When the National Committee for Quality Assurance appointed Dr. Ari Robicsek as its first chief medical officer in June, it signaled a shift in how the organization thinks about measuring healthcare quality. Robicsek, who started at NCQA after serving as executive vice president and chief analytics and research officer at Providence, brings a background that blends clinical work with data analysis. In July, he sat down with Healthcare Innovation to discuss what he wants to change.
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NCQA created the CMO role, Robicsek said, to help ensure “the measures that we build are measures that matter and are going to work in the future.” The organization sees room to collect more information that captures clinical practice and patient outcomes — things that were harder to get at before, especially from the patient’s perspective.
AI could change what quality measurement looks like
Robicsek pointed to unstructured data in medical records as a place where artificial intelligence could make a real difference. “A huge amount of what is important about the way a patient is being cared for is buried inside unstructured information in records,” he said. “It’s buried in the notes.” Advances in AI, he argued, make it possible to extract useful information from those notes — information that could show whether a clinician made a good decision in a specific case, rather than relying on simple rules that don’t account for real-life complexity.
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He also described a future where ambient intelligent tools like digital scribes could help answer questions the industry has never been able to address: Did the doctor listen? Did they answer the patient’s questions? Was there shared decision-making? “Those are things that we’ve been completely blind to until now,” Robicsek said.
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The lack of information about what happens to patients after we care for them creates at least two huge holes, he explained. One is if we don’t know whether people got better after we treated them, then our mechanism for paying clinicians can’t be based on whether the doctor helped the patient get better. It’s based on what the doctor documented they did. “We can’t pay on that because we don’t measure it,” he said. “Imagine if we were systematically collecting information about whether patients got better in the context of the care that they received, and we got that information directly from patients.”
