POSTED September 7, 2017
You Can Manage Only What You Can Measure
By now, it’s easy to see that there are health-related concerns that demand our full attention. Under traditional fee for service pathways, hospitals are incentivized to charge as much as possible, hiking up the averages used to define bundled pricing -- believed to be the benchmark of affordable care.
As we enter a value-based landscape, variation in episode costs can be $80,000+. Although patient variability is certainly a factor, serviceline variation is prevalent across the board. The national standard deviation for TJA procedures operating under the CJR payment model is $10,582 -- meaning, removing the vast majority of outliers, costs still differ by roughly $20,000. Patient satisfaction and outcomes also deviate from the theoretical procedural mean. By tracking patient reported pain levels 30 days post-op, we are able to visualize how varying surgeon practices yield varying outcomes.
Through the use of high level business intelligence -- clear data leading to powerful, repeatable solutions -- efficient entities (no matter the industry) operate with little to no variability. Best practices form when a system is explained with precise correlation between function and outcome. One way of doing this is recognizing consistent internal performers and observing their methods. This begs the ultimate question, how can we decisively measure and compare outcomes?
Healthcare is finally arriving at a place other industries have been for years. It’s not that hospitals and other health systems aren’t collecting data (they are). The concern is that coordinated care is extremely complicated and, for the most part, data is not clear enough to turn suggested changes into completed actions.
Force is tackling the issue by presenting stakeholders -- physicians included -- a clearcut dashboard where each surgeon is appraised and recognized based on costs, patient outcomes and variation among other factors. It’s a solution to the overflow of raw and unusable data that many hospitals face. Transparent, usable data are simply a way to proceed with intelligent decision-making in an efficient manner. With enough data collected, sorted and made transparent, there will be a shift to appropriate standardization of pathways.
For example, outpatient procedures are becoming more common and patients are routinely spending even less time in the hospital with physicians and their care teams. These methods, although thus far proven to reduce costs while sustaining positive outcomes, can only be done with continuous data collection and organization. As we delve into alternative post-acute practices, repeatable solutions and detailed insight within extensive patient populations become even more valuable.
"Physicians are driven by outcomes, research and evidence. In order to create a culture of continuous improvement, data and benchmarking are critical,” commented Dr. Richard Iorio. “Leveraging trusted and transparent physician dashboards that include quality, cost and patient satisfaction metrics is a key pillar of success in the value-based world we're entering."