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Lack of Standards for Public Reports Can Misguide, Rather Than Inform, Patients and Health Care Providers - 12/24/2014

Lack of Standards for Public Reports Can Misguide, Rather Than Inform, Patients and Health Care Providers

Release Date: December 24, 2014

A lack of standards for public performance reports can misinform patients and health care providers, say experts from the Johns Hopkins Armstrong Institute for Patient Safety and Quality and the Northeastern University’s Center for Health Policy and Healthcare Research. The paper, published this week in the American Journal for Accountable Care, states that a lack of standards for public reports can produce conflicting information that could lead to confusion and leave patients and clinicians with little assurance about the integrity of the data provided.

For more than a decade, providers have reported quality improvement measures publicly in an effort to answer the growing demand for transparency in health care. The results have led to dozens of publicly available reports that use a wide range of data collection methodologies.

Lead author J. Matthew Austin, an assistant professor at the Armstrong Institute, and co-authors Gary Young and Peter Pronovost, write that several of these public reports fail to use well-researched measures and rigorous data collection methods.

“Measures and reports that are not scientifically sound have the potential to misinform and confuse consumers and discourage clinicians from tracking their performance,” says Austin. “Health care needs to shift conversation about public reporting away from debates about the accuracy of measures and reports to how well providers are performing.”

To alleviate potential consumer confusion surrounding the publicly available data, the authors suggest the creation of an oversight model for public reporting; a model that closely resembles the Securities and Exchange Commission for financial reporting.

Austin, Young and Pronovost say the triad of an independent agency to set standards for data collection and public reporting, independent auditors to review compliance with those standards and an external body to enforce designated standards would ensure the integrity and usability of the information presented.

“Patients deserve valid reports of quality,” says Pronovost, director of the Armstrong Institute. “An agency can help ensure we have a good process in place to provide accurate and valid information to patients. This will help patients make those critically important health care decisions.”

Recognizing the vast differences between health care providers and patient needs across the nation, the authors say that regional and state collaborative groups could continue to customize reports that meet their communities’ needs and priorities.

“The goal is to create standards for public reports, not to standardize public reports,” says Austin.

About the Armstrong Institute

Established in 2011, the Armstrong Institute works to improve clinical outcomes while reducing waste in health care delivery both at Johns Hopkins and around the world. Led by Peter Pronovost, the institute develops and tests solutions in safety and quality improvement that can then be shared at the regional, national and global levels. Using a scientific approach to improvement, the organization employs robust measures that can be broadly disseminated and sustained. More information about the Armstrong Institute is available at