There was a nicely written op-ed in the Boston Globe on the issue of public disclosure of consumer-helpful information. Much is about other fields, but there are some applications to health care. I like this quote in particular:
Information about deadly risks or the way schools, banks, or airlines treat the public is not accessible if it is buried in government files or technical databases. It is not accessible if it is a year old. Access means starting with how people make choices and providing information then and there.
How much more so for the performance of hospitals and doctors? You have probably heard too much on this from me by now, but this horse is not dead yet. Look at any of the existing medical performance data bases and provide me with an example of one that is current, accurate, and understandable. Compared to what exists today, it would actually be a step forward if the public reports were only a year old. And, as I note below, some of the best, most statistically valid data is not made available at all.
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Speaking of beating dead horses, you may find this book useful for more insight into surgeons and anecdotal evidence:
Gawande, Atul. "Complications: a surgeon's notes on an imperfect science."
The author was a surgical resident at, I believe, one of the Boston hospitals. I apologize if I originally got this reference from your blog, I can't remember its source.
The book is excellent.
Great post(s) and the horse definitely will continue to have legs until:
(a) The technology catches up to the demands so that the data can be produced timely.
and
(b) We have an accurate method for evaluating the quality of a hospital or service so that an A,B,C grade can be assigned.
Pubic reporting of data is great, but it won't make a difference until the public knows that its available and are able to understand it.
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