Prescription for Change

Why health systems should be sharing performance data with physicians


When I work with our health system members, I’m often surprised to hear senior administrators express concern about sharing too much data with physicians.

When I press them on why, exactly, they are concerned, I get a few different responses:

  • They don't want to reduce physician performance on quantitative metrics
  • They don't want to distract physicians with too much information
  • They've had bad experiences in the past with sharing data with physicians, and they don't want to relive that experience

Frankly, I understand where they are coming from. Anyone who’s stood in front of a room of physicians and been interrogated about the statistical significance of a data point might not be anxious to do it again. And physicians are a critical constituency for every health system, so it pays for administrators to be careful how they interact with their medical staff.

But we think that health systems ought to embrace physician performance data—not just because their concerns about transparency are surmountable, but because using data on decisions, behaviors, and outcomes is the single best way to improve overall health care delivery in the coming years.

The horse is already out of the barn

The first argument I typically make to hospitals (and physicians, for that matter) about being more open about sharing performance data is that the horse is already out of the proverbial barn. Practically everyone else is sharing performance data, not just within the health system but with the general public.

Today, a quick scan of the Internet reveals a profusion of for-profit ratings companies like HealthGrades, government websites, and even Yelp-like services where people submit their own subjective opinions and ratings. In reality, information about physician performance is already ubiquitous, regardless of whatever decision a health system makes about sharing information about physician performance. So if a health system chooses not to embrace transparency, it isn’t forestalling the release of information into the public sphere; all it’s really doing is reducing its ability to contribute to what information is out there.

Quantitative metrics, even the best-designed and best-implemented ones, can never tell a complete story about performance or outcomes, but we’d argue that it’s better to engage in the conversation around metrics than to hope they go away.

A mechanism for strategic alignment

Not that health systems should view performance data as a defensive tactic—far from it.

Management guru Peter Drucker is often quoted (though apocryphally) as saying, “if you can’t measure it, you can’t manage it.” Even though apparently Drucker never actually said it, we have found that the quotation applies in health care as well: the best way to align health systems with their physicians is to agree on metrics of success and then engage physicians in accurate, up-to-date data.

At our annual Crimson Summit, we hear inspiring case studies every year of how health systems have aligned themselves with physicians to drive meaningful improvements, based around quantifiable metrics of success that they’ve tracked using the Crimson Continuum of Care platform. This approach works for the highest-level goals as well as it does for individual clinical initiatives.

 

Just one example I’m particularly proud of: in 2013, our Crimson Labs team created an infographic that summarized the most impactful ways hospitals could improve sepsis care—and the data that tracks their progress. Already, dozens of Crimson members have used this framework, or ones like it, to improve sepsis patient outcomes at their facilities.

Data concerns are surmountable

Despite all this promise, many health system administrators are leery about sharing performance data with physicians, because of physicians’ natural skepticism and deep knowledge of the subject area.

But when our Crimson Dedicated Advisors are working with administrators on sharing data with physicians, they almost always find that the underlying issue isn’t the quality or accuracy of the data, it’s how effectively the administrators explain what the data represents.

I’m not saying that health system executives will never have a difficult conversation with physicians around data. Sometimes data will reveal uncomfortable truths, but without the data and the resulting conversation, progress will never occur. And health systems have an enormous challenge ahead, with the imperative to manage population health better while maintaining financial margins and improving quality—it’s hard to imagine that will occur without a few challenging talks.

But ultimately, engaging physicians in performance data is most beneficial for the physicians themselves and the patients they care for. Through apps like our Crimson Continuum of Care platform, we want physicians to understand where their practice varies from others and where they could potentially be getting better outcomes, based on what colleagues might be doing differently.

We see data as a tool for learning, not judgment. Viewed that way, performance data is a companion to the peer-reviewed literature—almost a new form of medical education: practice-based, aggregated comparative data.

There’s a long way to go to reach that vision, but the first step is to engage physicians in performance data. And you can’t do that if you don’t share the data with them.

Crimson Continuum of Care members, join Nicole Latimer for an exclusive webconference on how enhancements to the Crimson platform will help engage physicians in their own performance data.

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