Melissa M. Stiles, MD; Bruce Barrett, MD, PhD; John W. Beasley, MD
Metrics are pulling medicine into a large data vortex at the potential expense of patient care and physician satisfaction. Primary care clinicians are inundated with data from patient satisfaction scores, patient panel size reports, quality metrics, and electronic medical record (EMR) meaningful use metrics. The use of metrics, like other medical interventions, has potential costs and harms as well as benefits and should be based on good science and a careful analysis of outcomes.
As physicians, we have a professional and ethical obligation to apply the same rigor of evidence to implementing metrics as we do for diagnostic testing and therapeutic decision-making. In this essay, we ask the following questions: Do metrics lead to positive patient care outcomes? What is the cost of measuring and reporting metrics? What are the risks and unintended consequences of focusing on metrics? We cannot definitively answer these questions, but we do provide a rubric to guide such endeavors.
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