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Report cards or instrument panels: who needs what?
E C Nelson1, P B Batalden, S K Plume
1Hitchcock Clinic, Lebanon, NH 03756-0001, USA.
Insights
Healthcare report cards provide comparative quality and cost data. Instrument panels offer a more actionable approach, improving data accuracy and utility for providers and patients.
Area of Science:
- Health Services Research
- Healthcare Management
Background:
- Healthcare report cards address consumer demand for quality and cost transparency.
- Providers express concerns regarding data validity and prudent use in report cards.
- Instrument panels are proposed as a more dynamic, decision-oriented alternative to static report cards.
Purpose of the Study:
- To introduce and describe the concept of instrument panels in healthcare.
- To present examples of instrument panel implementation in a large integrated health system.
Main Methods:
- Described three types of instrument panels developed within the Dartmouth-Hitchcock health care system.
- Highlighted the scale of operations for each described entity: a large group practice, a tertiary hospital, and a prepaid health plan.
Main Results:
- The Dartmouth-Hitchcock system implemented instrument panels across diverse healthcare settings.
- Examples included a 450-physician group practice, a large tertiary hospital, and a health plan with 120,000 members.
Conclusions:
- Integrating instrument panel data collection systems with report cards enhances accuracy.
- This integration reduces costs and increases the overall utility of data for providers and consumers.
- Instrument panels offer an efficient method for improving healthcare quality and cost information.
Background:
The report card movement in health care is a positive response to legitimate customer needs and requirements for comparative information on quality and costs. At the same time, providers have a legitimate concern about potential problems with gathering and using valid data in a prudent manner. Report cards have problems that often detract from their potentially constructive uses. In response to this concern, the authors propose that instrument panels--a newer concept in health care--compared to the static, judgmental image of report cards project an action-oriented, decision-making image.
Examples:
Descriptions are given of three types of instrument panels based on work in progress in the Dartmouth-Hitchcock health care system, a regional, integrated delivery system that serves the population of New Hampshire and parts of Vermont and Massachusetts: a 450-physician group practice (The Hitchcock Clinic), which provides more than one million visits per year in more than 25 locations; a tertiary health care facility (Mary Hitchcock Memorial Hospital) with more than 300,000 patient days; and prepaid health plan (Matthew Thornton Health Plan) with approximately 120,000 members.
Summary:
It would be wise and efficient for providers to design instrument panel data collection systems that can feed directly into report cards, leading to the triple benefit of enhancing accuracy, reducing total costs, and increasing overall utility to both providers and their customers.