Sustainable Approach to Justice, Equity, Diversity, and Inclusion Through Better Quality Measurement.

The US health care industry has broadly adopted performance and quality measures that are extracted from electronic health records and connected to payment incentives that hope to improve declining life expectancy and health status and reduce costs. While the development of a quality measurement infrastructure based on electronic health record data was an important first step in addressing US health outcomes, these metrics, reflecting the average performance across diverse populations, do not adequately adjust for population demographic differences, social determinants of health, or ecosystem vulnerability. Like society as a whole, health care must confront the powerful impact that social determinants of health, race, ethnicity, and other demographic variations have on key health care performance indicators and quality metrics. Tools that are currently available to capture and report the health status of Americans lack the granularity, complexity, and standardization needed to improve health and address disparities at the local level. In this article, we discuss the current and future state of electronic clinical quality measures through a lens of equity.
Competing Interests: Disclosures Dr Shah receives consulting earnings from Novartis Pharmaceuticals, Amgen, Amarin, and Merck and research support from National Institutes of Health, Amgen, Novartis Pharmaceuticals, and Janssen. Dr Sitapati is an internal advisor for the U.S. Food and Drug Administration and acts as an unpaid consultant to nonprofit organizations the College of Healthcare Information Management Executives and the Kelee Foundation. The other authors report no conflicts.