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Quality Outcomes in a Pay-for-Performance World

November 15, 2013
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I recently saw a news brief at Health Data Management’s web briefing (http://www.healthdatamanagement.com/news/vrad-radiology-opens-clinical-database-for-analysis-46886-1.html?ET=healthdatamanagement:e4022:129185a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_DAILY_111313_111213) on vRad’s announcement that it will make its clinical database available for analysis.  More information is available on vRad’s website (http://www.vrad.com/#/exprpc).  It appears that the impetus to make such data available is being driven by the need for quality outcomes in a pay-for-performance environment.  From my perspective, this is long overdue!

This is an area near and dear to my heart because prior efforts to do something similar failed.  Back in the 90’s while at GE Medical Systems (as it was then known), I maintained a close relationship with a large imaging center group with locations in several states.  We had several conversations about their CT procedures database, and the value it would bring to outcomes.  What intrigued me was the “value add” that GE could have brought to the table.  Besides the clinical expertise that resided within Medical Systems, GE still maintained a position in shared computer resources within its Computer Services group.  Hence, GE had the clinical knowledge and the computer infrastructure to commercialize the technology in conjunction with the imaging center group.  In the end, this initiative failed, both because it was ahead of its time, but more importantly because the market was not there for national access to the database. 

My second encounter came while employed at Affiliated Computer Services’ Healthcare Solutions group (ACS-HCS, now Xerox Healthcare Provider Solutions).  ACS prior to the acquisition of Superior Consultant Company, had acquired a small business for healthcare analytics known as Midas+ (https://www.midasplus.com/Pages/Products/UpdatedProducts.aspx) for the management, measuring and monitoring of care delivery.  The group’s primary emphasis was on business analytics, and not clinical analytics.  From my speech recognition days, I was familiar with Mike Mardini and his second venture, Commissure, Inc., which was acquired in 2007 by Nuance.  As part of its RadWhere suite, Commissure had a sophisticated database and analytics dashboard that enabled benchmarking clinical operations.  When I first saw this product I was excited about the prospect it offered in terms of the ability to compare operations, until I learned that it was limited to a facility’s data.  Discussions with Commissure suggested that a national database of information would be a logical extension of the product offering. 

I saw ACS’s Midas+ business as having the infrastructure to deliver the national database.  Unfortunately, the Midas+ management wanted to concentrate on business, not clinical applications, and consequently, nothing became of it.

My “historical” recount is a long way around the horn to emphasize the need for the proper marketing and access to vRad’s data.  Perhaps the major difference between prior initiatives and this one will be the changing environment that finally puts more emphasis on outcomes and the need for such databases. 

I think it is very noble of vRad to make this data available.  I just hope that vRad finds innovative ways to enhance the accessibility to the data, which I believe is key to encouraging its utilization.  vRad could have been selfish and restricted the data for its own competitive use.  Instead, by making it generally available, vRad has demonstrated how the greater good for healthcare takes precedence over other business interests. 

For accountable care organizations and pay-for-performance to succeed, it’s going to take more companies like vRad to step up to the notion of sharing data.  Here’s hoping this trend continues for the sake of healthcare!

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