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Expected and Unanticipated Consequences of the Quality and Information Technology Revolutions

Expected and Unanticipated Consequences of the Quality and Information Technology Revolutions COMMENTARY Expected and Unanticipated Consequences of the Quality and Information Technology Revolutions Against this background, this article aims to help indi- Robert M. Wachter, MD viduals and institutions to understand and better antici- pate some of the potential outcomes, both expected and po- EARLY 2 DECADES AFTER THE PREDICTION THAT AN tentially unforeseen, of the quality and information age of “assessment and accountability” would technology revolutions. soon transform health care, the quality move- Unforeseen Consequences Nment has finally arrived. Driven by evidence that of Quality Measurement US medical practice comports with best evidence approxi- mately half the time, that large numbers of medical errors The simple act of defining excellence, measuring it, and dis- continue to occur, and that clinically indefensible dispari- seminating the results skews the system. Although diverse ties in care exist across regions and racial and ethnic measures sometimes catalyze improvements in unmea- groups, health care payers and the US government have sured areas through fundamental system redesign, this is decided that quality should be measured, publicly reported, an unusual outcome. More typically, individuals and insti- and perhaps even compensated differentially. The latter tutions begin to focus on improving their performance on trend, known as pay-for-performance, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Expected and Unanticipated Consequences of the Quality and Information Technology Revolutions

Wachter, Robert M.
JAMA , Volume 295 (23) – Jun 21, 2006
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References (30)

Publisher
American Medical Association
Copyright
Copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.295.23.2780
pmid
16788133
Publisher site
See Article on Publisher Site

Abstract

COMMENTARY Expected and Unanticipated Consequences of the Quality and Information Technology Revolutions Against this background, this article aims to help indi- Robert M. Wachter, MD viduals and institutions to understand and better antici- pate some of the potential outcomes, both expected and po- EARLY 2 DECADES AFTER THE PREDICTION THAT AN tentially unforeseen, of the quality and information age of “assessment and accountability” would technology revolutions. soon transform health care, the quality move- Unforeseen Consequences Nment has finally arrived. Driven by evidence that of Quality Measurement US medical practice comports with best evidence approxi- mately half the time, that large numbers of medical errors The simple act of defining excellence, measuring it, and dis- continue to occur, and that clinically indefensible dispari- seminating the results skews the system. Although diverse ties in care exist across regions and racial and ethnic measures sometimes catalyze improvements in unmea- groups, health care payers and the US government have sured areas through fundamental system redesign, this is decided that quality should be measured, publicly reported, an unusual outcome. More typically, individuals and insti- and perhaps even compensated differentially. The latter tutions begin to focus on improving their performance on trend, known as pay-for-performance,

Journal

JAMA – American Medical Association

Published: Jun 21, 2006

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