Improving Outcomes with Data

On a recent afternoon, Peter Mariahazy, Chief Administrative Office for Catalysis’ and the host of our podcast, The Lens, had the opportunity to sit down with Dr. Dan Low, Chief Medical Officer at Adaptx and Pediatric Anesthesiologist at Seattle Children’s Hospital, to discuss how every patient can make the system smarter when it comes to data collection. Data can and should be used to drive improvement work and create sustainable change. Below are excerpts from their discussion:

Peter Mariahazy: What are some common challenges in using data for improvement purposes?

Dan Low: Well, the first one, I think is access. I think it's really hard for most hospitals to give their clinicians, the ones closest to the work access to the data. If a frontline clinician says I have two drugs: Drug A and Drug B. Half of my department says Drug A is better, half believes Drug B. For the same condition, and I have this same question today, how would they go about answering that question today? What does that process look like?

You don’t have to do a trial, you can look at the data for the last three years. They’ll be 1500 patients in the “virtual study” so to speak and if you could have access and actually dive into the EMR data and in 60 seconds surface the populations…now you have an insight and can show your group of clinicians that insight with a group of their own patients, you’re showing them real-world evidence. Not a theoretical…now they’re looking at in my hospital, in our hospital, in our department, in our hands, this happened. That’s actually way more powerful and way more motivating than reading another metanalysis in another medical journal.  If the drug A group comes over to the other side imagine if they could see their own outcomes. If I switch my mindset and my behavior, my patient outcomes get better too…and that is what is totally possible in today’s world. You just haven’t given your clinicians the ability to ask questions. 

It’s not a problem of collecting the data, you are collecting the data you need, the problem is you’re not analyzing the data. Or you haven’t given your clinicians the ability to analyze the data. In most hospitals, if you want to analyze the data you have to pick up the phone or put in a ticket for an analyst resource. That’s a really precious resource. They are highly trained, highly skilled but the average well-funded hospital might have only 15, 20 of these people. To give you some context there are some 700 physicians at Children’s Hospital and a few thousand nurses. There’s no way that 20, 30 or even 50 people can answer all of the questions that clinicians have. It takes time and effort and resources. So I might have, or ask a question and it will be triaged through a system and someone has to decide if my question is even worth answering. So if it doesn’t make it through that filter, then I have to engage in a manual process to pull the data. We measured that time at Children’s and on average it took 9-12 months. If you ask the questions today, by Halloween you might get your answer. At Children’s we said, 'Let’s not throw more people at the problem. Let’s throw technology at the problem and innovation.' So that’s why Adaptx came out. That 9-12 months takt time has been shorted down to one minute.

Another failure point we’ve seen in talking to hospitals is you might have analyzed the data but the data is held in the small committee’s head. You haven’t actually used the insight in a way that can be used to affect and to change patient care.

If you open any of the EMR’s today, there is a search box. And in the search box you can search for exactly one patient and you can open that one patient’s chart….and hidden underneath that is 10, 15 years worth of data but I can only look at that one patient at a time. There is no ability in any of the EMRs to say, show me the last 2000 patients with this diagnosis, aged between these two parameters….and show me how they did so I can see are we doing better or are we doing worse?

Peter Mariahazy: do you have any other examples you can share with the group of using real-world data to really help improve outcomes that you can share with us?

Dan Lowe: There’s three major themes I’m seeing: people use the data to drive operational efficiency, which is really important in this new post-Covid world where hospitals have lost all this revenue, the second theme is clinical effectiveness, so the Drug A vs Drug B, and the third thing which is starting to emerge really strongly this last year is that people are using the system to understand equity. Does it matter who you are for what outcome you get? Does it matter what gender you are, what race you are, what ethnicity, what language you speak? And we’re finding out that it does matter and that there are absolutely differences which you can surface. If you didn’t know you have a problem, they’re hard to fix.

To hear their full discussion and more details of Dan’s experiences using data and innovation subscribe to our podcast and check out his episode which includes more in-depth discussion and details.