Health Care Value Is the Next Challenge to Medicine

Abstract

Health care value is the analysis of clinical outcome compared with the use of resources for a clinical condition. With any of a number of tools, payers, hospitals, insurance companies, health maintenance organizations (HMOs), and physician groups can assess the quality of the care that has been purchased or delivered. Crude measurements derived from UB-92 or HCFA databases may not reflect the complexity of care. Chart analyses in the inpatient setting may not link an outcome to the outpatient setting. We use an open architecture database compatible with several methods of data entry to establish health care value by physician-determined clinical indicators for quality of care. This allows physicians, vendors, hospital systems, HMOs, and payers to evaluate numerous variables across the continuum of health care in a proactive physician-centered environment. Current programs are in development for the specialties of obstetrics and gynecology, cardiology, urology, gastroenterology, oncology, and orthopedics for implementation in 11 cities across the United States.