On this episode, we talk with John D’Amore. John is Founder, President and Chief Strategy Officer at Diameter Health and has been working on Quality Measures in healthcare since the early 2000s. Yup, pre-EMR quality measures!

John takes us on a fascinating journey from paper based quality measurement (see RHQDAPU… at least we’ve streamlined our acronyms!) to the dawn of electronic measurement. via the Electronic Medical Record (EMR).  He explains why the single-EMR approach made sense in the hospital, but how the industry was hurt when it decided to apply that approach in the ambulatory setting.  Finally, John describes the future state where quality measures are calculated from a longitudinal patient record that encompasses all the care a patient has received. This, of course, calls for a trusted central authority to do the aggregation, data remediation and reporting. Perhaps, an HIE?

It’s a complex story and John delivers it well. We dig through all that and so much more, including:

• What are Quality Measures and why do we need them? (1:23)
• John D’Amore’s background and the founding of Diameter Health (5:30)
• What has been the historic approach to quality measurement in healthcare? (8:00)
• Should we limit quality measures in the short-term to only those that can be understood by patients? (13:00)
• How do we pick the measures? What do we care about? (17:30)
• What might a quality program look-like in a “digital-native” world? (21:10)
• How can we move from a retrospective, tell me what happened world, to one where clinicians and administrators get the data when there’s still time to impact outcomes? (25:48)
• We talk about the difference between clinical and claims data, and explore why the clinical data is not flowing. (30:30)
• John gives an example of an HIE that’s achieved great success in Quality Reporting (Indian Health Information Exchange) and we explore why they’ve been successful (33:00)
• Will providers start to realize that a robust HIE can help them improve quality scores and potentially increase revenue? (36:15)
• Why is Data Quality such a linchpin issue when it comes to quality measures? (38:15)
• How does data fidelity, or fitness for purpose, differ when looking at a single chart vs. longitudinal data sources form many systems? (42:50)
• John and Shahid are both speaking at the Digital Quality Summit. We discuss their talks and goals for the event. (45:45)

We’ll be continuing the Quality Measurement series over the next month or two. I hope you enjoy the setup episode as much as I did!

~ Don Lee