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Unformatted text preview: pply broadly to all process
measures compared with outcomes (Table 1).
On the plus side, process measures can be used to provide
feedback for quality improvement initiatives. Because many
factors can inﬂuence patient outcomes, process measures
have the potential to identify for clinicians exactly which
processes they followed or didn’t follow that had the potential
to affect patient outcomes. Process measures provide information that is actionable; i.e. what is being done well
and what needs improvement. When process measures are
developed well, so that they accurately reﬂect the care that
clinicians are delivering, clinicians feel accountable for them.
In contrast, many other factors affect health care outcomes
that are beyond the provider’s control. When a clinician
discovers that his patient had worse outcomes than another
clinician’s patients, it is unclear what he or she should be
doing about it. When data collection about process of care
is generated unobtrusively simply by an electronic patient
record when a provider performs the process, these measures
become even more attractive and feasible because they eliminate burdensome additional data collection.
Secondly, most process measures require less risk adjustment for patient illness than do most outcome measures.
The use of a process measure requires deﬁning a population
that is eligible to receive the process such as which patients
with asthma should receive anti-inﬂammatory medications or
which patients should receive beta-blockers or aspirin after
myocardial infarction. Once the eligible population is speciﬁed, further risk adjustment is generally not required, although it can be useful. In contrast, comparing mortality rates
or other outcomes for speciﬁc clinical conditions requires risk
adjustment. Risk adjustment requires deﬁnition and measurement of many patient characteristics, including physiological,
anatomical, and health status data that are not part of routine
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This document was uploaded on 03/09/2014 for the course ACC 301 at HELP University.
- Spring '09