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In healthcare, better data early means better outcomes later

January 7th, 2016

by Carmela Coyle

It’s been a running theme in healthcare for decades--data, data and more data will be the panacea for all of the ills (figurative and literal) that providers face every day.

And, generally, data has proven to be a useful tool on many fronts, an article from the Journal of the American Health Information Management Association points out, from large predictive analytics to better information sharing among disparate providers. But its effectiveness, of course, waxes and wanes based on its integrity, as well as on the women and men who use it to inform how they provide care to patients.

Here in Maryland, data has played an important role in helping Maryland’s hospitals improve quality and contain spending, as detailed in a recent Health Affairs blog post. One of the notable achievements in the first year under our new fixed-budget payment model that incentivizes population health management and care coordination is a more than 26 percent reduction in the rate of potentially preventable complications--infections and other conditions that patients acquire while being treated, none of which they expect or deserve.

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Data, particularly a focus on the coding process during patient intake, has been among several factors driving the improvement. Under Maryland’s model, hospitals are required to reduce both potentially preventable complications and readmissions--goals that have generated the development of innovative and effective practices.

For example, when patients are diagnosed with one of a select 65 potentially preventable complications, many hospitals undertake a second, more intensive review of that patient’s conditions and treatment plan. The idea is that a more complete picture of the patient’s health better informs both short- and long-term clinical decisions.
Of course, obtaining accurate patient data from the outset is just the start of successful treatment. Maryland’s hospitals have also revamped care delivery procedures. Examples range from the complex--like the creation of multidisciplinary teams to specialize in treating specific illnesses--to the simple, like changing computer screensavers to two-hour countdown clocks so nurses can be reminded when to shift patients’ positions in their beds.

In addition to the reduction in potentially preventable complications, in-hospital mortality rates are down 21 percent, volume among high-utilizers has decreased more than 5 percent and readmissions rates are declining faster than the nation as a whole.

These improvements are valuable enough in and of themselves, but there’s another bonus derived from the focus on accurately capturing data early on--it significantly improves the reliability of that data. For all the grand promises that Big Data has made to improve healthcare, its lifespan has been riddled with obstacles, from human error to IT challenges to data overload.

Because Maryland’s all-payer model relies on the accuracy of its data to be successful, it means hospitals have a strong baseline of knowledge about their patients, and can design and implement practices that meet the needs of those patients.

Even these gains are only a starting point. No single hospital is experiencing wild success on all measures, and there’s much work to be done to identify valuable and reliable data, and then connect it with clinical care delivery. Still, one thing is certain: the more reliable information caregivers have early on, the better care they can provide.

Carmela Coyle is president and CEO of the Maryland Hospital Association

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