Doctors want to know about their own patients - are they getting better under our care or not? Departments need to have the data to know where and when to build programs around real patient needs.
Clinical Looking Glass is the tool I use to create a data-driven culture of quality throughout our department. CLG lets us see our patients' data any way we want it, transforming the data into actionable information. We track the relationship between each patient's progress and their treatment plans over time; we discover failing patients and bring them to the attention of physicians for remediation; and we produce reports on both an individual physician and a department-wide basis.
Time to Event: Track the Trajectory of Results Over Time
CLG’s Time-to-Event capability is a wonderful feature. It allows us to treat each patient as an individual, looking - for example - at how the individual has progressed subsequent to the first visit. This contrasts with most data mining tools, which require that you specify an overall time period for the whole group of patients under study without regard for when each individual person started treatment. Methodologically CLG's approach is unique and much more valuable.
Reinforce Good Results
One area that I pay particular attention to is using the data from CLG to reinforce good results. Quick comparative studies that we do with CLG help me to open up important discussions among the clinicians about how we can continuously improve and enable the results of our top performers to flourish throughout our department. CLG lets me help individual physicians better understand their personal panel of patients.
I am also responsible for coordinating care across the clinical departments with other chairs. I recall an important conversation I had with the surgical leadership who did not want to encourage the use of local anesthesia for patients aged 65 and over because of perceived risk of mortality. I argued that there was a corresponding risk using general anesthesia. We were at loggerheads. To resolve the impasse, I brought my surgical colleagues to my computer and quickly created a CLG study to see what was happening to our patients under both anesthesia regimes. In less than ten minutes I was able to show the surgeons (and myself) that, in fact, there were no greater complications using local anesthesia. The surgeons accepted the analysis and agreed to continue treatment with local anesthesia. This would not have been achieved without CLG.
Improve Quality of Care
Keeping quality improvement efforts front and center is an essential role for a department chair. One of the techniques I use is to post CLG-generated story boards in the hallways of my department. This way not only the doctors and other staff, but also the patients and their family members, can see that our department team is committed to paying attention to achieving measurable and high quality results.
It is sometimes a challenge in primary care, where physicians cover for each other, to attribute patients' results to individual clinicians. This issue is becoming increasingly important as we focus on building accountability and meeting regulatory requirements. I use CLG to peruse patient data to see if a PCP is designated; if not, whether the patient has been seen frequently by one physician; and, if still inconclusive, to see who is ordering the tests or making the referrals that a PCP typically makes.
Going forward, I see CLG becoming even more important. Soon we will be reimbursed differently, perhaps under pay-for-performance, or as part of an Accountable Care Organization, or in some other way that creates a financial incentive for producing better outcomes, not just for performing procedures. When we start to see opportunities for getting more revenue by delivering higher quality, CLG will become an invaluable tool for revenue production.
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