The challenge with tracking health outcomes

Rising health care costs, questions about the effectiveness of medical interventions and demands for greater accountability and efficiency with respect to health care delivery have led to a growing interest in using patient outcomes as a primary measure of the quality of care. However, measuring outcomes is complex and expensive given the widespread lack of an integrated and comprehensive electronic health information system. Furthermore, the science of outcome measurement is relatively undeveloped and caution needs to be taken when attempting to relate health care provision to differences in outcomes. While the foregoing problems do not invalidate outcome measurement programs, they do stress the point that such initiatives need to be pursued cautiously and that their limitations must be clearly appreciated. The challenge with tracking health outcomes is discussed from the perspective of the Improving Cardiovascular Outcomes in Nova Scotia study. This outcome measurement and management project, one of the most ambitious ever undertaken in Canada, has been seeking to improve the medical care of patients with cardiovascular disease in Nova Scotia since October 1997.