Enlisting data scientists to help drive clinical and financial behavior change is only half the battle when it comes to quality improvement. The other half: gaining physicians' trust in the information, so appropriate clinical recommendations can be derived.
This content is sponsored by HealthTrust.
In comparison to other industries, healthcare is lagging in making the most of big data. However, that is quickly changing as IT, clinical and supply chain leaders see value in using data to cut medical supply costs and improve patient outcomes. Nearly half of IT leaders plan to increase spending on analytics programs in 2018, according to a February survey published by International Data Group.
Still, implementing data-driven initiatives requires more than IT solutions and data. Helping physicians understand exactly how and why analytics programs use information is critical to these programs' long-term success.
Becker's Hospital Review and four data and quality improvement experts from HealthTrust joined to discuss opportunities and strategies for using data to drive clinical and financial outcomes in health systems.
Roundtable participants included:
- David Osborn, senior vice president of advisory services
- April Simon, MSN, RN, vice president of clinical data and analytics
- Kim Wright, RN, assistant vice president of clinical data solution and analytics
- Todd DeVree, director of bundled payment solutions for inSight Advisory
Editor's note: Responses have been lightly edited for length and clarity.
Q: How do hospitals go about fostering a data-driven culture that utilizes data to improve both clinical and financial outcomes?
Todd DeVree: If you want people to adopt something new and have it embedded into your culture you have to both demonstrate the value and include them in the process of developing it, especially physicians. Involving them in the process of designing your reports and how the data will be aggregated and disseminated gives them ownership and the result will be actionable data that is assimilated into their decision making. They won't just perceive the value, but experience how the data can impact performance and it will become further ingrained into your culture.
April Simon: Engage your physicians — that's the No. 1 thing.
You have to make sure you have solid information and that you focus on what matters to physicians. Clinical outcomes of patients are always the clinicians' priority. Physicians don't like being spoken to about finances. Instead, focus everything on the patients — making their experience better, reducing complications, making healthcare more affordable.
Q: How can organizations use data to develop sustainable programs that improve outcomes and lower costs? What are some examples of programs?
TD: They can utilize data to drive value by first and foremost leveraging it to identify variations in care, outcomes and cost. Data tells you what is actually happening — there is no need to rely on your perceived value if you have data in front of you telling the real story. There's no denying your performance when you have accurately and timely data. When you continuously leverage the data to identify areas of weakness and strength it becomes the foundation of any improvement strategy you put in place and allows you to monitor and track your progress to goals.
David Osborn: At the core of sustainable performance improvement are two components: gathering, analyzing and presenting data that stands up to scrutiny and doesn't focus on trivia, and truly being open to input and feedback from clinicians. I find that some hospitals give lip service to physician input. Sometimes the administrators or data keepers are the sole decision-makers, or the analytical tools aren't flexible enough to accommodate physicians' requests — the end result is that physicians believe there was an "illusion" of participation, which rarely is received well by anyone.
Q: How do hospitals turn data into actionable information that can be reconciled and presented in a way that resonates with all stakeholders, most importantly with physicians?
Kim Wright: It's important to have the same patient-focused orientation as physicians. We don't only look at DRGs, we talk about conditions, and that's also how we frame and analyze data. We have a physician advisory board that helps put together our patient populations in a way that makes sense to doctors. We also work with our clients to create new population reports that make sense to them specifically. We are responsive to their questions and concerns when we show them information.
AS: We have a system that tells us what the commonalities are in patients who have adverse events. For example, we might see that of patients who had vascular complications in the cath lab, 80 percent were women who were malnourished with a BMI below 19. Or, if we have an infection problem, we run a report looking for everything that patients who had infections had in common, whether it's procedure, location, demographic traits, comorbidities or staff. That's a starting point; that's food for thought. If you aggregate data that physicians trust physicians will figure out how to solve the problem. We've been using multiple data sets for over 20 years to work with clinicians, the one thing we know is that there is no perfect data set. It's understanding those limitations, putting it into context with our clinical experience, and getting it to your physicians as soon as possible that allows one to both identify issues quickly and solve real issues and not react to noise.
Q: Are there service lines that are particularly receptive to this kind of data-driven change management?
DO: It varies across health systems, but you need the following to affect real change: opportunities that matter to people, interest from physician champions, and practitioners who are amenable to change. You can find these in all service lines and areas of medicine. One thing to remember is that if you only engage your physicians in change efforts when you see something bad, you're missing real opportunities. We should also pay attention to good signals — physicians with significantly lower infection rates, great surgical outcomes — as learning opportunities we can investigate, replicate and scale.
KW: I don't think the concept of using data to drive results is limited to any one group. Physicians, generally speaking, are scientists. However, we have worked primarily in cardiac, orthopedics and spine.
Conclusion
Today, everyone has data. To survive in a value-based healthcare landscape, organizations need a defined plan to put their data to work across the enterprise. This includes building the skills and processes to transform raw data into information with context that drives earlier patient interventions and better health outcomes.
Hospital systems that are ahead of the data curve are partnering with third-party vendors like HealthTrust for support in establishing best practices from the start. HealthTrust's team of advisors can help organizations identify valid data sources, securely aggregate information, design algorithms to meet their unique needs, and gain physicians' trust and participation in data initiatives — core competencies that health systems will need for continued success.