Thursday, October 28, 2010

Transparency arises in the South

Novant Health is a not-for-profit health care organization serving more than five million residents from Virginia to South Carolina. Their team recently decided to dramatically expand the degree of transparency they provide with regard to clinical outcomes.

Paul Wiles, Novant's President, said to me: "We are delighted that you are willing to let your readers know of our efforts to enhance the field with respect to transparency of clinical information."

If you go to this website and click through the various categories, you will see an honest and open exposition of how they are doing on central line infections, ventilator associated pneumonia, and other important items. They mean it when they say that they are "committed to providing clear, accurate and honest information about the quality of care we offer to all of our patients."

Here's the VAP chart, which is illustrative, too, of the presentation of quite recent data. Why wait two years for national numbers based on administrative data when virtually every hospital collects real-time data on actual clinical outcomes?

Paul continued, "Our latest quarter is now posted. We had some improvements, some the same and unfortunately some declines in our performance. With our results in the public domain we have a real incentive to make our results better."

This view is consistent with what I have said before:

Transparency's major societal and strategic imperative is to provide creative tension within hospitals so that they hold themselves accountable. This accountability is what will drive doctors, nurses, and administrators to seek constant improvements in the quality and safety of patient care.

Congratulations to everyone at Novant for making this commitment. Do I detect a movement? Will the Boston hospitals join in?


Leigh Hamby said...

Hi Paul, as southerner I feel compelled to share that our system has posted our infections on our public website for a couple of years now.

Anonymous said...

Thanks, Leigh. Awesome! (It IS a movement.)

justme said...

This is important information the public needs to make informed choices. Consumer driven healthcare has people shopping for best value as defined by service, quality and price.

I find John Torinus' book "The Company That Solved Healthcare" compelling and would be interested to know your thoughts

Anonymous said...

Haven't seen it, but I don't know anyone who has solved health care! Explain why you think it is helpful, please. Thanks.

Anonymous said...

Novant recently acquired a large community hospital in one of the less affluent counties in my area - and the acquired hospital cited its commitment to quality programs in the decision to affiliate. Good to see them take it one step further.

As for Boston, I recently visited your fair city and, finding myself near Mass General, walked down the hill to take its picture, because it WAS famous in medical lore when I trained in the '70's. But when I read things like this, I have to wonder why they maintain this lustre. One can only coast on reputation so long - it's time to back it up with facts. Right now, if I had to recommend an academic center in the area, I'd pick BID; I sure know more about it.

nonlocal MD

Anonymous said...

I know that there is little or no evidence that patients choose hospitals based on actual quality of care. But I believe that that, too, will change. Parallel to new transparency in leading quality institutions is a generational change in patients as consumers. The next generations are less likely to think of their physician as keeper of magical powers, and more likely to shop for a new one online. Trust in medicine is reaching new lows, and the lack of real health reform will not be helpful. Empowered consumers and good comparative data go hand in hand. The genie, thanks to you and others, is out of the box.

sammack said...

There will be a resolution up for vote at this weekend's AMA conference in San Diego dealing with transparency at the individual physician level. It can be read in full on the AMA website (, but the Resolved clause reads as follows:

RESOLVED, That our American Medical Association encourage development of public and hospital-based reporting systems that create transparency in individual physician performance to stimulate quality improvement and better-informed patient and physician decision-making. (New HOD Policy)

As a note to you, Mr. Levy, I'm a medical student who attended a talk you gave at our regional meeting in Providence last winter. I also happen to be the author of this resolution. If you've got time before the end of the week, I'd love to hear from you, if only for the sake of assembling enough fodder to see this through.

Sam Mackenzie

Anonymous said...


Go for it! Not that I am a member of the AMA, but sometimes it's good to work from within. Will be following this with interest!

nonlocal MD