Modern Healthcare By Laura Green | June 1, 2015
ASHINGTON—Making health data more widely accessible and useful to patients and providers could change communities.
That’s the message resonating during the first day of the three-day Health Datapalooza conference, held in Washington, this week.
Farzad Mostashari, former head of the Office of the National Coordinator for Health Information Technology, said health data must be actionable and providers must be ready to respond to it.
A doctor receiving a notification that a patient is in the emergency room should realize that means money and opportunity lost, Mostashari said. An office visit, instead, could bring his practice $700 and save his patient from unnecessarily intensive treatment at the hospital.
Too often doctors are stuck in the fee-for-service model and focus on how to see a waiting room full of patients rather than how to provide the best quality care. Eliminating unnecessary hospital visits is key to that mindset shift, Mostashari said.
During a conversation about data sharing that’s working, Craig Brammer, CEO of the Health Collaborative, told the story of a Cincinnati girl. Her doctor diagnosed her with asthma. Then, for the next year, as far as he knew, her condition had not flared. That’s because when she had an attack, her grandmother took her to the ER.
Over the year, the family made five emergency room visits — all without the primary care doctor’s knowledge.
That sort of disjointed care is not uncommon in the American healthcare system. But it could be if the seamless data sharing system now employed by providers and hospitals in Cincinnati became a nationwide practice.
Under the Cincinnati system, the doctor received an electronic notice when the girl registered at a hospital, even if the hospital was part of a competing chain.
Her doctor became more proactive and the health system worked together to keep her well. A year later, the little girl had no more hospital visits.
“They wrapped her and her family with a care management plan,” Brammer said.
Monday’s conference sessions included plenty of stories of health data widely shared in some communities and data that is inaccessible in others.
Open data must move beyond local doctors and hospitals, speakers urged.
Jonathan Mathieu is chief economist at Colorado’s Center for Improving Value in Health Care. The Denver-based not-for-profit organization runs a database that includes information from Colorado’s largest commercial insurers as well as from the state’s Medicaid and Medicaid programs. The data they collect allows consumers to compare risk-adjusted average prices and quality metrics for a variety of medical procedures by provider and payer.
Mathieu says decisions about how to evaluate and change healthcare in response to the data are often best made close to home.
“Like politics,” he said, “healthcare is local.” “A lot of really neat things are going on at the local, regional and state levels,” Mathieu said. “We need to leverage those things.”
In Cincinnati, CEOs, health system managers and community groups were faced with data telling them the city had a serious problem of children born addicted to drugs. With the facts in front of them, Brammer said, decision-makers agreed “nobody goes to the bathroom, nobody looks at their phone til we solve this.”
After a candid conversation, the group promised to push for mandatory urine tests for pregnant mothers. Prosecutors and providers agreed that doctors would not share test results with law enforcement. Babies are now spending fewer days in the neonatal intensive care unit, an indicator that they are getting prenatal care that improves their health at birth, Brammer said.
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