Theory of Change for an Equitable, Patient-Centered Measurement Ecosystem That Supports an Advanced Healthcare System

For the work of patient-centered measurement (PCM) to reach its full potential as a strategy for transforming the health care system into one that works for everyone, we must explore the following questions: How do we make the practice of patient-centered measurement more equitable? That is, how do we ensure that the funded research teams that develop, select, implement, and use measurement are informed by a much wider range of lived experiences? And what is the path to shifting the power of measurement away from entrenched interests within healthcare and toward patients, families, and their communities?

To answer these questions, our team explored making the case to all stakeholders that measurement must be simultaneously patient-centered and equitable while also exploring the power dynamics within measurement. This plan also referred to as a Theory of Change, considers how to increase the uptake of PCM while ensuring that equity is embedded within its practice and ultimately shifting the power dynamics in measurement such that it is community-owned and driven. Based on this Theory of Change, our research has uncovered key questions and action steps that need to be addressed as the nation advances a pathway toward the elimination of inequities and health disparities. This product is intended to guide subsequent work that ensures the adoption and practice of equitable PCM and supports a new paradigm of measurement, as one of the ways communities hold power to reshape health care.  

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