From 'Cookbook' to Evidence-Based Medicine

Philip Betbeze, for HealthLeaders Media , March 4, 2011

You won't find too many physicians who will debate that point anymore. According to results of the HealthLeaders Media Industry Survey 2011, senior healthcare executives ranked quality and patient safety among their top three priorities. But it's still difficult to gather the large amounts of information necessary for best practices to be developed. At least it has been.

Paul Grundy, MD, is hoping that will change quickly. He leads a massive effort by his employer, IBM, and the Premier Healthcare Alliance, to integrate healthcare data from hospital and non-hospital care sites to measure performance and improve population health.

Grundy, who is IBM's director of health care transformation, says the effort will involve more than 2,400 hospitals and thousands of other sites of care (physician practices, outpatient clinics, etc.) Those participants will share their data about outcomes to gain insight, measure performance and improve population health. The project, they say, will support hospitals, doctors and other health providers in working together to enhance patient safety while reducing the overuse of procedures, readmissions, unnecessary ER visits and hospital-acquired conditions.

"We're moving to a place where we'll have data—and actionable information--for the first time," he says. "This is beginning to help build the tools and solutions to make use of that data."

The key, though, outside of the data, is physician direction and accountability, he says. In addition to the data component, the effort is meant to provide this information to physicians so that they set standards for themselves by which they will be held accountable. Contrast that with the old-time utilization reviews that HMOs used to employ and it's a quantum leap forward.

Regarding the purchase or use of clinical technology, healthcare leaders rated high quality care and physician alignment as their top priorities, according to the 2011 HealthLeaders Media Industry Survey.

By using cloud computing, the system is aimed at providing physicians clinical decision support, analytics, data, and a quickly accessible dashboard, so that they have much more information about the patient.

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2 comments on "From 'Cookbook' to Evidence-Based Medicine"

Michael Cadger, CEO (3/7/2011 at 12:37 PM)
Evidence-based outcomes have been discussed for decades with virtually no progress [INVALID] for many reasons but one common theme, the greatest impediment and most absurd myth: adoption requires physician consensus. If evidence-based outcome tools are to be accepted, there must be a re-prioritization of stakeholder "buy-in". Employers pay for all health care costs (either directly or through taxes) so their approval trumps all other stakeholders. In that respect, the ROI to employers of evidence-based outcomes is the key driver to adoption. Make evidence-based outcomes transparent on a provider-specific basis in employer health plans and watch the stampede of consumers flocking to the best value providers as the poor performing providers scurry to improve efficiency and quality. Practice pattern and price disparity will virtually overnight; while quality will improve. Let's eliminate this artificial barrier that stymies evidence-based outcomes. And let full transparency and market forces apply to health care just like every other sector of a free-market economy. Employers, transparency and free-market competition are the answer. Michael Cadger, CEO Monocle Health Data, LLC

Lisa Sams MSN, RNC (3/4/2011 at 6:14 PM)
Clearly technology is an essential tool to speed the adoption of evidence based practice. This article speaks to only one facet of our laggardly use of evidence to improve care for our patients. The environment of care itself is central to how, why and when clinicians adopt innovation. Greenlaugh and team's extensive work with the complexity of organizational cultures offers insights that can aid the success of new tools outlined in this article. Tools will help, but quality clinical care will only be achieved when we learn to work as high functioning interprofessional teams committed to improving outcomes for the people who depend on us...our patients.




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