Analytics December 4, 2023

Setting Proper Outcome Metrics Balances Patient Care With Profits

by Barry P Chaiken, MD

The effort by physicians and pharmacists to unionize to take control of their workplace indicates that company profits take precedence over clinical outcomes and the patient experience. While analytics and its metrics are essential to ensure desired outcomes, incorrectly setting the target outcomes delivers undesirable results.

The general focus on profits alone at the expense of the patient hurts the critical balance between clinical care and costs. The question should always be: “What value am I obtaining from the resources expended?” If the answer to that question is positive, where the value is equal to or greater than the cost, then the expenditure is warranted. Using metrics tied to broad incentives that are not relevant for every patient – requiring a conversation about a chronic illness that is already under control – may increase revenue in the short run but will often lead to higher expenditures later as the clinician lacks the time needed to address the more critical patient problem.

Society’s investment in training physicians, nurses, and other clinical staff requires us to best utilize those individuals. Forcing them to reject their training and experience to follow strict protocols focused solely on generating profits rather than positive clinical outcomes wastes resources. There must be a balance between patient care and the provider organization’s financial health. The problem is not the use of analytics and related metrics.

Removing perverse incentives and properly setting outcomes metrics that balance patient and provider interests will achieve the goal of obtaining maximum value from our investment in healthcare.

Source: Why Doctors and Pharmacists Are in Revolt, NY Times, December 3, 2023

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