Show Us the Evidence

December 31, 2009 by Mark Hagland
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With a solid IT foundation in place, hospitals are leveraging data to establish new clinical guidelines and change the face of patient care.

  • At Abington (Pa.) Memorial Hospital, leaders have implemented a software program that has brought evidence-based guidelines and clinical decision support to nursing and to the respiratory care, physical therapy, and dietary areas of the hospital. Not only do the clinicians love the program (from the Grand Rapids, Mich.-based CPM Resource Center), but the use of evidence-based guidelines in allied health areas is “changing the conversation” around how care is delivered at Abington, says Barbara Wadsworth, R.N., senior vice president, patient services, and CNO. Alison Ferren, vice president and CIO, says, “Implementing knowledge-based charting in nursing (and other allied areas) has really changed the way we've used clinical systems. It's really about getting the clinicians and the IT department to work collaboratively on care processes to provide the best care.”

    • All of these case studies present “irrefutable evidence” for data-driven, evidence-based care, according to Jeffrey Bauer, Ph.D., a healthcare economist and futurist who is a Chicago-based partner in management consulting at ACS Health Care Services (Dallas). In fact, Bauer is such a strong believer in evidence-based care that he says, “It should be made mandatory - at the level of the individual patient care organization, rather than at a federal agency level,” and implemented with intellectual rigor and objectivity. In addition, the whole evidence-based movement, he and other experts note, is strongly aligned with the desire of purchasers and payers to wring greater value out of dollars spent on healthcare, a desire that could be reflected in aspects of the federal healthcare reform legislation being debated in the U.S. Congress.

    Geisinger Health System, a three-hospital, 41-clinic network based in Danville, Pa., has established itself as a leader in evidence-based care. Several years ago, cardiac surgeons at Geisinger came together to develop ProvenCare, a 41-step protocol for elective coronary artery bypass graft (CABG) surgery that is embedded into the health system's EMR, and requires documentation for variation from the set of rules.

    Not only did Geisinger's leaders achieve a high level of adherence to the CABG protocol on the part of surgeons, they attached to CABG surgery a pricing guarantee that has drawn interest from purchasers, payers, and the news media. And since then, Geisinger clinicians have added percutaneous intervention (stenting), total hip replacement, cataract and gastric bypass surgery, and low back pain care into the ProvenCare program, and have created similar evidence-based care programs across such areas as diabetes and congestive heart failure.

    Phil wasson

    Phil Wasson

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