Big data as a means to improve patient care has emerged as a big buzzword in healthcare recently, yet for many organizations driving tangible change remains a challenge. That's not the case with MEDNAX, however. The national medical group specializing in neonatal, anesthesia, maternal-fetal, pediatric cardiology and other pediatric subspecialty services is using robust quality and outcomes data tools to change how clinicians practice medicine for the better.
The following are four thoughts from Richard Gilbert, MD, MBA, anesthesiologist and CMO at MEDNAX, on using big data to improve patient care and drive value.
Question: What does "value in healthcare" mean to you?
Dr. Richard Gilbert: Clearly, the healthcare sector is undergoing transformative changes. As our world shifts from "fee for service" to "value-based payments," the concept of value in healthcare becomes not only about the quality of outcomes we seek, but also how quality can be achieved at a given cost. Driving value is about being able to lower costly complications, improve outcomes, maximize efficiency and optimize the patient experience, all at a reasonable price. This can be achieved through the use of big data — not just collecting and reporting it, but analyzing data for opportunities to achieve systemic improvements, improve practitioner performance, and demonstrate cost savings.
Q: What can data management tools mean for hospitals and health systems?
RG: According to author and management consultant, Peter Drucker, "If you can't measure it, you can't manage it." This is true in healthcare, as it is in industry globally. If we look at data across the board, use it to decrease variability, decrease errors and ensure compliance with evidence-based medicine, then we can achieve improved outcomes and better efficiency. That is how you successfully manage data and drive value.
Within MEDNAX, we use various data tools and solutions to support our partners and clinicians to achieve better outcomes for our patients and efficiency for the operating rooms. Specific to anesthesia, the Quantum Clinical Navigation System, recently approved by Medicare as a Quality Clinical Data Registry, can collect objective information and make it available for timely feedback to clinicians and managers. The system can identify individuals or facilities that may not be meeting benchmarks in certain areas, which allows leaders to customize process improvement. We've found that a combination of a systems-level approach and an individual accountability approach has been successful to driving sustainable improvement
Q: Why is immediate feedback so important?
RG: Our system provides timely critical alerts and other clinical reports to providers and other stakeholders. If you give clinicians information months after a procedure, they're not likely to remember the patient or think back to what could have been done differently. You need timely feedback, positive and negative, or it loses much of its relevance. This facilitates a change in practice.
Another important point to mention is Quantum also relies on human nature. If clinicians know they are being monitored for quality and compared to their peers, both the clinician's competitive nature and the "Hawthorne Effect" come into play. Meaning, people change their behavior if they are being monitored and compared; they want to show improvement.
Q: How does Quantum use big data to achieve value?
RG: Quantum monitors 85 metrics, specific to anesthesia and perioperative care. We use these metrics to track and trend demographics, risk factors, quality outcomes, individual performance, efficiency and patient satisfaction. Where needed, we conduct a root cause analysis, and then make systems and process changes to decrease errors and variability. For example, nausea and vomiting are among the most common post-operative complaints, leading to patient dissatisfaction and unplanned admissions. We launched a global initiative that was driven by Quantum data analysis which led to decreased rates in high-risk patients. This equated to substantial cost savings for all stakeholders. Quantum data is also used to develop process improvement initiatives customized to the individual clinician.
Dr. Gilbert will present further on this topic with his presentation "Bending the Cost Curve: Using Big Data to Drive Value in Healthcare" Thursday May 7 at 2:15pm at the Becker's Hospital Review 6th Annual Meeting, held in Chicago at the Swissotel. To learn more about the conference, click here.