Quality extends beyond data

We all know the saying, “Garbage in, garbage out.” Let’s take a look at the flip side, “Quality in, quality out.” And the phrase doesn’t have to refer to only data.

This week marks the Healthcare Information and Management Systems Society (HIMSS) annual conference in New Orleans, a mega-event that features luminaries ranging from a former president—Bill Clinton—to a healthcare rock star—Eric Topol, MD—and one of the biggest names in health IT—Farzad Mostashari, MD, ScM. Besides those headliners, there are numerous presentations designed to inform health IT professionals and improve health IT performance.

Presentations touch on many components to quality: data, infrastructure, design and outcomes, to name a few. But culture also plays a large role in quality health IT, according to Stephen M.R. Covey, in a March 3 presentation to CIOs. Covey maintained that to be effective, a leader must earn the trust of his or her employees and customers. With a foundation of trust, a CIO can guide a team that is functional, fast and fruitful during periods of change.

“Always start with personal credibility, of the team and organization,” he said. “Then create and extend that trust. Trust makes a group of people a team. And when you get good at trust, you will get better at everything else. Nothing engages people like trust.”

EHRs also offer a potential resource for quality improvements, if the data within are robust, the datasets are large and the analytical methods are up to the task. In a recently published feasibility study, Jeremy B. Sussman, MD, MSc, of the Veterans Affairs Center for Clinical Management Research in Ann Arbor, Mich., and colleagues challenged the traditional Framingham Risk Score (FRS) in a comparative analysis. They concluded that an EHR-derived risk model more accurately estimated cerebrovascular and cardiovascular mortality than did the FRS. The FRS was especially weak at predicting deaths in low-risk people.

“Our study shows that, once the data exist, developing good risk scores is within the scope of most large health systems,” they wrote. The authors described the Veterans Health Administration data used in the analysis as “impressive relative to other data sources,” but nonetheless imperfect. They also gave credit to flexible statistical methods for the EHR approach’s stronger predictive power.  

HIMSS will be in full swing this week. Please be sure to check here as well as this week’s newsletters for updates.

Candace Stuart

Cardiovascular Business, editor