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On Page 27 of the CMS Quality Strategy Document “Engage Individuals and Communities to become partners in their care” is stated to be an overall objective of this quality initiative. The author(s) of
On Page 27 of the CMS Quality Strategy Document “Engage Individuals and Communities to become partners in their care” is stated to be an overall objective of this quality initiative. The author(s) of this article then provide four specific outcomes which demonstrate this. How might the HIM Profession contribute to the attainment of each of these four specific outcomes?
18 CMS National Quality Strategy (NQS) | [email protected] EM ENTEngage Individuals and Communities to Become Partners inTheir CareObjective: Ensure individuals and caregivers have the information needed tomake the best choices for their health, as well as a direct, significant, andequitable contribution to how CMS evaluates quality and safety.Authentically engaging individuals, families, caregivers, and communities as active partners intheir care ensures that the health care systems that serve them are respectful of and responsiveto their preferences, needs, and values. This partnership is essential to person-centered careand to improve health care quality, safety, and equity. The Engagement goal of the CMS NationalQuality Strategy focuses on two components of engagement. The first is ensuring thatindividuals and caregivers have information to make the best choices for their health. Thesecond is ensuring the voices of individuals are valued and that they directly contribute to howCMS evaluates the impact of its programs on quality, safety, and equity.Key strategies for promoting the delivery of person-centered care include collecting experiencemeasures and person-reported outcomes (PRO) and PRO-based performance measures (PRO-PM). Experience of care measures can assess a wide range of interactions that individuals havewith the health care system and the aspects of those interactions that they value, such as timelyappointments, easy access to information, and good communication with health care providers.A PRO is any report of an individual’s health condition or health behavior that comes directlyfrom the individual (or proxy when appropriate), without interpretation of the individual’sresponse by a clinician. A PRO-PM captures person-reported outcome data on meaningfuloutcome metrics and incentivizes collaboration and shared responsibility for improving patients’health along the full spectrum of care. Self-reported data are a rich source for measuringoutcomes such as health-related quality of life, symptoms and symptom burden, and healthbehaviors.Together, experience surveys, PROs, and PRO-PMs provide the individual’s perspective of theirown health, their experience of the treatment or service, and the outcomes that are mostimportant to them. Providers can use this data to assess the person-centeredness of the carethey deliver and inform their treatment plans, and CMS can use PRO and PRO-PM data toincentivize providers to deliver high-quality care.Key Actions to Ensure Engagement to Improve Health Care Quality• Incorporate individual and community input into strategy and policy.• Expand use of person-reported outcomes and experience measures.• Give individuals access to their own health data and meaningful information.• Provide a platform for public reporting.