Amid the clamor in Washington over the Affordable Care Act, the medical community is trying to stay focused on improving outcomes for today’s patients—and those who will require treatment tomorrow—by finding ways to strengthen the quality of care.
Whether it’s the receptionist who confirms patient identities by making sure every file contains a photo, or the surgical team that uses an evidence-based checklist to avoid infections, improving care is an effort that benefits from widespread contributions. Medicare, for instance, is doing its part by reducing payments to hospitals that readmit patients at high rates. The program will impose $227 million in fines this year to prevent repeat visits—not a perfect solution, but good medicine for a critical issue.
Physicians care so deeply about the quality of care they provide that it can affect how they feel about their profession. A recent study by the RAND Corporation found that a physician’s ability to provide high-quality care is closely tied to job satisfaction and that obstacles to care are sources of stress for doctors.
The momentum towards providing the level of care that patients deserve shows what can be achieved when we can all work together toward a common goal. It’s a phenomenon that’s inspiring new ideas every day. Among the most promising are those that harness patient data to make information readily accessible to physicians not only on their desktops but where they need it most—at the point of care.
There are three main advantages to making information-driven healthcare a reality at bedsides and clinics.
Improved precision. Healthcare data are like pieces of a jigsaw puzzle to physicians; the fuller the picture of past office visits, treatments and symptoms, the better the outcome generally is for patients. But most physicians today have on-demand access only to data generated by their own practice. Supplementing that information with records generated at other care facilities and from patient self-monitoring allows physicians to fine-tune and confirm decisions on the spot, saving valuable time. A record from another practice showing that a certain medication had been previously tried with poor results, for instance, may help a doctor decide to prescribe an alternative regimen.
Less duplication. There are times when repeated tests and scans are needed to provide physicians with the latest picture of a patient’s current state. For example, repeat scans are warranted in hospitals when doctors need regular updates to track a patient’s progress post-surgery. But all too often, diagnostic methods are repeated unnecessarily because physicians don’t know what happened in other healthcare settings. A patient may arrive at the emergency department of the local hospital and the physicians there may be unaware of an imaging study or lab test ordered by a primary physician days earlier. Duplicating efforts in this way not only inconveniences patients and imposes unnecessary costs, but with x-rays or CT scans also exposes them to excess doses of radiation.
Better compliance. Evidence suggests that patients who understand how they are being cared for are more likely to follow doctors’ orders and ultimately experience positive outcomes. Doctors have been engaging patients this way for years, hence the familiar scene of the x-ray of the broken bone displayed on the light box. But the availability of other kinds of data, coupled with the growing prevalence of tablet computers, opens up new opportunities for engagement. A diabetic, for instance, may develop a clearer understanding of his blood sugar if the information is shown on a colorful graph rather than with rows of numbers on a piece of paper or if it’s just described by his physician.
Despite these advantages, several roadblocks are preventing providers from improving the quality of care with data. Allowing data access and aggregation without compromising security and patient privacy remains a huge challenge for proponents of information-driven healthcare. Solving that problem will require the collaboration of healthcare professionals, policymakers, and technology executives.
What’s more, many organizations lack the financial wherewithal and managerial bandwidth to delve deeper into data when they are still focused on the first step — transitioning to electronic health records from paper-based systems. Government-led incentive programs have been effective in accelerating EHR projects and should continue as a means of getting us closer to a fully digitized healthcare landscape.
If we allowing these challenges to stymie information-driven healthcare, it could prevent future generations from reaping the benefits of remarkable advances that are just beginning to emerge. Today clinical-decision support systems automatically alert pharmacists to sensitive drug combinations and the availability of intravenous medications in pill form. Years from now, similar systems will quickly analyze multiple streams of complex data to generate more nuanced suggestions in real-time. Imagine a tablet app, for instance, that could recommend a course of action based not just on a patient’s symptoms, but also family history, journal articles, and the outcome of patients in the same peer group.
Being able to synthesize and provide immediate access to this kind of multifaceted data could dramatically reshape the structure of healthcare as we know it today. Cancer researchers and oncologists, for instance, might join patients to form communities of care dedicated to sharing information and promoting wellness for all. Silos would disappear across all specialties, and in their place would rise thousands of condition-specific communities comprising doctors and patients working together toward a common end—to improve the quality of care.
Andrew Litt, MD, is a board certified neuroradiologist and the Chief Medical Officer of Dell Healthcare and Life Sciences. He is a fellow of the American College of Radiology.