Use of outcome data by purchasers and consumers: new strategies and new dilemmas

OBJECTIVE: The complexities involved in measuring outcomes of care are perceived as a core challenge of health services research. However, the complexities associated with making outcomes data useable for purchasers and consumers are just beginning to be recognized. The purpose of this paper is to outline some of the barriers to purchaser and consumer use of clinical outcome (and other performance) data and to identify strategies for supporting greater use of these data. Dilemmas associated with current and proposed strategies are highlighted and recommendations are proposed. EVIDENCE: Three recent studies focusing on consumer and purchaser use of outcome data are used to illustrate barriers. The decision research literature is also drawn upon to describe the information processing challenges faced by purchasers and consumers when using performance information for making choices. FINDINGS: Information packaging strategies and decision support tools designed to overcome barriers are described, and dilemmas associated with their use are outlined. One major concern is that if we adopt strategies to make report card data more digestible, we may be trading off some of the market effects (e.g. improved health plan performance) that justify report card efforts in the first place.