Health-Care Metrics in Oncology

© 2015 Harborside Press® In 1986, the Institute of Medicine (IOM) set out to define health care in terms of quality. Its goal was to establish standards for desired health outcomes that were consistent with current professional knowledge (Donaldson & Lohr, 1990). It has become apparent, however, that variability in the quality of cancer care exists across the United States (Desch, 2008; Hewitt & Simone, 1999; Neuss, 2013). In the 1999 report of the National Cancer Policy Board (NCPB) entitled “Ensuring Quality Cancer Care,” it was concluded that “for many Americans with cancer, there is a wide gulf between what could be construed as the ideal and the reality of their experience with cancer care” (p. 215). Inconsistencies in cancer care were identified, including the lack of patient-focused care, the lack of evidence-based care, and the lack of care coordination (Hewitt & Simone, 1999). Their recommendations included the creation of quality metrics and a national reporting system (Hewitt & Simone, 1999). Current challenges in health care such as access, cost, quality, and safety have ignited a renewed emphasis on defining and improving health care. The follow-up report by the IOM in 2013, entitled “Delivering High-Quality Cancer Care,” identified six specific components to achieving high-quality cancer care. A key component was quality measurement and performance improvement (Levit, Balogh, Nass, & Gantz, 2013). Common pathways to achieve both of these goals are to measure tangible actions, interventions, and processes, collectively known as metrics.