More orthopedic practices have leveraged data analytics to measure patient outcomes and costs. Here is how two surgeons utilize analytics at their practices.
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Editor's note: This response was lightly edited for clarity and length.
Question: How do you track and analyze cost and outcomes data at your practice? What have you learned?
Philip Louie, MD. Virginia Mason Franciscan Health (Seattle): Our cost and outcomes data are collected separately, and I am not involved much in the cost analytics. Whereas the outcomes data is carefully collected and monitored.
From a patient-reported outcomes standpoint, we continually review this data in many of the research studies that we perform. We discuss the value and importance of these data points with our patients at multiple time points, and they feel as though they are contributing to the future care of others who are going through the same thing they are. We also participate in multiple registries in which we contribute our patient reported outcomes, as multicenter efforts and collaborations are critical in improving the safety, efficacy and value of patient care. Lastly, we often will discuss these outcome scores and surveys in our various multidisciplinary conferences.
From a surgeon outcome standpoint, our hospital system tracks this data carefully. One of the major strongholds of our group is the transparency amongst each of us spine surgeons. Each month, we hold an M&M (morbidity & mortality) conference, and we review many of the surgeon-based outcomes (readmissions, complications, re-operations, patient feedback, emergency department visits, etc.). We have learned that if we are to grow and improve as a group, we need to be transparent and collaborative with all outcomes. And I think seeing that we all deal with a large spectrum of outcomes together — we have been able to develop an atmosphere in which we can openly discuss and evaluate them. In fact, we have made several practice changes in responses to these outcome metrics.
Michael Amini, MD. The CORE Institute (Mesa, Ariz.): Tracking, analyzing and improving outcomes is one of the foundational principles of the CORE Institute, and we have been doing so for the last 15 years. We set out to be the leaders in value-based care for our region, and therefore we participate in multiple value-based contracts and shared risk contracts throughout the state.
Historically, the challenge for most orthopedic groups has been accessing reliable and timely data, both in terms of payer claims and patient outcomes. Through our partnership with Healthcare Outcomes Performance Company, we have been able to utilize their vertically integrated data platforms to access clinical data, payer claims and patient outcomes in a single tool to ensure we are improving outcomes and lowering costs. Every procedure we perform is included in this data so that we can see our outcomes both individually and as an organization as a whole.
What we have learned is that improving outcomes requires more than just historical data. Having the ability to access evidence-based clinical protocols allows us to provide the right treatment at the right time and not immediately recommend surgery. If surgery is the best pathway, we also review which site of service is most appropriate based for each specific patient. If a procedure can be performed at a lower cost on an outpatient basis, that will be the recommendation. However, if the patient is at risk of complications or readmission, an inpatient setting may be recommended.