ORYX Performance Measurement System

ORYX is a tool used by healthcare organizations to evaluate their ongoing performance and to inform continuous quality improvement efforts. The ORYX initiative was developed and implemented by the Joint Commission and came into use in 1997. This system for the first time included performance and outcome measures in the accreditation process that was applied to hospitals, long-term care organizations, and healthcare networks. ORYX was later expanded to also include behavioral healthcare and home care organizations.

The concept of ORYX was to be a continuous, data-driven process that evaluates a healthcare organization's standard of compliance and the outcomes of this process. Joint Commission officials note that ORYX provides purchasers and consumers of care with another level of assurance that Joint Commission-accredited organizations are evaluated on outcomes in addition to the on-site surveys that take place.

Initial policies regarding ORYX called for accredited healthcare organizations to select two of the approved measures, also known as noncore measures, and to report data on at least 20% of the patient population from a list of 60 performance measurement systems that met the Joint Commission's criteria. This information was to be collected on monthly data points and transmitted on a quarterly basis in an electronic machine-readable format via the Internet or electronic bulletin board services to an approved Performance Measurement System (PMS). The Joint Commission delayed the reporting of core measures for long-term care, home care, and behavioral-health organizations so that applicable core measures could be identified. This was in response to the lack of national consensus on appropriate performance measures for nonhospital settings of care. ORYX provides healthcare organizations with a greater degree of flexibility in selecting measures, which was identified as a problem in the past under the Indicator Measurement System (IMSystem).

In July 2002, the first ORYX measures on accredited hospitals were collected. Hospitals are required to collect and report on at least three core measures or up to nine measures if not participating in core measurement activities, to satisfy the requirements of accreditation. Nonhospitals must collect six measures to satisfy accreditation requirements. To reduce the burden of reporting requirements for hospitals and other healthcare organizations, the Joint Commission has worked closely with the Centers for Medicare and Medicaid Services (CMS), the National Quality Forum, and other entities to develop and standardize these core measures.

One criticism of the ORYX program is that healthcare organizations may focus their quality improvement efforts on only the reported measures of quality or selected measurements that they perform well on. In addition, critics cite that the measures only represent a small number of medical conditions. The Joint Commission concedes these facts; however, it is acknowledged that healthcare organizations will eventually have to report measures on a greater percentage of their population. Some professionals question how performance data will correlate with hospital accreditation and the ability of the Joint Commission, a private organization supported by the hospital industry, to objectively evaluate hospital performance.