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Data Transparency: When the Numbers Don’t Tell the Whole Story

Resource issues, high-risk patients can make health care quality appear worse

Data transparency is a priority for hospitals and health systems, but raw data often don't convey the nuances of care quality, according to an article in U.S. News & World Report.

Even as more data are available to show which providers are low performers, far less information exists on why they are low performers, writes Elaine Cox, MD, medical director of infection prevention at Indiana University’s Riley Hospital for Children. This means that financial penalties may punish providers for what amounts to limited resources or a particularly high-risk patient population, a concern also raised by the American Hospital Association (AHA).

Data transparency is even more susceptible to missing the big picture when it comes to individual providers or specialties, according to Cox. For example, the field of congenital heart surgery is complex and nuanced enough that when physicians take on high-risk patients with low chances of survival, raw data are unlikely to provide the proper context.

“We need stratified information on outcomes and complications based on the complexity of the cases themselves in ways that truly allow fair comparison,” Cox writes. “We need to find a just culture of interpretation of data so that organizations and individuals are not unfairly judged. We need opportunity to pursue innovation and continuous improvement. We need a system that allows heroic efforts for the individuals that otherwise would not have a chance at survival. That is why so many physicians devote years of their life to honing their skills, and that is what our children deserve. We don’t want to lose that in the data.”

In March, the AHA called for changes in the Hospital Readmissions Reduction Program (HRRP) to avoid penalizing facilities for readmission factors beyond their control.

“While hospital readmissions are declining, there are serious questions about how the HRRP assesses penalties that affect the fairness and long-term sustainability of the program,” the AHA said in its report.

Sources: FierceHealthcare; September 1, 2015; U.S. News & World Report; August 31, 2015; and AHA; March 20, 2015.


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