Measuring Success: Disease Intervention Specialists Performance Metrics and Outcome Assessments

Abstract

Disease intervention specialists (DIS) are the cornerstone of public health. However, the incremental gains of DIS-led interventions are difficult to detect at the population level. Health departments attempt to quantify the impact of key DIS activities through performance measures that assess how many and how quickly both patients are interviewed, and contacts are notified, tested, and treated. However, DIS work encompasses more than case finding and existing performance measures may not capture the full value DIS provide to health departments. In this article, we first describe how DIS investigations and contact tracing are conducted for sexually transmitted diseases and other communicable diseases to understand how the definition of effectiveness may vary by disease. Then, we examine the benefits and limitations of traditional performance measures using syphilis investigations as an example. Recognizing the limits of existing measures will improve our understanding of DIS impact and assist in the development of new measures of effectiveness that better represent the totality of DIS work.

Creating a Sexually Transmitted Infection Disease Intervention Workforce for the 21st Century

“…35 In addition, measures may not include what was missed by syphilis partner service interviews (e.g., unnamed partners, partners not reached, partners treated without DIS contact), and many DIS activities are not included in existing metrics. 35 Another method to assess the impact of DIS work is through cost-effectiveness analyses, which can aid in a prioritization of disease intervention activities. 36 As previously noted, various contextual factors that are often interconnected can impact disease intervention activities, and this relationship is often bidirectional.…”

“…Disease intervention activities can be evaluated using performance metrics, outcome assessments, and cost-effectiveness analyses. Over time, there has been little change in the performance measures, including process and clinical measures, used to assess disease intervention activities 35 . In addition, measures may not include what was missed by syphilis partner service interviews (e.g., unnamed partners, partners not reached, partners treated without DIS contact), and many DIS activities are not included in existing metrics 35 .…”

“…Over time, there has been little change in the performance measures, including process and clinical measures, used to assess disease intervention activities 35 . In addition, measures may not include what was missed by syphilis partner service interviews (e.g., unnamed partners, partners not reached, partners treated without DIS contact), and many DIS activities are not included in existing metrics 35 . Another method to assess the impact of DIS work is through cost-effectiveness analyses, which can aid in a prioritization of disease intervention activities 36 …”