The danger of “quality reporting”

Evan Falchuk has written an absolutely brilliant piece about performance measurement – Stop the Phony Quality Measures

Right there in the middle of the top of the page is a big tab that says “Compare Care Quality.” If you click on it, you are taken to an “interactive web tool” that claims to show you “44 quality measures” about hospitals. The site says it will help you compare the quality of care hospitals provide.

I decided to look at hospitals in the area where I live, Boston, Massachusetts. It gives you a list of hospitals in your area, and gives you options to compare hospitals based on medical conditions and surgical procedures.

I decided to compare the Brigham and Women’s Hospital in Boston with the Hallmark Health System in Melrose. If you don’t know these two facilities, the Brigham is a Harvard teaching hospital, justifiably world-renowned in many areas of care. The Hallmark Health System is a network of community hospitals, which I suspect most people even in the Boston area aren’t familiar with.

I decided to run my search based on the idea that I was trying to help someone with breast cancer.

The first problem I ran into is this: they don’t have any data on breast cancer. Actually, they don’t have data for cancer at all. The only things they can tell you about are chest pain, heart attack, heart failure, chronic lung disease, pneumonia and diabetes in adults.

How about a search on surgical procedures? Nothing again. My only option is a “general” search.

So did he find useful performance measures?  Does he know any more than if the website did not exist?  Here is the problem:

Unless one can show that these "reports" correlate with patient outcomes, we are just showing numbers rather than providing information.  I submit that reporting incomplete information means that we are reporting wrong information.  I have problems with the ethics and externalities associated with these reports.