Health-related quality-of-life data should be regarded as a vital sign

OBJECTIVES: The health care system systematically collects data on risk factors, processes of care, and the amount and type of services provided; in short, it mainly measures inputs. The system only sporadically collects data on the health status and health-related quality of life (HRQL) of those served. What does the system actually produce? It produces quality-adjusted survival; yet, there is little systematic effort to collect such outcome-output data. STUDY DESIGN AND SETTING: Systematic routine use of HRQL instruments to assess the health of all patients is one step toward filling this void. RESULTS: Assessing the HRQL on all patients provides the information needed to create a report card on the system. Furthermore, the routine use in the context of chronic care management has the potential to improve patient-clinician communication, provider and patient satisfaction, shared decision making, and health outcomes. CONCLUSION: Over five decades of methodological development have provided a rich array of HRQL instruments. A plethora of technologies facilitate the collection, transmission, and storing of information. What is needed is training to assist patients and providers in the meaning and use of such information and the will to use it to improve performance, accountability, and patient care. Administrative support is also necessary.