Thursday, April 26, 2012

Old data is valueless

A part of my presentation to folks in Denver related to the organizational value of clinical outcome transparency in helping the clinical staff to hold themselves accountable to the standard of care that they value for their hospital.  (Regular readers of this blog will not be surprised by that message, as I have been making this case for a long time!)  One person later suggested that this was being accomplished in Colorado because the state government has had a website for several years with publicly reported data.

Well, not so.  Sure, there is an official website, but the data contained is old and not helpful for the purposes I have set forth.  Here, for example, are the rates for central line associated blood stream infections.  The data is from 2009 and 2010.  The chart says nothing about the current state of things.  Try to imagine how you could possibly use the posted information in your hospital if you were committed to reducing patient harm.  You really cannot.  As I have noted with regard to another such site run by CMS and a recent report from the CDC, unless real-time data is presented, such presentations offer no value to clinicians in helping to improve care in their organizations.

The existence of government websites of this sort does not preclude a hospital or group of hospitals from expanding the concept of transparency and offering value to the clinical staff by posting real-time information on progress in reducing infections and making other clinical improvements.  Whether such transparency is adopted is solely a matter of local choice, and each place needs to make its own decisions as to the value thereof.  The hospitals in the New Hampshire Hospital Association, for example, have to decided to present a website with much more recent information on topics of interest to them.  This is part of a jointly determined common goal of eliminating patient harm over the next few years.


Toni Brayer, MD said...

I totally agree. Old data just gets ignored (as it should)and it is a waste of time...or worse a distraction from real improvement.

Logan said...

Organizations can contact their state QIO (Quality Improvement Organizations) if they want fairly up-to-date data. Even better, QIOs work with organizations to build and track claims-based QI measures. There is still a 2-3 month delay but thats the best they've got. QIOs provide these services free of charge under a CMS contract. I work as an analyst at a QIO and we continually seek to get health care providers to partner with us in QI collaboratives using PDSA cycles and almost real-time data.

Anthony Begando said...

Amen. I could not agree with you more. Hospitals and health plans cannot base their analytics on years old information. They must leverage real-time data driven from current provider, procedure, and outcomes information to judge performance and manage risk.