Douglas Flora, Executive Medical Director of Yung Family Cancer Center at St. Elizabeth Healthcare, President-Elect of the Association of Cancer Care Centers, and Editor in Chief of AI in Precision Oncology, shared a post on LinkedIn:
“What Patients Count: What we measure in cancer care—and what we should.
‘Speed without comprehension creates noise. Clarity creates ground to stand on.’
Every oncologist has learned to read between the lines of ‘I’m fine.’ The patient who says it while their hands shake. The caregiver who insists, ‘We’re managing,’ while visibly unraveling. The family that nods understanding while terror fills every silence between words.
We chart weight. We chart performance status. We chart pain on numerical scales. What we do not chart: the ratio of terror to determination, the gap between what cancer demands and what patients actually have left to give. We do not measure adaptive reserve—and yet it predicts adherence, quality of life, and probably survival, though we haven’t studied it with the rigor we bring to drug development.
Meanwhile, your quality dashboard looks excellent. Time to treatment initiation trending down. Treatment delays nearly eliminated. Patient satisfaction scores at 87 percent top box. The metrics that keep accreditation bodies satisfied and executive committees funded are all moving in the right direction.And yet. A patient leaves your clinic less certain than when she arrived. Not because information wasn’t provided—it was, thoroughly documented in the after-visit summary that auto-populated her portal. But information and comprehension are not the same thing, and only one of them appears on your dashboard.
Another patient nods when asked if he understands the treatment plan. Performance status: 1. Pain scale: 3 out of 10. Depression screening: negative. All documented. What isn’t documented: he’s three months from financial collapse, his primary caregiver is approaching burnout, and his adaptive reserve is nearly gone.We have gotten remarkably good at measuring what keeps our organizations alive. We are less practiced at measuring what makes care feel human.
Last week, I wrote about a few other ‘Key Performance Indicators’ I thought we might consider measuring. I go deeper in this week’s piece. Five metrics that patients are already counting, whether we measure them or not. Not soft data. Not nice-to-haves for ideal circumstances. Essential information that shapes whether care heals or merely happens.
What gets measured gets managed. But are we measuring what matters most?”
More posts featuring Douglas Flora.