Involvement of physicians in data-driven health care

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Before the Covid-19 pandemic, doctors were in tune with the operational and financial challenges facing most hospitals and healthcare systems. They were not necessarily experiencing these challenges first hand.

However, when the paperwork was canceled and the demand for supplies skyrocketed, the experience became more personal. Many physicians experienced a sharp decline in income as well as the challenges of securing adequate medical supplies when needed. They also saw how the industry’s struggle to create clean, standardized data shared between systems made it harder for front-line workers to fight the pandemic. For many physicians, this experience served as a recovery, giving them a broader perspective on their role in the healthcare ecosystem, especially when the industry seeks to recover from the financial impact of the pandemic.

More than ever, doctors are committed to helping address the financial pressures facing providers, playing an increasingly critical role in the rush of healthcare to become data.

Breakdown of data silos

The shift to a value-based care model has placed even more emphasis on data to help healthcare finally understand the true cost of providing care, including the cost of supplies, the expected outcomes of patients. and how to reduce unjustified clinical variation. Today, few hospitals and health systems have a comprehensive understanding of where variation lies; doctors have even less visibility.

The next step in data transparency is for hospitals to analyze the cost and variation at the physician and case level and give physicians access to data and evidence to fully understand the cost per case, the cost per discharge, and the results. of the patient. The good news is that many healthcare organizations have been investing in technologies and systems, including EHRs, ERP and supply chain automation, to modernize your infrastructure and business processes.

Use of data to drive visibility and collaboration

We know that unjustified clinical variation can have a negative impact on patient outcomes, while at the same time increasing hospital costs. As clinically integrated supply chains become the norm, it will be easier to identify where and why variation occurs. Specifically, we will have a broader view of physician use, identifying differences in how a particular product is used and whether the product has an impact on local outcomes, such as operating room time, length of stay, and readmissions. This improved visibility will allow hospitals to have a clearer picture of supply costs per case by a physician. Data combined with clinical evidence will allow supply chain teams and physicians to work together to understand where the data supports the use of a particular product (and, consequently, where not). and develop strategies that will reduce unwarranted variation.

We use antimicrobial mesh envelopes as a hypothetical example of how we can link data and clinical evidence to local results to understand whether a premium product is right for an organization. A randomized controlled trial could show that the use of antimicrobial mesh envelopes reduces infection rates by 5% (reducing surgical site infection rates from 1.2 to 0.7%). While it may be tempting to decide only on the basis of numbers, it is important to evaluate all the data to understand whether standardization will have a measurable impact on the organization. The data provide a critical insight into the decision-making process.

For example, it may indicate whether the use of the mesh is appropriate in light of the current state of infection at the organization’s surgical site, and it may help supply chain teams to evaluate the volume of mesh purchased in comparison. with the industry standard. EHR data can be used to evaluate the use of the product in specific procedures and specific patient populations. Local outcome data can help find out surgical site infection rates in cases that use this product and those that did not. When we put this information in the hands of physicians, it will facilitate more informed and collaborative conversations with supply chain teams about product selection and use, ensuring a patient-centered approach as the organization pursues strategies. cost optimization.

A Southeastern hospital took this approach by sharing clinical evidence on the effectiveness of using a type of antibiotic-laden bone cement with its doctors. Following a data-driven discussion, physicians agreed to follow the evidence-based guidelines for adjusting the use of this product only for high-risk patients. The healthcare system was able to reduce the clinical variation of this product, reducing annual costs by more than $ 500,000.

The healthcare business is in the midst of a complex but exciting transformation. We need to recover from the financial losses of the pandemic as we continue to accelerate the shift toward value-based care. We also have to deal with a growing number of non-traditional competitors entering the healthcare market, such as Amazon Care, CVS and Walmart, as well as the rise of consumerism. Meeting these challenges requires a new level of efficiency and financial, clinical and operational agility.

The pandemic underscored the role of data in the future of healthcare. It also created more strategic and lasting partnerships between the supply chain and physicians. To move forward, we need to build on these relationships to better understand how supply options influence the total cost of care, reimbursement, safety, quality, outcomes, and patient experience.


About John Cherf, MD, MPH, MBA

How of Lights The medical director, Dr. Cherf provides clinical and organizational leadership for the development and application of evidence-based knowledge. It works closely with health systems to design programs to reduce care variation and to implement specific initiatives. He previously served a five-year term as head of orthopedics at the Illinois Masonic Medical Center. Dr. Cherf has more than 20 years of clinical experience in sports medicine and knee surgery.




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