Measuring and monitoring health care

The era of assessment and accountability is upon us. The health care system is being asked to measure and monitor medical care in terms that are meaningful to patients and society. Hopefully, this effort will allow us to construct a medical care system that will achieve the safe, efficient, effective, and appropriate use of medical resources in the most cost-effective and humane manner possible. Pharmacists must become familiar with the technology and terminology of outcomes measurement. Quality of life and functional status will become an integral part of our everyday practice as we expand our definition of the therapeutic goal for drug therapy. Isolated physiologic goals such as DBP or cardiac output are neither broad enough nor meaningful in terms of what our patients expect from treatment. If we have not changed their lives through the relief of symptoms, prevention of complications, and increased longevity, is it a favorable outcome? This new era creates a new set of expectations for technology assessment and standards development that has implications for pharmacy. Eddy suggests that any medical policy statement, whether in a journal, national meeting, or pharmacy and therapeutics committee be accompanied by the following information: a list of the medical and economic outcomes considered in implementation of such a policy or standards, an estimate of what will happen to the above outcomes if the policy or standards are followed, and all supporting empiric evidence for such estimates.