Data-Driven methods for motivating physician quality improvement

Quality improvement (QI) is a continuous process of improving the safety and quality of healthcare delivery, often guided by data-driven methods. Recording physician performance provides an opportunity to identify weaknesses and improve performance and quality. We conducted a prospective study investigating trends in physician performance metrics in two departments, Internal Medicine (IM) and Combined Internal Medicine and Pediatrics (MEDP), when individual physician performance metrics were shared amongst their peers in an anonymized and non-anonymized manner. This study assessed aggregated physician performance of each department using quality metrics in four categories: asthma, cardiovascular disease, diabetes, and preventative screening. The results were heterogeneous by both departments and by specific measures within each category. For example, in the diabetes category, the percentage of physicians ordering an HbA1c significantly improved for IM, while for MEDP, the yearly eye exam metric improved. In the preventative category, colorectal cancer screening, mammogram screening, and cervical screening showed significant improvement for both MEDP and IM as a result of the intervention. There is a debate amongst physicians regarding the usefulness of quality metrics, which may contribute to the variability of the results, along with contextual factors such as the environment, macrosystem, microsystem, QI support and capacity, and QI team.