Abstract

The Affordable Care Act, which was signed into law in 2010, established several national priorities for health care delivery, including reinforcing the importance of high-value health care. Cost and quality are fundamental functions of value. Although costs may be clearly definable, quality can be more elusive to calculate and measure. The use of structured quality measures, which are standardized tools to quantify health care processes and outcomes, can reduce variability in quality reporting. One prominent example of a gastroenterology-focused quality measure is the adenoma detection rate, which reflects the percentage of average-risk screening colonoscopies in which at least 1 adenoma is detected. Like adenoma detection rate, all quality measures require discrete specifications for calculating a numerator and denominator to allow widespread standardization and reliable measurement across practices. Ultimately, this reproducibility permits the establishment of benchmark targets, which in turn allow insights into variable measure adherence and opportunity to develop and implement improvement.

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