Measuring Patient Outcomes- An Elusive Proposition?

Improving patient health has been the question that plagued the medical society for years if not decades. In fact, I dare to say, that improving patient health is the impetus of the medical community.
In our modern era, improving patient health is rapidly becoming synonym with patient outcomes. With economic concerns over cost of diagnoses, therapies and subsequent monitoring, the third-parties (governmental or private) cost reimbursements leave us scrambling to find what works and what doesn't. While articles after articles in peer-review journals and in common news outlet speaks of novel therapy or newly discovered diagnostics, the burden of new information is crippling health care professionals and/or is pigeon-holing them into a super-specialties. Furthermore, continuing education, an ethical obligation for healthcare professionals, should be designed to meet certain objectives that address performance (Moore's level 5) and patient health (Moore's level 6).
However, our poor attempt to categorize patients according to their age/gender/race and disease or attempt at bucketing diagnostics/therapies into a one group, have led to unsatisfactory results in measuring patient outcomes. At best, some were subjectives on part of the clinicians, or retrospective and anecdotal evaluation. In addition, the lack of guidance on patient outcomes measurement compound the problem even further.
What now? The question remains; how do we measure patient outcomes? This elusive endeavor can prove challenging in the modern paradigm of healthcare. Are objective biomarkers for a particular disease state a determinant of positive or negative patient outcomes? In other words, if for example we manage a patient with diabetes to attain a hemoglobin A1C below 7%, does that mean we have a positive outcome? How about that patient weight? complications? yes, I submit that the diabetic guidelines account for all of these, and perhaps on a singular patient level a clinician may have evaluated all known factors. But chasing these factors and numbers reduces the practice of medicine into a fruitless play of cat and mouse.  Healthcare practitioner after all "do not treat numbers but treat people".

Ultimately the outcomes measurement is only achievable in a holistic, multi-disciplinary approach that relies on the three main pillars of medicine: the physician, the pharmacist and the nurse. This endeavor is attainable when all three pillars are interconnected and not standing alone; physician feels safe being challenged on certain therapy choice, pharmacist welcomes the nurse's input on the patient's concern or shortcoming, and the nurse provides accurate and complete patient information and relays patient's concern to the physician. This leads me to my first proposition: there must be a genuine and complete open communication across the healthcare medium. 

However, for this communication to be successful it should be patient driven. All conversations of patient outcomes should be put aside until the patients themselves take charge. Although patient apathy is a different issue for a different discussion, recognizing the submissive, inherent attitude of patients as subordinate to their healthcare providers should be noted. Because this patient behavior is well documented in lower socioeconomic environment, special effort should not be spared in providing compatible education. Which leads me to the my second proposition: patient education material should be engaging with less text and more infographics providing the appropriate contexts.

In summary, measuring patient outcomes will continue to be elusive, but it is not illusive. It is attainable provided we approach the subject in a systematic, comprehensive way and are willing to challenge and be challenged by a new healthcare paradigm.