Healthcare is missing the point

It's about functionality, stupid.

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

Three thoughts -

First, it's not just "mobility" - its functional capacity. Can the person pick up their grandchild, dance with their partner, carry groceries?

Second, healthcare'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 their steps, walk to their seats for their grandkid's swimming meet?

Third - Healthcare could learn a lot from workers' compensation, where the injured worker's functionality is of primary importance. Unlike all other healthcare payment schemes, workers comp requires returning the worker to their pre-injury functional status to close a claim (unless it is settled by negotiation).

Our healthcare 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 outcomes 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 the patient really understands 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 healthcare buyers - governments, employers, taxpayers and public entities - start focusing on what actual humans care about instead of of tangentially-important “metrics” we have no chance to fix our crumbling healthcare system.