A revolution is working its way through America’s health care systems. Like many great revolutions, it’s about empowerment and the creation of a new paradigm. It won’t happen overnight, but the forces at work are irresistible and will bring new hope and new responsibilities. The agent of change in this revolution is our long, national quest to improve the quality of health care. Its army comprises every consumer of health care—in other words, every single person reading this article, and every single person you see. Although not the ones making the diagnosis and holding the scalpel, you consumers will ultimately determine the quality of your health care. It’s time to understand the roots of this revolution, its progress and what it means for all of us.
Individual consumers are making more health care decisions on their own, a change fueled by the rapid growth of Health Savings Accounts (HSAs). About 17 million people now have an HSA and this number is expected to exceed 29 million within five years. A focus on health care quality by millions of individual payers may someday revolutionize our understanding and acceptance of the standard of care we receive.
Today, consumer knowledge about how to ensure high quality care is low. One reason is that employers, insurers and government payers have been the de facto guardians of quality on behalf of the consumers they serve. It’s time that the same commitment to driving quality improvements by these third parties be applied to the education of the consumer, who has the most at stake.
The more health care consumers know about how quality is measured and what constitutes high quality care, the more emphasis health care institutions will place on quality. Information and knowledge will ultimately fuel the consumer health care quality revolution.
I started my career as a public health director in Jefferson County, in Alabama. One of my major concerns involved the sanitation standards of the restaurants we inspected. To drive quality improvements, we were one of the first health departments to publish restaurant sanitation ratings in the local newspaper. Once consumers became educated on the process and aware of the quality grade of these restaurants, owners began calling the health department for assistance in improving their grade. While some like to contend that health care is different, the same consumer pressure applies and, most importantly, drives improvements.
The first step, of course, is to define quality for consumers. The Institute of Medicine defines quality care as patient-centered, timely, efficient, effective, safe and equitable. It’s also coordinated, compassionate and innovative because medicine must continue to innovate if we intend to improve the quality of medical care in this nation. Consumers should call on the health care system to provide the information they need to make confident decisions in choosing a physician, a hospital or a course of treatment. They must insist that health care providers measure and report how well they do their job. Information about how well health care meets accepted standards must be presented to consumers in a way they can understand and act upon.
It’s no easy task to define and measure quality, and it will take a consumer revolution to make continuous quality improvement one of the top priorities of all health care providers. But the same consumer power that ensures your next restaurant meal doesn’t harm you can certainly become the driving force that motivates every health care provider to meet or exceed the high standards of care we all expect them to deliver.
