Road to Recovery? Medicine Moves from Proficiency-Based Art to Data-Driven Science

Wednesday, March 5, 2014

Author: Rick McGuire

One year ago, our cover story looked at NAVIGATING 'THE VALLEY OF DEATH,' based on the "creative destruction" sweeping through health care. As William Zoghbi, MD, then ACC president, put it: "This change is mammoth, it is historic, and it affects everyone's life involved in health care." Like last year's cover story, we returned once again in January to the ACCF Cardiovascular Summit: Solutions for Thriving in a Time of Change. Once again, whether you thrive—or survive—may mean the difference between steering a strategic course focused on solutions versus wandering the desolate valley of shifting expectations and accountability.

Some days it may seem more like the Road to Perdition, but—at least compared to this time last year—signs suggest it’s more a Road to Recovery. Still, it largely remains under construction so expect plenty of delays and obstacles ahead.

The problem continues, as it has for several years now, that everything is happening at once. Suzette Jaskie, MBA, president and chief executive officer of MedAxiom Consulting, points to a convergence of critical changes occurring across the health care industry:

• changing payment paradigms
• industry consolidation
• rise of the consumer (e.g., demand for transparency)
• the data revolution (driving performance)
• looming physician shortages

One example of these changes: Despite an aging population, hospitals are experiencing a drop in volume, from 123.2 inpatient stays per 1,000 population in 1991 to 111.8 in 2011. Their response? Jobs cuts in an effort to be more efficient and more effective; some hospitals have even closed their doors altogether. An accumulated total of 275,000 lost jobs are projected by 2022, according to the American Hospital Association.

Ms. Jaskie said, "Physicians not only have to be ready to respond to these changes but also lead us through these changes and retain control of your industry."

She added, "What's happening inside hospitals is a reaction to the economics. Cost-cutting has primarily been tactical—meaning we’re reducing staff and trying to cut supplies—but we’re not doing the hard work, yet, of re-engineering the way we work." Importantly, she emphasized the word "yet" because clearly she thinks re-engineering is inevitable—and coming soon.

One doesn't have to travel far to understand why re-engineering will be coming soon to a hospital near you. Cost transparency, for example, is driven by data, such as the fact that a pacemaker implanted in Livingston, New Jersey, costs $70,712, while 22 miles away in Rahway, New Jersey, implanting the same pacemaker system racks up a bill of $101,945. Recently the Centers for Medicare and Medicaid Services (CMS) released common procedure cost data and states have started requiring transparency of commonly billed procedures, with North Carolina hospitals tracking 140 most common procedures and Arizona the top 50. Some health systems are voluntarily posting cost estimators and common pricing. Knowledge equals power, and this puts the power of the dollar into clinician and consumer hands.

Read the full story at http://www.cardiosource.org/News-Media/Publications/CardioSource-World-News/2014/02/Road-to-Recovery-Medicine-Moves-from-Proficiency-Based-Art-to-Data-Driven-Science.aspx?w_nav=CVNewsDig