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Benchmarking with Patient Outcomes - Unmasked Surgeon Comparisons within a Learning Community for Continuous

Gregory Katz1,2, Cécile Rousseau3, Béatrice Cochener-Lamard4,5,6

  • 1Professor and Chair of Value-Based Health Care, Université Paris Cité School of Medicine, Paris, France.

NEJM Catalyst Innovations in Care Delivery
|July 8, 2026
PubMed
Summary

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Peer benchmarking using patient-reported outcome measures (PROMs) encourages cataract surgeons to modify indications, improving patient health gains and reducing unnecessary procedures. This approach fosters continuous improvement in surgical care.

Area of Science:

  • Ophthalmology
  • Health Services Research
  • Medical Quality Improvement

Background:

  • Patient-reported outcome measures (PROMs) are crucial for assessing healthcare quality and patient outcomes.
  • The application of PROMs for peer performance benchmarking among clinicians remains under-explored.
  • Benchmarking aims to foster a collaborative environment for continuous improvement in surgical practice.

Purpose of the Study:

  • To evaluate the impact of unmasked peer benchmarking on cataract surgeons' practice patterns and patient outcomes.
  • To assess whether benchmarking encourages modification of surgical indications and reduces unnecessary procedures.
  • To determine if benchmarking improves patient health gain and reduces the rate of suboptimal outcomes.

Main Methods:

  • A stepwise benchmarking approach was implemented for cataract surgeons, making individual performance data visible to peers.

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  • The study involved voluntary participation, patient involvement, and quarterly peer meetings to discuss results.
  • Data from over 2600 patients were analyzed, comparing pre-benchmarking and during-benchmarking periods.

    • Main Results:

    • Surgeons actively using the benchmarking dashboard were five times more likely to modify their surgical indications (42% vs 8%).
    • Among surgeons modifying indications, average patient post-surgery health gain increased by 22%, and procedures with minimal patient benefit decreased by 34%.
    • These improvements mirrored results seen when comparing with performance prior to benchmarking.

    Conclusions:

    • Unmasked peer benchmarking, utilizing PROMs and clinician-reported outcome measures (CROMs), can significantly enhance surgical care quality.
    • Benchmarking effectively motivates surgeons to refine indications, leading to better patient outcomes and reduced healthcare waste.
    • This model supports the advancement of value-based surgical care through collaborative, data-driven improvement cycles.