measurements of cost/efficiency/productivity. However in healthcare the inputs are both numerous and not always quantitative, but today that is no longer a barrier.

Love it or hate it, the ‘Big Data’ revolution taking place has produced technologies and methodologies to compute with ‘subjective’ data! Now measuring patient outcomes and the factors that affect it can be mechanised and thus reasoned over to improve the ‘value’ within our healthcare system.

Now while Australia is participating in ICHOM’s work and I wonder how much impact their results will have on our system as a whole?