Saturday, November 27, 2021

Core Metrics for Better Health



Allen S Weiss, M.D.
President & CEO NCH Healthcare System

It can be difficult to understand all the new healthcare metrics that sometimes add confusion, not clarity, for patients, families, physicians, health care systems and payers. So it’s important to remember that all those metrics are designed to realize one goal—namely, better outcomes at lower cost, which is the value equation defined as outcome/cost = value.

This equation was at the heart of discussions last week in which I participated as a member of the Regional Policy Board of the American Hospital Association (AHA) for Region 4, which extends from Tennessee south and Alabama east and includes Puerto Rico. A group of about 45 of us discussed issues of common concern, shared best practices, and learned of national healthcare trends.

First we reviewed AHA’s strategic planning assumptions, which include a strong interest in retail health, digital strategies, consumerism, and other “market disrupters.” There are many creative partnerships of physicians, healthcare systems, and insurers, all of which benefit patients as we adapt to the changing health care landscape.

We then discussed the Institute of Medicine’s (IOM) report from the Committee on Core Metrics for Better Health at Lower Cost, entitled Vital Signs.

Vital Signs seeks to remedy this problem of confusing healthcare metrics with a set of 15 priorities that best measure progress toward realizing the value equation: (1) life expectancy, (2) well-being, (3) overweight and obesity, (4) addictive behavior, (5) unintended pregnancy, (6) healthy communities, (7) preventive services, (8) care access, (9) patient safety, (10) evidence-based care, (11) care matched with patient goals, (12) personal spending burden, (13) population spending burden, (14) individual engagement, and (15) community engagement. Interestingly, these 15 priority measures overlap significantly with those of our Blue Zone Project.

Next up at the AHA meeting was creating a new delivery system based on seven principles:


  1. Patient centered—where patient needs and access precede practitioner needs and convenience.
  2. Empower patients with technology—ensuring that technology supports quality and safety.
  3. Build care management and coordination systems—embedding an organized process to simplify better outcomes for all.
  4. Integrate behavioral health and social determinants of health with physical health—mind and body are intimately integrated and should be treated as such.
  5. Collaborative leadership and governance—trust, shared goals, and accountability are necessary throughout the care continuum for everyone to be successful.
  6. Integrate care delivery into the community—most of health is controlled in the community, outside the hospital, with everyone being responsible for his/her own health outcomes.
  7. Create a safe and highly reliable health care organization—organizations can create a culture of safety by managing and avoiding risk.

The value of these Policy Board discussions is captured in something my parents used to say, “Nothing happens when you stay home.” Or to put it another way, “In our turbulent healthcare waters, learning from other ships at sea is both comforting and instructive.”


In September 2006, Dr. Allen Weiss was appointed president and CEO of the NCH Healthcare System, a 715-bed, two-hospital integrated health care system. NCH is one of only twenty hospitals in the country affiliated with Mayo Clinic, and has been named three times by “U. S. News and World Report” as best in the region and among the 50 best cardiovascular programs according to Truven. He is a graduate of Columbia University’s College of Physicians and Surgeons, and completed his training at both the New York Presbyterian Hospital and Hospital for Special Surgery of Cornell University. He also had a solo practice in Rheumatology, Internal Medicine and Geriatrics for 23 years, and is board certified in all three specialties. He is recognized both as a Fellow of the American College of Physicians and a Fellow of the American College of Rheumatology. His wife, Dr. Marla Weiss, is a writer and educator, and they have two daughters who are physicians.


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