Monday, June 16, 2008

Predicting the Future

In 2005, the Physician Quality Reporting Initiative, an effort by the Center for Medicare and Medicaid Services (CMS) to assure quality healthcare was tied to physician reimbursement, began with a mere 36 measures. This initiative has grown steadily, such that now 138 measures (with 16 new ones just last week!) have been defined.

I wondered if there was a growth trend that could be predicted as to how many quality measures for physicians will exist by 2019, when the Medicare Trust Fund is predicted to be bankrupt.

What was striking, was the remarkably linear relationship of growth of these measures. If one applies a least squares method to determine the annual rate of growth of measures so far, the number of measures is defined by the equation:
y = mx + b, where:
y = number of measures
m = 25
b = 11

Here's how the graph looks:

So if this formula holds true, by 2019 physicians should expect 386 measures to track!

Wow. Let's look at that. If we have an 8 hour work day, and there are 60 minutes in an hour, then there are 480 minutes to the average work day. If each of these measures take, say, one minute to collect and record, then 94 minutes will be left over to see patients.

Now, if we leave 15 minutes for a potty break and maybe a very quick bite to eat, then we've whittled it down to 79 minutes left for patient care. If the average doctor expects to see 20 patients a day, then 3.95 minutes will be devoted to each patient.

All in the name of healthcare rationing.

Keep up the good work, CMS!



Ian Furst said...

for the past 3 days I've been tooling around the NHS sites looking for stats. There database makes medicare look like a joke. The have online dictionaries and more "assessments" then you can imagine. I agree that you can't change what you can't measure but there should be a test before implementation. 1) repeatable 2) predictable 3) cost effective 4) useful. I found at least 4 different sites that have just the raw statistics.

Rogue Medic said...

Stop blogging and get back to documenting the care that is so much more important than the actual care. :-)

Does unexpected patient death count against you any more than any other "quality measure?"