Q: You’ve been at the National Quality Forum since July, bringing deep experience in geriatric medicine to the work of creating and reviewing quality measures. What measures do you see on the horizon for long-term care?
A: The frontier for geriatrics is when people have multiple chronic conditions. Decisions about what medications to use and what tests to take are very personal, and often don’t fit in a standardized model. You can say, if a patient has diabetes, blood sugar should be at “this” level. But with a 90-year-old, maybe that isn’t the most important thing.
Q: Which are the most important measures?
A: In an aging population, probably the single most important measure is the functional outcome of the patient’s level of care. This is not as easily tracked as lab tests or vital signs, which are automatically entered in a medical record. We have to ask, what’s the most important info that goes into those records?
Q: What about providers feeling burdened by increasing quality measures?
A: I’m sympathetic. The board has asked me as an incoming president to reduce unnecessary measures, and align different entities around using the same kind of records.