The sad corruption of the performance measurement movement

This rant reflects conversations with experts, but it does not qualify as good reporting.  I will take some liberties, and have not done careful checking of information.  Nonetheless I believe everything that I am typing. Too many decision makers in the performance measurement field ignore the evidence.  While the initial impetus for performance measurement came from the belief that with measurement we could improve adherence to evidence based treatments or testing.  If one truly believes in evidence based medicine, then the evidence should be indisputable and we should even have evidence that measuring performance actually helps patients. But too many who have influence in the decision making for performance measures do so without understanding evidence, the concept of unintended consequences, or even the clinical situations involved.  Too often groups lobby for their favorite goals, without really understanding what adopting a performance measure means. For the near future we are stuck with performance measures and payments influenced by our performance.  Hospitals already influence patient care so that their payments do not suffer. Those who do this are often practicing medicine without a license  While they likely do not really understand that concept, that is the case de facto. The famous 4-hour pneumonia rule, now rescinded, unfortunately still influences practice.  Too many patients get labeled as having community acquired pneumonia on the basis of incomplete d...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs