After 25 years, the Healthcare Effectiveness Data and Information Set (HEDIS) is still criticized for focusing on process and taking up doctors’ time. But it has been incorporated into physicians’ workflow and may yet be instrumental in bringing about value-based care.
Requiring some patients with chronic conditions to try and fail multiple medications leads to complications and drives up costs, say many physicians. Insurers answer that the trial-and-error approach can be an important way to rein in costs.
The challenges include not overburdening physicians and fitting into an increasingly complex, multilayered informatics ecosystem. Artificial intelligence is a work in progress, but early adopters of gamification could get ahead of their competition.