As the healthcare system gets more complex, measuring quality of care becomes paramount

Advances in healthcare in the United States have led to a variety of positive patient outcomes, according to Dr. Charles Bennett in his article Imperative: Managing Rapidly Increasing Complexity. These positive outcomes include an increase in life expectancy and a decrease in infant and maternal mortality rates. However, in this increasingly complex climate, measuring the quality of healthcare has become imperative — and Medical Affairs departments are uniquely placed to assist with this process.

Healthcare Becomes Increasingly Complex

While opinions about the American healthcare system can vary widely, one thing that most experts agree on is that it is becoming increasingly more complex. The authors of Engineering a Learning Healthcare Systempublished by the National Academies Press, note that this increasing complexity stems from many things, including new technologies and the explosion of new biomedical knowledge.

In discussing this complexity, Dr. Bennett notes that these advances in knowledge and technology have resulted in “more to do, more to know, and more to manage” in healthcare than ever before. He also believes that this complexity has created a paradox: advances in medicine have improved the potential of the system to treat patients, but at the same time the sheer number of these advances has made it more difficult to take this new knowledge and translate it into actual patient care.

Why Measurement is Important

The authors of the National Academies report note that the extent to which Americans receive “timely, efficient, and appropriate care” depends entirely upon the efficiency and quality of the healthcare system. They also note that there is currently no systematic approach to collecting and analyzing medical data to measure quality. Furthermore, the healthcare system has not fully taken advantage of the immense amount of available clinical data, which could be used to improve patient outcomes and efficiency of care. The result: healthcare quality is extremely variable.

A Peterson-Kaiser article, Measuring the Quality of Healthcare in the United States, notes that measuring quality in healthcare delivery is critical since the consequences of poor care can have dire effects on individuals and the increased complexity of care often means that patients do not know if they have received quality care or not. Accurate, meaningful metrics can help patients to gauge this and can aid them in making informed decisions about their health. On a broader level, these metrics can also help fuel discussions and inform policy on the state and national levels.

How Medical Affairs can Help

So where does Medical Affairs fit in to this increasingly complex system? As mentioned in The Changing Face of Medical Affairs on eyeforpharma, the surge in Medical Affairs in recent decades has been driven by pressures for increased federal and state oversight, public demand, and the needs of payers and healthcare providers. The author of the article notes that as the “traditional single-customer pharmaceutical engagement model is replaced by a village of interconnected stakeholders, Medical Affairs is uniquely placed to engage with them.”

In the article, Keith Allen, former medical director at Novartis, comments that “the needs of the medical community have expanded enormously, together with the technical complexity associated with the interactions.” In light of these changing needs, Allan believes that Medical Affairs departments can act as “ambassadors and facilitators of information exchange” to help measure healthcare quality and interpret those results. This can increase communication and collaboration between the various healthcare stakeholders.

As healthcare becomes more complex, the need for metrics to measure and interpret the quality of this care increases for patients, healthcare providers, and policy makers at both the state and federal levels. Medical Affairs is uniquely placed to help with measurement and to facilitate communication between an increasingly complex ecosystem of stakeholders in the healthcare delivery system.

These three inputs are especially relevant in this age of Big Data, where clinical specialties — such as immunotherapy and metabolic insights — hinge on personalized medicine. Medical Affairs departments equipped with the latest data and deepest knowledge about these individualized patterns and patient populations will increasingly be the difference to physicians of any age.