Measuring What Matters: Developing a Patient-Centered Engagement Rubric for Quality Measurement

Monday, March 25, 2019

By: Matt Pickering, Senior Director, Research & Quality Strategies, Pharmacy Quality Alliance (PQA), and Mel Nelson, Director, Research & Academic Affairs, PQA

Health care quality is increasingly being measured to better inform patient decision making. However, while current quality measures may be evidence-based and valid, many lack meaningful involvement of the patient community (defined as patients, family caregivers, advocates, and patient groups) in their development. For example, representatives from the patient community may have not been included of certain segments of the quality measure development or be brought into the process after much of the work is complete. Additionally, individuals may be asked to represent the views or experiences of all patients.

To have true utility, quality measurement must meaningfully incorporate patient community input. As noted by the Centers for Medicare & Medicaid Services, involving individuals, family representatives, and caregivers in the measure development process further strengthens their engagement as partners in their care. To achieve this, quality measure developers and agencies must have a robust process in place to incorporate the patient voice.

A similar requirement has been expressed in other facets of health care, including research, drug development, and value assessment. Within each of these areas, there are tools available so that the patient community and other stakeholders can evaluate the patient centeredness of their respective efforts and to guide the meaningful incorporation of patient engagement throughout their processes.

PCORI’s Engagement Rubric provides guidance for patient engagement in research. For drug development, the Center of Excellence in Regulatory Science and Innovation at the University of Maryland established a framework and a rubric for assessing meaningful patient engagement. Lastly, the National Health Council (NHC)’s Patient-Centered Value Model Rubric provides value framework developers the ability to incorporate and assess patient engagement throughout their processes. However, with respect to quality measurement, a patient-engagement rubric for measure development and implementation does not exist.

To address this gap, the Pharmacy Quality Alliance, in partnership with the NHC and the National Quality Forum (NQF), convened a national roundtable, with representatives from the patient and stakeholder communities, to develop a Patient-Centered Engagement Rubric for Quality Measurement. This work builds on existing rubrics and will focus on describing the hallmarks of patient centeredness in the context of quality measurement.

The development of a quality-focused, patient-centered rubric will increase the patient community’s capacity to engage within quality measure development and implementation. This tool will improve the ability to evaluate and discern high versus low engagement within quality measurement.

Use of the rubric will identify emerging best practices of patient engagement within quality measurement and opportunities for further refinement and implementation of the rubric. The roundtable is expected to complete its work in August 2019 and we look forward to sharing the rubric with you then.

This initiative is supported by an independent educational grant from Merck & Co., Inc.