When the Going Gets Tough, the Tough Need to Get Transparent
Jun 4, 2013 7:00 AM
Bringing to light the many aspects of our health care crisis, many newspapers, magazines, and blogs seem to be attacking our national health systems. An informed consumer (patient) is a necessary piece of the puzzle, and of late, we are proud to note the good news that we have bent the cost curve. Just last week, reports show that Medicare has risen at just 1.7% per year from 2010 to 2012—that’s significantly below the growth of the economy—and this slow down is expected to carry on through 2017.
We take this as a valuable step in the alignment of patients and systems and at the University of Utah feel more invigorated than ever. Let me share with you an update on where we stand.
Utah: Highest Value State in the Nation
Thankfully, we are starting from a very strong position. As shown in the figure below, our state enjoys a unique position as one of the lowest cost, highest health states in the country.
Within the state, the University of Utah is also one of the lowest cost providers; we intend to keep this focus despite the challenge of advancing as an academic medical center where we not only apply the latest advances in science and discovery to provide state-of-the-art care, but also train the health professionals of the future.
For our patients and payers, we are committed to providing the best outcomes at the lowest costs and with the greatest patient satisfaction. The latest data show that we have made great progress towards these goals.
While we always strive to be better, we are gratified to see that based upon some of the tough metrics of reputable organizations like University HealthSystems Consortium (UHC) and other major national consumer review publications have recently ranked us top 10 in the country in terms of quality, safety, and accountability. Our LEAN initiatives are intended to help improve many aspects of patient care, including addressing patient safety and variability in our clinical practice. We continue to track a growing number of patient outcome metrics and seek to add patient-reported outcomes to our measurements.
While the public’s attention has focused on the high charges of health care, those of us in the field appreciate that the high and variable charges are actually a symptom of the problem. At its core, one of our most significant problems is that we do not really understand our true costs of providing care. Professors Kaplan and Porter from the Harvard Business School wrote about this last year in the New York Times, and they are right.
About a year ago, we launched the Value Driven Outcomes (VDO) initiative to do a deep dive into this problem—to understand our costs at the University of Utah—from pharmacy to imaging to OR time to physician time. And our goal has been to do this for every patient, every doctor, every procedure and every diagnosis. Thanks to the remarkable diligence of our VDO team, we have a beta version of this web-based tool now available to teams across our system to begin testing and using. With this tool (see figure), we can compare our costs against the patient outcomes and start to drill down into the causes of variability—whether different drugs, imaging, lab tests, or patient differentiation. We believe we are the first in the country to do this and hope to share the success of this model with other institutions. Knowing our costs means we’re going to be even more effective in starting to bring down our costs, while, simultaneously, improving quality.
Greatest patient satisfaction
Thanks to the leadership of my predecessor, Lorris Betz, we are now one of the highest ranked academic medical centers in terms of our patient satisfaction. This fall, we made a decision to post our patient satisfaction scores online—to share them with patients and families. A visit to our “Find a Physician" directory, will show that along with every provider’s name and information, we publicize the familiar 5-star rating system, alongside patient comments. We’re the first in the country to do this, and we have already received much appreciative feedback from our patients and the public. Our patient satisfaction scores overall have continued to improve, and we are proud to be putting our patients first.
Here at the University of Utah, we are committed to leading the transformation of health care, and we are optimistic and confident that we are on the right track.comments powered by Disqus