Patient Safety Perspective: Eliminating Data Lags Could Enable Better Preventive Care
Commentary by Della Lin, MD, Senior Fellow, American Hospital Association, Senior Fellow in Patient Safety, Estes Park Institute, adjunct faculty, Institute for Health Care Improvement (IHI), and faculty, Jefferson School of Population Health Quality Safety Leadership Series (QSLS).
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With the huge potential of information technology, it is important to avoid looking at it as a panacea to solve all our problems. IT should be viewed as part of a socio-technological system that comes together to help the patient. We should think of IT as an added member of the health care team, not a replacement for the team. Data and technology may be beneficial, but they must fit the workflow.
One of the problems now is there is so much data available it can be hard to pull out salient information. Another problem is in the feedback lags that occur in the data we work with. If data comes to us three to six months after the event occurred, such as with an adverse drug reaction or an unintended consequence to newly placed technology, that sub-optimizes the potential use of the data.
We need data that’s more immediate and meaningful. For example, data and patterns about an emerging disease outbreak can have huge benefits to a population when the information is shared as close to real-time as possible. We need to change how we look at data from something that is to be followed up on, to something that will be followed during care. This shift will also require changes to IT systems and a mind shift in how we share data.
Nationally, the PCORnet has just announced it’s looking at patients with Hepatitis C and conducting a comparative effectiveness analysis of the new, effective and costly treatments. Getting this information promptly can have important ramifications on how a community or ACO will effectively manage these patients as individuals and as a community.
On a local level, hospitals could benefit from information systems that aggregate data from different sources and use predictive analytics to tell them which patients are most at risk to develop certain problems that day. That concept could be expanded beyond the hospital to improve population health. With timely data and analytics, we could create early warning systems for patients at home based on their environment, health and other factors. With an early warning system, we could develop appropriate preventive care and thriving strategies for patients and populations — e.g., targeting high-risk patients with something more specific than a shotgun approach.
Some of the information needed to power these analytics programs would come from sources outside the hospital, which highlights how the hospital’s role in patient care is changing. Hospitals still have leadership and command over managing patient outcomes, but they no longer have as much control as they once did. Imagine the power of information combining the analytics of mobile technology, doctors’ offices, hospitals, retail-based clinics, pharmacies, health plans and the community department of health!
That’s one reason it’s important to view technology solutions as part of a socio-technological system, and to make sure all components are aligned and integrated. The “follow during” concept has amazing potential we can tap into. The challenge will be to develop systems and processes to make it possible.
