#IHI TRIPLE AIM FRAMEWORK ZIP#
Sometimes county data are available but target populations are mostly resident in a few zip codes. Perhaps county data is needed but the data are aggregated only at the state level. The data are not aggregated at a useful level. Perhaps the most important factor in determining the speed at which results are produced is the capability and capacity for improvement in the region. It is useful to develop goals for 1, 3 and 5 year periods. However, important measures such as self reported health status, readmission rates, admissions for exacerbations of chronic illness, trends in per capita cost can all be impacted in a three year period. Of course for some initiatives there will be a delay between cause and effect. How long will it take to move these high level measures? The region might expect to see an improvement in the self reported health status for people making less than 50,000 per year when the data becomes available. For example, suppose a region provided equitable access to primary care and developed an integrated approach to chronic disease prevention and treatment. The trends in some of these “drill down” data sources can be confirmed by the “official” data when they are available. Quality Improvement Organizations contracted in each state by CMS have access to current Medicare data. For more timely feedback these publically available data can be supplemented locally by utilization data from health plans for the under 65 year old population. They then are useful for building will and setting priorities. Without some aggressive initiatives to change the relative results high level measures will be stable with respect to these comparison groups. One is to compare trends in the data against other comparison groups such as national or state results. However, they can be useful in several ways. This limits their use in providing real time or even quarterly feedback to guide improvement efforts. It is true that some publically available data are a year or more behind. The data are not current and therefore not useful. Hospitals, doctors and other providers can and should develop the capability to use their existing data for improvement. Publically available data such as Hospital Compare or CAPHS from CMS or some the NCQA measures would be useful at a project level. High level measures, such as years of potential healthy life lost, are useful for operationally defining health and for establishing long range, 5-10 years, plans. The measures you propose are too high level.
The measures you propose are too high level.
Below is a list of questions or concerns and proposed answers. By now the IHI team has heard a set of frequently asked questions or concerns regarding measures.
#IHI TRIPLE AIM FRAMEWORK HOW TO#
The primary issue with measurement is how to use it at various levels and for various purposes. The IHI Triple Aim team has put together a prudent set of suggested measures that also help operationally define the IHI Triple Aim.
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