A growing number of Chartered Value Exchanges (CVEs) and other multistakeholder community quality collaboratives are now producing some type of private performance feedback report to physicians or other health care providers in parallel to their public report for consumers. In contrast to public reports, private performance feedback reports for physicians are designed to serve the measurement and improvement goals of clinicians and other health professionals, as well as health care organization leaders. Community quality collaboratives face a range of considerations as they develop or redesign private performance feedback reports for physicians. This guide offers 13 specific recommendations intended primarily for CVEs and other collaboratives engaged in private feedback reporting.
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Dale Shaller, M.P.A., Shaller Consulting Group
David Kanouse, Ph.D., RAND Corporation
Overview of Private Feedback Reporting for Physicians
Goals of Private Feedback Reports
Relationship to Public Reports and Patient Registries
Guidance for Private Feedback Reporting
1. Understand the Goals and Information Needs of Your Target Audience
2. Identify Your Value-Added Reporting Niche
3. Select Performance Measures That Are Relevant and Actionable
4. Include Benchmarks for Comparison to Peers and Normative Standards
5. Use Displays To Highlight Most Important Patterns
6. Provide Access to Patient-Level Data
7. Enable Physicians To Correct Patient-Level Data
8. Use Sound Methods and Make Them Transparent
9. Update Data At Least Quarterly
10. Build in Capacity To View Performance Trends
11. Distribute Reports Through Multiple Channels
12. Embed Feedback Reporting as an Integral Part of Quality Improvement
13. Evaluate Private Feedback Reports Against Reporting Goals
Appendix A: Ambulatory Quality Alliance Principles for Reporting to Clinicians and Hospitals
Appendix B: Case Study: The Cincinnati Health Collaborative Physician Dashboard
Figure and Tables
Figure 1. Private Feedback Reporting Audiences, Functions, and Information Flow
Figure 2. Plan-Do-Study-Act (PDSA) Cycle
Table 1. Variation in Performance Measures Used Across Five Community Collaboratives
Table 2. Variation in Benchmarks Used Across Five Community Collaboratives
Table 3. Variation in Benchmarks Used Across Five Community Collaboratives
Example 1. Report showing a single physician's scores (column 2) compared to selected benchmarks (columns 3 and 4)
Example 2. Report comparing physicians in the same practice site and indicating whether scores are above or below a target goal
Example 3. Online report of services provided to patients eligible for breast cancer screening
Example 4. Patient-level feedback popup
Example 5. Monthly run chart showing results of an individual practice site participating in a diabetes improvement collaborative
Copyright and Source Information
Work for this report was conducted under contract with The Lewin Group: Contract No. HHSA290200810037C
The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
Disclaimer: The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
AHRQ appreciates citation as to source:
Shaller D, Kanouse D. Private performance feedback reporting for physicians: guidance for
community quality collaboratives. Rockville, MD: Agency for Healthcare Research and Quality; 2012. AHRQ Publication No. 13-0004.
The authors thank the following five community quality collaboratives for providing demonstrations of their private feedback reporting systems, which form the basis of many of our findings and recommendations:
- Health Collaborative of Greater Cincinnati,
- Oregon Health Care Quality Corporation,
- P2 Collaborative of Western New York,
- Indiana Health Information Exchange, and
- Wisconsin Health Information Organization.
We are especially grateful to leaders of the Cincinnati Health Collaborative for their assistance in arranging physician focus groups and interviews with health system quality managers as part of our indepth case study of the Collaborative's private physician dashboard report. We also thank 25 peer reviewers who generously contributed their time and expertise in commenting on early drafts of this resource document; reviewers included representatives from Chartered Value Exchanges and physician organizations, technical experts, and colleagues at the Agency for Healthcare Research and Quality (AHRQ). Finally, we thank Peggy McNamara and Jan De La Mare at AHRQ and Jennifer Kuo at The Lewin Group for their invaluable guidance and support.
About the Authors
Dale Shaller, M.P.A., is principal of Shaller Consulting Group, a health policy analysis and management consulting practice based in Stillwater, Minnesota. David Kanouse, Ph.D., is a Senior Behavioral Scientist at RAND in Santa Monica, California.
AHRQ Publication No.13-0004
Current as of November 2012
Private “Performance Feedback” Reporting for Physicians:
Guidance for Community Quality Collaboratives.. AHRQ Publication No. 13-0004, November 2012, Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/privfeedbackgdrpt.htm