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Giving the Physicians the Evidence—On a Broad Scale

October 4, 2012
by Mark Hagland
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At the UPMC health system in Pittsburgh, Francis X. Solano, M.D. and Jim Venturella are helping physician colleagues to move evidence-based medicine forward, one data point at a time

Solano: Well, Jim has put together a team to do this work. But the meaningful use dollars don’t begin to pay for the creation of quality reporting systems in the electronic record. It takes a tremendous amount of resources. But we’re developing a program in Epic.

Venturella: We’re working with Radar. It’s a dashboard within Epic that you can use to present reports from either the revenue cycle side or the clinical side. It presents it in an easier fashion. We’re going to bring it out next month, and we’re going to start going live next month [September]. It’s actually a dashboard within Epic itself.

Solano: When you log in, you’ll see this dashboard within Epic. So, how many encounters, and how many were closed, etc.? And if you’re a CT surgeon, it will probably give you how you’re doing with your SpS [spinal stenosis] benchmarks, and so on. The biggest challenge is, you hope that once you build it, they will come, but that’s not always the case. And so getting this so that it becomes part of their standard workflow, is important.

How long will it take for even large medical groups to do this?

Solano: Well, at least large organizations have the resources for this. And there is some out-of-the-box reporting, but we’ve had to spend a lot of time building our own reports so they look the way you want them to look.  And ensuring attribution—that even within my own practice, my patients are correctly attributed to me and not to one of my partners—is a challenge. We’ve just purchased a tool called Crimson that helps with quality and cost measures. And we have nine physicians in my group; and is it the attending of record, or the person who does the initial history and physical, or the physician who discharged, who should be held responsible?

And hospitals are going to get a lot of pushback from docs, because of the way the hospital reports the data. If Fran Solano is the PCP, even if Fran Solano didn’t see the patient, Fran Solano is the patient to whom the patient is attributed. So attribution is a huge issue moving forward, especially in the electronic world. And it’s even a bigger headache when profiling specialty care. Say a patient goes to a cardiology clinic, and sees three or four doctors over the course of a few months, which guy gets the reports?

Venturella: I think the big takeaway from that is that there’s a ton of work to do from a technology standpoint, to get the systems in and established, but the operational and workflow issues that follow are tremendous. And there’s a tremendous amount of work involved. There are multiple ways to do things in these electronic systems.



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