There’s an opinion piece in HealthAffairs from last week calling for providers to add “mobility” to the list of quality indicators assessed by governments, employers and health care practitioners. 

Joe Paduda

Three thoughts:

• First, it's not just "mobility," it's functional capacity. Can the person pick up a grandchild, dance with a partner, carry groceries?
• Second, health care's "outcomes" are lacking what's important to the patient. Does the result of the treatment enable the patient to function — use the bathroom, sweep the steps, walk to the seats for a grandkid's swimming meet?
• Third, health care could learn a lot from workers' compensation, where the injured worker's functionality is of primary importance. Unlike all other health care payment schemes, workers' comp requires returning the worker to preinjury functional status to close a claim (unless it is settled by negotiation).

Our health care system is drowning in “outcomes” data, little of which has anything to do with whether the patient has recovered functionality. Yes, there are “PROMs” — patient reported outcome measures — but these are, at best, an afterthought, peripheral to the important stuff: blood sugar levels, ocular pressure, blood pressure, lipid counts and the like. 

Sure, these are all clinically important. But unless patients really understand the link between those metrics and their ability to do the things they want, they’ll be less motivated to actively participate in their health. 

What does this mean to you?

Until health care buyers — governments, employers, taxpayers and public entities — start focusing on what actual humans care about instead of tangentially important “metrics,” we have no chance to fix our crumbling health care system.

Joseph Paduda is the principal of Health Strategy Associates, a consulting firm focused on improving medical management programs in workers’ compensation. This column is republished with his permission from his Managed Care Matters blog.