Public Release: 

Coherent, robust performance measurement system needed

ACP agrees with report by Institute of Medicine

American College of Physicians

Washington -- The American College of Physicians (ACP) agreed today that the development, validation, selection, and integration of performance measures should be a multi-level process. It takes advantage of the most recent scientific evidence on quality measurement and has broad inclusiveness and consensus among stakeholders in the medical and professional communities. In evaluating a report released by the Institute of Medicine (IOM), ACP agrees that the full impact of quality improvement initiatives cannot be realized without a coherent, robust, integrated performance measurement system that is purposeful, comprehensive, efficient and transparent

"IOM's intention to establish a centralized organizing structure may be one way to set clear quality goals, coordinate performance measurement efforts, support fair comparisons of cost and quality, and ensure stable funding for organizations involved in performance measurement," said ACP President C. Anderson Hedberg, MD, FACP.

ACP has engaged in several activities aimed at improving physician performance, including:

  • Leading advocacy efforts to help internists provide well-coordinated, evidence-based, culturally competent, and patient-centered care;
  • Influencing the development and implementation of reliable quality measures and practice guidelines;
  • Helping internists, particularly those in small practice, understand and use technology to improve the care delivered to patients;
  • Making educational materials available on the College's Web site and through the Physicians' Information and Education Resource (PIER).

"ACP appreciates that the IOM's proposal to establish a National Quality Coordination Board recognizes the substantial progress made by public- and private-sector initiatives in developing, implementing, and reporting on measures of provider performance," Dr. Hedberg added. "As one of the founding members of the Ambulatory Care Quality Alliance (AQA), ACP aims to improve health care quality and patient safety through a collaborative process in which multiple stakeholders agree on a strategy for measuring, reporting, and improving performance at the physician level. ACP is pleased that the starter set of performance measures proposed by the IOM comprise the AQA's 26 'starter' clinical performance measures for the ambulatory care setting."

In further evaluating the IOM report, ACP agrees that federal leadership is necessary to overcome the limitations of the current system, particularly in terms of funding. Sustained, adequate funding is needed for a structure capable of encouraging multiple performance measurement initiatives and sustaining patients' interest.

Perhaps most importantly -- as the IOM makes clear in its report -- society's investment in learning is necessary to understand how measurement can best accelerate health care quality improvement.


The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 119,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection and treatment of illness in adults.

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