Sharing Clinical Data to Improve Quality of Care and Outcomes

In a major boost to comparative effectiveness research, six of the nation’s top healthcare organizations announced that they will share clinical data in an effort to improve quality of care and reduce expenses for several common but costly conditions and treatments….

The Cleveland Clinic, Dartmouth-Hitchcock Medical Center, Denver Health, Geisinger Health System, Intermountain Healthcare, and the Mayo Clinic have a combined 10 million patients. They will work with the Dartmouth Institute for Health Policy and Clinical Practice to determine best practices and disseminate actionable recommendations throughout the medical community. Results should start being available within a year or two. 

Marc Harrison, MD, chief medical operations officer of the Cleveland Clinic stated that, “The goal of the collaborative is to improve the efficiency of standard clinical care delivery to reduce the per capita cost in these conditions and to keep costs in line with the Consumer Price Index.”

The collaborative will focus on 8 conditions and treatments “for which costs have been increasing rapidly in recent years and for which there are wide variations in quality and outcomes across the country,” according to a news release. The 8 conditions and treatments are; knee replacement, diabetes, heart failure, asthma, weight loss surgery, labor and delivery, spine surgery, and depression.

“What makes this collaboration so unique is that we have 6 systems, each already distinguished as providing high quality in a cost-conscious way, seeking to share best practices with each other and the entire medical community,” Dr. Harrison said. “This project is for real-time rapid cycle improvement among competitors.

“We plan on writing papers in mainstream medical journals,” he said. “We want to be completely transparent about what we identify as best practices. We understand that the least expensive option isn’t always the best value option. We’ll function on the premise that there’s no ‘secret sauce’ that only we possess. Our responsibility is to share what we learn so that optimal care models can be replicated across the country.”

Other medical leaders of the 6 organizations echoed Harrison’s sentiments. “By collaborating to gather data and identify the most effective care models, we can address variation in treatment, cost, and outcomes to give patients the quality care they need and bend the cost curve down in a meaningful way,” Brent James, MD, chief quality officer at Intermountain Healthcare, said in a statement.

Robert Nesse, MD, chief executive officer of the Mayo Clinic Health System, noted in a statement that, “If we know that the treatment path for diabetes at one institution results in better clinical outcomes, higher patient satisfaction, and lower overall costs, then there is knowledge to be shared and replicated in other institutions. “We need to learn from each other and put systems in place that ensure that every patient gets the very best, most appropriate care, every time.”

Comparative effectiveness research is controversial among physicians. Although most believe that it can improve the quality of care, they also think it will limit their clinical freedom. In a survey published in the October 19 issue of the Annals of Internal Medicine, 56.5% of physicians agreed that national guidelines should be developed to influence clinical practice, and 55.2% said they believed that comparative effectiveness research would improve the quality of care. However, almost two thirds agreed with the statement: “Comparative effectiveness data will be used to restrict my freedom to choose treatments for my patients.”

Medscape Today, Dec. 17, 2010