PERFORMANCE-MEASURES AND MEASUREMENT - REPORT CARDS OR INSTRUMENT PANELS - WHO NEEDS WHAT

Background: The report card movement in health care is a positive resp onse to legitimate customer needs and requirements for comparative inf ormation on quality and costs. At the same time, providers have a legi timate concern about potential problems with gathering and using valid data in a prudent manner. Report cards have problems that often detra ct from their potentially constructive uses. in response to this conce rn, the authors propose that instrument panels-a newer concept in heal th care-compared to the static, judgmental image of report cards proje ct an action-oriented, decision-making image. Examples: Descriptions a re given of three types of instrument panels based on work in progress in the Dartmouth-Hitchcock health care system, a regional, integrated delivery system that serves the population of New Hampshire and parts of Vermont and Massachusetts: a 450-physician group practice (The Hit chcock Clinic), which provides more than one million visits per year i n more than 25 locations; a tertiary health care facility (Mary Hitchc ock Memorial Hospital) with more than 300,000 patient days; and a prep aid health plan (Matthew Thornton Health Plan) with approximately 120, 000 members. Summary: It would be wise and efficient for providers to design instrument panel data collection systems that can feed directly into report cards, leading to the triple benefit of enhancing accurac y, reducing total costs, and increasing overall utility to both provid ers and their customers.