The Waze of Healthcare
Newtown, CT - October 16, 2015
If you spend any amount of time in your car, you either know of or use Waze - The concept of Waze is simple. It aggregates data from its users and feeds it back real time. The more people use it - and there are close to 100 million that do - the better the data. In places like Los Angeles, traffic patterns have shifted because Waze provides you with immediate alternatives to the congested traffic ahead. What makes the app far more useful than alternatives is that it helps you quickly differentiate routes and make far better decisions than you would on your own. We naturally should wonder why, therefore, there isn't a Waze for healthcare. Every day millions of Americans go to a physician's office, a retail walk-in clinic, the outpatient department of a hospital, a lab, a diagnostic imaging center, a pharmacy. They go there based on incoherent, incomplete, and mostly incorrect information. That trifecta of useless data was compounded recently by the deterioration of Hospital Compare on the Medicare web site. And the really sad thing is that it's by design, not by accident. Medicare's method for calculating hospital scores creates an overall lack of differentiation. It squeezes scores to the average, leaving a handful of outliers on either side as either "good" or "bad". The same is true for most of the measures that are endorsed, collected and reported on "official" websites. That results in a Haze, not a Waze.
What this means to you - Earlier today Catalyst for Payment Reform released a report on a parsimonious list of priority measures for employers to focus on. These measures are not widely collected or reported today because, contrarily to the Haze, they would actually differentiate provider performance on quality outcomes that matter to patients, such as optimal diabetes care, blood pressure control, high quality maternity care, and low rates of avoidable complications in patients with chronic conditions. We encourage employers to read the report and engage their third party administrators in ensuring their systematic collection and reporting. CPR's call to action comes on the heels of a bold move by the American Board of Orthopedic Surgery to use the surgical complication rates published by ProPublica as part of its decision to renew the Certification of surgeons. Orthopedic surgeons, more so than many other specialties, are particularly sensitive to shifts in the volume of their patients. They have also been widely targeted for bundled payments and know that the inevitable price compression that is coming can be countered by greater traffic of patients. And that probably means thinning out the ranks of those whose skills aren't up to reasonable standards. The upshot is that scorecards like ProPublica's and CPR's respond to a very clear and definitive consumer need to know which physician or facility will do a better job taking care of them. They also pave the way for the Waze of healthcare. Those that have benefited from the Haze will resist, but there's little that can stop 100 million people.