Is All this Quality Reporting Making Things Better?

A recent study in Health Affairs attempts to quantify the amount of time doctors spend on reporting quality measures.  According to the article by Casalino, L.P et al

“Primary care physicians spent 3.9 hours per week dealing with quality measures, compared to 1.7, 1.1, and 3.0 hours for cardiologists, orthopedists, and physicians in multispecialty groups, respectively. Primary care practices spent 19.1 hours of physician and staff time per physician per week dealing with quality requirements of external entities; cardiology, orthopedic, and multispecialty practices spent 10.4, 11.3, and 17.6 hours per physician per week, respectively. Time spent varied little by practice size (Appendix A3).⁸”

In perhaps the most worrying aspect of the study, “Only 27 percent believed that current measures were moderately or strongly representative of the quality of care. Just 28 percent used their quality scores to focus their quality improvement activities. “

Of course we all hope that the reporting of quality measures serves to increase the quality of care delivered. These findings might suggest an imbalance in the relationship between quality improvement and reporting.

On reflection, one wonders if the medical profession has become good at quality assurance as opposed to quality improvement.  In addition, while there is value in reporting the numbers, has the practice of medicine become too focused on numbers and as a result, the autonomy of doctors is being eroded or lost?  (All good topics for future blog posts.)

What do you think?