The annual report shows there is not as much of a direct relationship between quality and cost as one would like to see. But I applaud Massachusetts for producing this report. Recognizing and understanding a problem is the first step in creating a solution to the problem. One cannot create a value-based system without understanding the existing quality and cost.
This is one of the reasons why, several years ago, the BIDMC leadership posted my hospital’s quality data online for public consumption (www.bidmc.org/QualityandSafety.aspx). The BIDMC website even features a short video of hospitalist Ken Sands, MD, who also happens to be the vice president of quality at BIDMC, telling you about the hospital quality data. Before the hospital posted this data online, most of our hospital staff and providers, let alone our patients and their families, were unaware of the data. BIDMC is not the only hospital who does this. I understand Cedars-Sinai Medical Center in Los Angeles and Dartmouth-Hitchcock Medical Center in New Hampshire have long shared their quality data publicly.
But the truth is, if you look hard enough, you can find these data for just about all acute-care hospitals in the country. Start with Medicare’s Hospital Compare website (www.hospitalcompare.hhs.gov). However, BIDMC and others have simply made it easier to find the data by putting it directly on their websites.
Policy of Transparency
An interesting thing happened over the past decade at BIDMC. In 1997, there were no hospitalists who cared for BIDMC patients. Today, hospitalists manage nearly 100% of the patients hospitalized on our large medical service.
When you look at the data being reported by BIDMC and the state of Massachusetts about nonsurgical conditions, doesn’t that reflect the care being provided by the hospitalists who work at BIDMC? I imagine that is what will run through my CEO and CFO’s minds when we discuss the hospitalist budget this summer. They will ask themselves, “What is the value of our hospitalists? What is the quality of their care? How much do they cost us?”
Some of you might be in a similar position. Do your hospitalists now provide the bulk of the care at your hospital? Are your hospital’s data being publicly reported? I think the answer is a resounding “yes” for many of you.
Allow me to ask this question: What are you doing to collect data to understand the quality and cost of your hospitalist program? Wouldn’t you rather know this information before your hospital or state government tells you?
As the director of my hospitalist group, I spearhead our group efforts to better understand the quality of care we provide. This proactive, introspective approach is essential, especially if hospitalist groups around the country hope to continue being perceived as “high value” providers.
I am interested in hearing from you about your efforts to understand the care being provided by your hospitalists. Feel free to email me at [email protected]. TH
Dr. Li is president of SHM.