The Affordable Care Act’s call for a shift to pay for performance is spurring new ways to assess physicians’ performance. MediQuire has jumped in with a tool to track clinicians using metrics such as Medicare measures, guideline standards and comparing performance relative to their peers.
At Blueprint Health’s demo day, the co-founder and CEO Klaus Koenigshausen talked through its approach. It uses data analytics to generate meaningful insights about physician performance to determine what areas need to be fine tuned. MediQuire provides targeted educational content and fosters peer-to-peer mentoring in areas where clinicians show room for quality and cost improvement.
“The current system of chart reviews is not personalized and it’s not tied to an action plan,” Koenigshausen said.
It also plans to mine electronic health records to see, among other things, how many tests they’re ordering, which gets right at the cost-saving aspect of its service. Hospitals pay the healthcare IT company an annual licensing fee of $100,000 to $200,000. It’s raising $500,000 to increase its hospital customers.
Although the goal is to reduce patient complications and re-admissions that can increase costs, the question is how will hospitals use the information. Will hospitals use the data in the way envisioned? Or will they use it as a punitive measure for physicians? How frequently physicians order tests touches a contentious debate in healthcare on the motivation behind ordering a lot of these tests. Medical necessity? Fear of malpractice? Or well-intentioned but misguided conclusions? At a time when hospitals are looking for ways to save money, it offers a solution but also raises some questions as well. Still, it’s part of a national trend that will produce a variety of approaches.
[Photo from BigStock Photo]
This is just one of many out there, tons of programs like this being developed and sure there's overlap. How far do you want to push doctors on these types of analytics is a good question as were are seeing analytics going over the ceiling. Had a great discussion about another analytics program called PAM. It even has a patent for an "old query" system. Everyone jumped on it but it was an old research program funded by the NIH in turn funded by the Robert Woods Foundation which is funded largely by Johnson and Johnson. The PAM program was created long before electronic medical records and now a company is using the old research to sell more software.
It's a fine line and before I wrote my blog post I chatted with an expert on this over at the National Institute of Statistical Science who works with pharma stat data and information. We both came to the same conclusion, not needed as designed by the software company and more clunk if you will. It will end up being more data for sale at some point. It's a process doctors should be doing anyway as far as educating a patient and the program creates yes another data base to "score" the patient on how well they understand their care, healthcare, etc. When you go into a scoring routine you lose the subjective which can be stated in a medical record. Couple doctors and I talked about that and subjective text here is worth much more than a score and can be documented in a medical record.
As far as "scoring" goes here then we have part two where doctors end up getting "scored" on how they are "scoring" their patient. With this data base of "scores" it becomes "salable" as information is added and you end up with a chart that look like the old curve used in the growth chart percentiles, same charting process. Does this have value? Do you know how difficult it's getting to be with complex EMRs out there today for doctors? Do you know why scribes exist?
I used to write software and sure it's easy to glob onto anything new that does any form of analytics but a while back a banker and I had a conversation and a rare meeting of minds here that half of the analytics created are going to be a waste of investment and I'm not saying this program is but could be.
With the PAM program I mentioned when you look at Robert Woods funding it largely backed by J and J, the motivation is this, you have patient getting a diagnosis, gets a prescription and then a "no fill" on the prescription so from that angle very well motivated as they are losing money. I try to look at the entire picture and I don't care what you do as far as analytics if the patient doesn't fill it, they don't so keep up with education, the best tool here as we all do better when we learn and to have to score this level of participation..not needed and you lose the subjective notes as doctors should be noting progress anyway. Doctors end up having to be responsible for increasing a PAM score when really a subjective note in an EMR is better as that's how people work.
Now the cost of MediQuire..brings in another thought..how about inequality of hospitals, you know the money is running dry with many of them and this is in the category of not being required but rather on option so your market to sell it is cut by the hospital that have money. I call it the big picture view. CMS is stuck here too with thinking that we still hospital ratings...focus changed and we are now interested more in which ones are going to be around.
I see the point of the software and obviously the creators have not spent a lot of time working along side a doctor to understand how they work so it's a software model and they all don't work. Been there done that myself with writing software so where I come from having eaten some of my own dog food over the years and working side by side with doctors:) I call this glut right now as there's so much of it out there. In summary I'll leave you one more link that refers to "The Grays"...where people can't tell the difference anymore where the values of virtual worlds leave off and where the real world kicks in, and we all get caught up there with marketing. It is to the point to where even Google is having to do a study to find out "how people work"...and that's something I end up saying a lot "people don't work that way" words of wisdom I learned from learning from Quants.
I felt fine about that post as even people like Larry Ellison who's a genius of course with software that makes us productive in saying "be careful" when dealing with artificial software that's smarter than you, a great video presentation with maturity added as we need a bit of that. I used to be a query monster myself so I'm critical on a lot of this as I also have a sales background so look from the nerd side on if it is useful, another duplication, will people work this way and use this model, and finally how's the creator going to market it, so I look at all sides.
This looks to be just one more analytics piece of software in the big sea out there created by folks who maybe don't get "how people work" so stay tuned and see that Google finds out maybe with their study which is kind of funny they are wanting to find out how humans work as they certainly have hired many over the years and now all of a sudden they don't understand them..oh you have to give that a smile:)
I did not see anything outstanding here overall and again I used the PAM program as another one to talk about, so not picking on them at all but be aware of "how people work" more so than just more analytics and algorithms that someone designed:)