Sustainable Approach to Justice, Equity, Diversity, and Inclusion Through Better Quality Measurement

Area of Science:

• Health Services Research
• Health Equity
• Health Informatics

Background:

• The US healthcare system widely uses performance and quality measures derived from electronic health records (EHRs), linked to payment incentives.
• These measures aim to improve health outcomes, increase life expectancy, and reduce healthcare costs.
• Current quality measures often reflect average performance and do not adequately adjust for population diversity and social determinants of health (SDOH).

Purpose of the Study:

• To analyze the current and future state of electronic clinical quality measures (eCQMs).
• To examine eCQMs through the lens of health equity.
• To highlight the need for improved granularity, complexity, and standardization in health status reporting tools.

Main Methods:

• Discussion and analysis of existing literature and industry practices regarding eCQMs.
• Examination of the limitations of current eCQMs in addressing population diversity and SDOH.
• Exploration of the impact of demographic variations on healthcare performance indicators.

Main Results:

• Existing eCQMs, while a foundational step, lack the necessary adjustments for demographic differences and SDOH.
• Current tools for capturing health status lack the granularity and standardization required for local-level health improvement.
• The impact of factors like race, ethnicity, and SDOH on healthcare performance is significant but inadequately addressed by current metrics.

Conclusions:

• There is a critical need to evolve eCQMs to incorporate SDOH and demographic factors for a more equitable healthcare system.
• Enhanced granularity, complexity, and standardization are essential for developing effective tools to address health disparities.
• Future eCQM development must prioritize equity to truly improve health outcomes across all populations.