Availability/applicability of performance benchmarks

The use of industry benchmarks to monitor performance is uncommon; likewise, few governing guidelines for clinical quality reporting provide them. Some organizations publish national and/or regional statistics, but there are issues in using this data. For instance, the data may not be endorsed by any quality initiative organization or does not account for contextual/regional variations (health of population being served, resource availability, environmental and seasonal variations, etc.).

The lack of industry benchmarks makes it difficult for healthcare organizations to set and track realistic goals and get a better sense of their performance. This issue is becoming more acute in the context of newer payment models such as value-based payments and shared savings programs.

Tracking care of measure exclusions/exceptions

Most quality measures are based on clinical evidence at a population level. However, during the computation of these measures, data may be excluded for many patients due to medical reasons or other significant deviations (exclusions/exceptions). Where exclusions/exceptions are provided, alternate best practice guidelines for excluded populations are not always available or tracked. If a patient is excluded from an influenza immunization measure due to contraindication, for example, it is important to follow best practices for this population as well.

In summary, the more clinical quality measures shape healthcare delivery and performance, the more pressing the need for governing agencies and healthcare organizations to address these systemic challenges and pave the way to standardization. But for now and the foreseeable future, the road remains a bumpy one.