Using big data to create a quality culture in a cost-cutting era: 5 takeaways

Fostering a culture of quality in an era that places so much emphasis on cutting costs is not easy for hospitals, but using big data can help improve quality.

Alan R. Spitzer, MD, senior vice president and director of the Center for Research, Education and Quality for MEDNAX, outlined a few ways big data can be harnessed to create a quality culture at the Becker's Hospital Review 6th Annual Meeting in Chicago May 8.

MEDNAX is a national medical group specializing in neonatal, anesthesia, maternal-fetal, pediatric cardiology and other pediatric subspecialty services.

Dr. Spitzer defined big data as collections of information that are so large and complex that they require special handling and statistical evaluation to reveal information that would otherwise not be available. Dr. Spitzer proposed that big data can, in some instances, replace randomized prospective clinical trials in researching and determining care approaches that can optimize clinical outcomes for patients.

Big data has the capacity to generate and rapidly disseminate new knowledge, create personalized medicine initiatives and improve the delivery of health information directly to patients when it is harnessed in an EHR or clinical data warehouse.

To harness data, MEDNAX developed its own proprietary EHR in 1996, known as BabySteps, and began the stage the organization's clinical data warehouse is currently on in 2004.

Highlighted below are five things to know about using big data to drive quality improvements, as outlined by Dr. Spitzer.

1. For an EHR to be useful, it should be more than just a charting tool. The EHR should facilitate complex data extraction for use in coding, outcome information, research and quality improvement.

2. Data extraction that is both automated and validated is a crucial EHR feature that many healthcare providers overlook and should be careful not to underestimate.

3. Other key features of a solid EHR include conciseness of notes and the ability to confirm clinical decisions and convey information clearly to others. EHRs should also be consistent internally.

4. Unlike clinical text fields, drop-down menus in EHRs improve the conciseness of notes, enhance communication by forcing an agreement on definitions and terminology, and enable high accuracy of data extraction for outcome evaluation and quality improvement efforts.

5. Showing physicians their extracted, up-to-date outcome data — along with comparisons to their colleagues, other practices and various benchmarks — helps drive quality improvements among physicians, who tend to be competitive in nature.

"It's not enough to just show physicians their outcome data, you have to teach them what they can do about it," said Dr. Spitzer. "We've developed an education program that combines teaching about strategies in quality improvement and providing education materials to address problems."

Dr. Spitzer suggested provider organizations create similar educational programs or have their physicians attend one of MEDNAX's three clinical quality improvement summits held every year.

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