Healthcare quality measurement

• US 8,538,773 B2
• Filed: 05/26/2010
• Issued: 09/17/2013
• Est. Priority Date: 05/27/2009
• Status: Expired due to Fees

• Current Assignee: Azara Intermediate LLC
• Original Assignee: Archimedes, Inc. (Thermo Fisher Scientific Incorporated)
• Inventors: Eddy, David M., Adler, Joshua, Morris, Macdonald Scott
• Primary Examiner(s): Gilligan, Luke
• Application Number:
  US12/788,242
• Publication Number:
  US 20100305964A1
• Time in Patent Office: 1,210 Days
• Field of Search: 705 2- 3, 600/300
• US Class Current: 705/2
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms

Abstract

A method of determining a quality of care provided by a healthcare provider to individuals in a population is provided. A data processing apparatus that has one or more processors is disclosed. Data representing biomarkers for individuals in a population is received. Baseline and present risks are determined. Risk reduction values are determined. Based on the current risk reduction, a quality score is determined. A scale is created, and the quality score is mapped to the scale. The global quality score of the disclosure provides numerous benefits over past performance measures.

Claims

1. A method for determining a quality of care provided by a healthcare provider to individuals in a population, comprising:

receiving data representing a plurality of biomarkers for at least a portion of the individuals in the population;

determining a baseline health outcome metric based on baseline treatment information associated with the population;

wherein the baseline health outcome metric represents an expected rate of an outcome of interest obtainable if no person in the population had received a treatment;

determining a current health outcome metric based on current treatment information associated with the population;

determining a current health outcome metric reduction value as a difference between the baseline health outcome metric and the current health outcome metric;

determining a quality score value based at least in part on the current health outcome metric reduction value;

assigning the baseline health outcome metric to a quality of care scale;

mapping the quality score value to the quality of care scale;

determining a target health outcome metric representing a desired value of the metric for the population, wherein the target health outcome metric could be zero;

determining a potential health outcome metric reduction value as a difference between the baseline health outcome metric and the target health outcome metric;

determining the quality score value based at least in part on the potential health outcome metric value;

assigning the target health outcome metric to the quality of care scale;

wherein the steps are performed by one or more processors.

2. The method of claim 1, wherein determining a quality score value comprises dividing the current health outcome metric reduction value by the potential health outcome metric reduction value.

3. The method of claim 1, wherein the baseline health outcome metric represents a baseline risk of the population incurring one or more healthcare outcomes, and the current health outcome metric represents a present risk of the population incurring the one or more healthcare outcomes.

4. The method of claim 3, further comprising:

determining the target health outcome metric representing a reduced risk for the population incurring the one or more healthcare outcomes;

determining the potential health outcome metric reduction value as a difference between the baseline health outcome metric and the target health outcome metric;

determining the quality score value based at least in part on the potential health outcome metric value;

assigning the target health outcome metric to the quality of care scale.

5. The method of claim 4, wherein determining the quality score value comprises dividing the current health outcome metric reduction value by the potential health outcome metric reduction value.

6. The method of claim 4, further comprising determining a cost associated with the baseline risk, the current risk, and the target risk, wherein cost determination comprises subtracting a savings value associated with prevention of the one or more healthcare outcomes from a treatment cost associated with a risk level.

7. The method of claim 1, wherein determining the baseline health outcome metric comprises determining an individual baseline health outcome metric for each of the individuals in the population, determining a sum of the individual baseline health outcome metrics of all the individuals, and determining the baseline health outcome metric per person year.

8. The method of claim 1, wherein the baseline health outcome metric is based, at least in part, on one or more of:

an assumption that the population is receiving or had received none of one or more treatments or medical interventions that address the healthcare outcomes;

a prior healthcare state of the population; and

deciding which changes in patient risk factors between two dates can be attributed to the efforts of the care provider or other entity whose efforts are being assigned a quality score.

9. The method of claim 1, further comprising mapping the quality of care scale to a performance scale that measures performance based on guidelines.

10. A non-transitory computer readable storage medium storing one or more sequences of instructions for determining a quality of care provided by a healthcare provider to individuals in a population, which instructions, when executed by one or more processors, cause the one or more processors to perform:

receiving data representing a plurality of biomarkers for at least a portion of the individuals in the population;

determining a baseline health outcome metric based on baseline treatment information associated with the population;

wherein the baseline health outcome metric represents an expected rate of an outcome of interest obtainable if no person in the population had received a treatment;

determining a current health outcome metric based on current treatment information associated with the population;

determining a current health outcome metric reduction value as a difference between the baseline health outcome metric and the current health outcome metric;

determining a quality score value based at least in part on the current health outcome metric reduction value;

assigning the baseline health outcome metric to a quality of care scale;

mapping the quality score value to the quality of care scale;

determining a target health outcome metric representing a desired value of the metric for the population, wherein the target health outcome metric could be zero;

determining a potential health outcome metric reduction value as a difference between the baseline health outcome metric and the target health outcome metric;

determining the quality score value based at least in part on the potential health outcome metric value;

assigning the target health outcome metric to the quality of care scale.

11. The non-transitory computer readable storage medium of claim 10, wherein the instructions that cause determining the quality score value further comprise instructions which, when executed, cause:

dividing the current health outcome metric reduction value by the potential health outcome metric reduction value.

