In the airline industry, safety not only
depends upon the pilot to do his/her job properly; it also
depends upon the air traffic control tower. Without someone
overseeing the entirety of the airspace, it would be
impossible for aviation to maintain its current level of
quality and efficiency.
The health care industry is not so different, according to
Isaac Kohane, MD, PhD, professor of pediatrics and medicine,
as well as co-director for the Center for Biomedical
Informatics at Harvard Medical School. Kohane believes that,
in order to maintain a safe and efficient practice,
physicians must be able to use the data contained in their I.T.
systems, to track quality improvements and catch problems
before they turn into the medical equivalent of a mid-air
collision.
"As physician leaders, we are uniquely advantaged to
observe care patterns at our own facilities," says
Kohane. "You don't need to wait the years it often takes
for the Centers for Disease Control to inform you about
dangerous trends happening in medicine. There's a lot that we
can learn today, right now, if we just take the time to look
at the data."
Catching
Up with the Data
Kohane believes that because the medical industry has not yet
wholly embraced data-driven care, overall quality is not up
to the standards that the ARRA legislation is now demanding.
"For years, caregivers have been 'flying blind,' so to
speak, because there hasn't been anyone in our control tower
monitoring what's really going on," he says. "We're
facing man-made epidemics, and we're risking our patients
lives as well as our businesses if we don't change."
Kohane cites a research study he participated in at two
prominent Boston-area hospitals with the drug Avandia, as an
example of how patient data can close the gap between
government regulation and current practice. "We were
noting an increase in heart attacks over a span of several
years relative to other oral hypoglycemics in the same drug
class. And we were seeing this trend before other hospital
systems and regulatory authorities were aware," he says.
"By extracting data from their I.T. systems and
examining the trends, our teams were able to determine that
there was a correlation between the drug and the heart
episodes. And even before the FDA made any public
pronouncement, we were able to quickly predict those patients
who were at increased risk of a cardiovascular event."
Trending
for Improved Outcomes
If physicians spend more time looking at their own hospital's
radar scope, Kohane believes that they will be better
equipped to bring the results of reporting and research to
their individual patients, which means better outcomes in the
long run.
"We can predict a patient's total length of stay, with
75 percent accuracy, simply by examining lab results on their
first day in the Emergency Department. We've been able to
determine instances of domestic abuse well before the
Department of Social Services can," he says. "By
bringing these areas of research and individual practice
together, we can ensure that our patients will always receive
the most appropriate care for their situations."
And while ARRA has put considerable strains on care providers,
Kohane sees great promise ahead for those who become more
data-focused. "Technology has put us on the verge of a
major revolution in care surveillance and diagnosis," he
says. "The time for change is now. By using tools like
the EHR, we can make a real difference in the lives of our
patients—today, as well as in the years to come."
MEDITECH
Medical
Information Technology, Inc.
MEDITECH Circle
Westwood, MA 02090
781-821-3000
www.meditech.com