by Ryan Heyborne, MD, MBA, Proskriptive Chief Medical Officer
It isn’t often easy for clinicians and patients to do the right thing in the current healthcare environment. Lack of easy access to meaningful data is a major reason why. Healthcare has too long been a black box of obscured outcomes data, cost opacity, and incompatible record storage methodologies. Those of us focused on healthcare performance improvement know that the importance of access to high-quality, easily-understood, actionable data cannot be overemphasized.
Dr. David Blumenthal, in his New England Journal of Medicine (NEJM) article “Performance Improvement in Health Care – Seizing the Moment”, discusses four critical levers for advancing health system performance: payment policy, organization and infrastructure, public health, and essential information for healthcare decision making.
Obviously, much could be said about each of these factors, but I want to briefly highlight the fourth lever. The provider-patient relationship is key to performance improvement in healthcare. While systematic changes are crucial, they must be implemented with this relationship in mind. This relationship is supported by access to information, as the following quote from Dr. Blumenthal’s article makes clear:
The guiding vision should also be based on the understanding that performance improvement requires that clinicians and patients be enabled to make better health care decisions by giving them the best available information when and where they need it and making it easy to do the right thing.
There are many reasons why, despite this great need, healthcare continues to struggle with data management. At the level of the provider-patient relationship, I want to highlight two major obstacles to making meaningful change (in no way a comprehensive list):
1) We are used to “getting by”: Providers have come to expect sub-par information management and delivery systems. We practice in the dark in many ways. We know it is unlikely that we will have access to a comprehensive medical record, effective patient monitoring tools, accurate risk scores, impactability calculations, or meaningful outcomes data for our patients. It is difficult to even keep afloat in the current environment, much less reach for the stars.
2) Overcoming the inertia of the current state: As lacking as the current system is, we are all suffering from change fatigue. Clinical medicine is in a constant state of turmoil and upheaval. While we all know things could be done better, there is a lack of optimism that process changes will really lead to performance improvement.
These are challenges I face in my practice, as well as working with other clinicians. I have found actionable data to be key in overcoming these obstacles. Clinicians are trained as scientists. They generally know what good data is, and what it can do for them and their patients. Providing providers and patients with “essential information for healthcare decision making” is crucial to process improvement in the field. This means data has to be accurate, timely, and presented in a clear and actionable format.
I look forward to hearing your thoughts:
- What role do you think effective data management plays in healthcare process improvement?
- Do you agree that data sharing at the level of the provider-patient relationship is integral to system-wide enhancements?
- What are some of the obstacles you see, and what ideas do you have to overcome them?