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Leveraging Big Data to Improve the Standard of Care

September 18, 2013
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Happy National Health IT Week everyone!

This week, I was honored to the moderator of a panel at the 2013 iHT2 Health IT Summit in New York City, a collection of various HIT stakeholders both from the provider and vendor side, hosted by the Institute for Health Technology Transformation. Not long after my panel was finished, I and others in attendance were treated to a tremendous keynote address from Richard Tayrien, D.O., chief health information officer (CHIO) at the Hospital Corporation of America (HCA), the Nashville-based operator of 162 hospitals nationwide.

Dr. Tayrien gave a fascinating 40-minute speech, focusing on how his organization has leveraged big data to gain insights and ultimately improve the standard of care and clinical outcomes at HCA. While I’ve seen my share of big data miracle stories in my two years here at HCI, this presentation was something else. He laid out three specific examples at the company where this occurred.

In order, they were…

  1. Eliminating kernicterus, which happens when a newborn has a severe case of jaundice and can leave babies brain damaged and often physically impaired. HCA, Tayrien said, studied data surrounding the issue to understand it better and why it was occurring. Leaders then initiated universal screenings of newborns, and increased phototherapy. By 2008, the organization eliminated kernicterus, which ultimately has become a national standard of care.
  1.  Reduced early-term deliveries, which if you’re a frequent reader of HCI, you’d know this was recently achieved at Baystate Health, in Springfield, Mass. At HCA, the organization collected data on 27 hospitals surrounding the frequency of electing early-term deliveries. What they found was trips to the neonatal intensive care unit (NICU) were two-to-four fold higher for 37-week deliveries than for 39-week deliveries. They then conducted studies at different hospitals where they either instituted a hard-stop of early-term deliveries, had a soft-stop policy where clinicians would better understand the reasons why someone wanted to do an early-term delivery, or simply educate a person on the dangerous of an early-term delivery. The hard-stop group had achieved better outcomes than the other two groups and has become a benchmark.
  1. Reduced infections in the ICU. Working with the Centers for Disease Control (CDC), HCA studied the effectiveness of antimicrobial agents on an entire patient population (decolonization). Again, studying three separate scenarios regarding decolonization, led HCA to discover that universal decolonization reduced the number of patients harboring MRSA by 37 percent. This has also become a national standard of care, Tayrien said.

Naturally, it’s fair to point out that HCA has advantages that many other organizations do not. Mainly, it is a huge company, and thus has a large amount of all kinds of data and capital investment that can be poured into projects like these.

Still, as Tayrien told us, this is exciting, game-changing stuff, allowing the organization to really drill down on specific problems that may have been previously hard to detect. Using the organization’s astounding 60 petabytes of data, they are able to gain evidence-based insights that improve the quality of care. Not surprisingly, with this kind of data, the work being done at HCA goes far beyond these three clinical outcomes.

The hype of “big data,” has likely left us all a little jaded by now. It reminds me of a blog I wrote last year about patient engagement. It’s impossible to take all the hype for these phrases and drill it down to what’s real and capable. Thus, it’s encouraging to hear the Dr. Tayriens of the world give us a look into a window of reality.

As always, I want to hear your thoughts. Feel free to leave comments below or respond to me on Twitter by following me at @HCI_GPerna.

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