12. The non-transitory computer readable storage medium of claim 10, wherein the baseline health outcome metric represents a baseline risk of the population incurring one or more healthcare outcomes, and the current health outcome metric represents a present risk of the population incurring the one or more healthcare outcomes.

13. The non-transitory computer readable storage medium of claim 12, wherein the instructions further include instructions for:

determining the target health outcome metric representing a reduced risk for the population incurring the one or more healthcare outcomes;

determining the potential health outcome metric reduction value as a difference between the baseline health outcome metric and the target health outcome metric;

determining the quality score value based at least in part on the potential health outcome metric value;

assigning the target health outcome metric to the quality of care scale.

14. The non-transitory computer readable storage medium of claim 13, wherein the instructions that cause determining the quality score value further comprise instructions which, when executed, cause dividing the current health outcome metric reduction value by the potential health outcome metric reduction value.

15. The non-transitory computer readable storage medium of claim 13, further comprising instructions which, when executed by the one or more processors, cause the one or more processors to determine a cost associated with the baseline risk, the current risk, and the target risk, wherein cost determination comprises subtracting a savings value associated with prevention of the one or more healthcare outcomes from a treatment cost associated with a risk level.

16. The non-transitory computer readable storage medium of claim 10, wherein the instructions that cause determining the baseline health outcome metric further comprise instructions which, when executed, cause:

determining an individual baseline health outcome metric for each of the individuals in the population, determining a sum of the individual baseline health outcome metrics of all the individuals, and determining the baseline health outcome metric per person year.

17. The non-transitory computer readable storage medium of claim 10, wherein the baseline health outcome metric is based at least in part on one or more of:

an assumption that the population is receiving none of one or more treatments or medical interventions that address the healthcare outcomes;

a prior healthcare state of the population; and

deciding which changes in patient risk factors between two dates can be attributed to the efforts of the care provider or other entity whose efforts are being assigned a quality score.

18. The non-transitory computer readable storage medium of claim 10, further comprising instructions which, when executed by the one or more processors, cause the one or more processors to map the quality of care scale to a performance scale that measures performance based on guidelines.

19. An apparatus comprising:

one or more processors;

data receiving logic configured to receive data representing a plurality of biomarkers for at least a portion of individuals in a population;

health outcome metric determination logic configured to determine a baseline health outcome metric based on baseline treatment information associated with the population and a current health outcome metric based on current treatment information associated with the population;

wherein the baseline health outcome metric represents an expected rate of an outcome of interest obtainable if no person in the population had received a treatment;

health outcome metric reduction logic configured to determine a current health outcome metric reduction value as a second difference between the baseline health outcome metric and the current health outcome metric;

quality determination logic configured to determine a quality score value based at least in part on the current health outcome reduction value;

scale compilation logic configured to assign the baseline risk to a quality of care scale and map the quality score value to the quality of care scale;

wherein the health outcome metric determination logic is further configured to determine;

a target health outcome metric representing a desired value of the metric for the population; and

a potential health outcome metric reduction value as a difference between the baseline health outcome metric and the target health outcome metric, wherein the target health outcome metric could be zero;

wherein the quality determination logic is further configured to determine the quality score value based at least in part on the potential health outcome metric value;

wherein the scale compilation logic is further configured to assign the target health outcome metric to the quality of care scale.

20. The apparatus of claim 19, wherein determining a quality score value comprises dividing the current health outcome metric reduction value by the potential health outcome metric reduction value.

21. The apparatus of claim 19, wherein the baseline health outcome metric represents a baseline risk of the population incurring one or more healthcare outcomes, and the current health outcome metric represents a present risk of the population incurring the one or more healthcare outcomes.

22. The apparatus of claim 21, wherein:

health outcome metric determination logic is further configured to determine;

the target health outcome metric representing a reduced risk for the population incurring the one or more healthcare outcomes; and

the potential health outcome metric reduction value as a difference between the baseline health outcome metric and the target health outcome metric;

quality determination logic is further configured to determine the quality score value based at least in part on the potential health outcome metric value;

scale compilation logic is further configured to assign the target health outcome metric to the quality of care scale.

23. The apparatus of claim 22, wherein determining the quality score value comprises dividing the current health outcome metric reduction value by the potential health outcome metric reduction value.

24. The apparatus of claim 22, wherein the scale compilation logic is further configured to determine a cost associated with the baseline risk, the current risk, and the target risk, wherein cost determination comprises subtracting a savings value associated with prevention of the one or more healthcare outcomes from a treatment cost associated with a risk level.

25. The apparatus of claim 19, wherein determining the baseline health outcome metric comprises determining an individual baseline health outcome metric for each of the individuals in the population, determining a sum of the individual baseline health outcome metrics of all the individuals, and determining the baseline health outcome metric per person year.

26. The apparatus of claim 19, wherein the baseline health outcome metric is based at least in part on one or more of:

an assumption that the population is receiving none of one or more treatments or medical interventions that address the healthcare outcomes;

a prior healthcare state of the population; and

deciding which changes in patient risk factors between two dates can be attributed to the efforts of the care provider or other entity whose efforts are being assigned a quality score.

27. The apparatus of claim 19, wherein the scale compilation logic is further configured to map the quality of care scale to a performance scale that measures performance based on guidelines.